PRKAA1 and diabetes mellitus: While exercise in mice increased the expression of the mitochondrial deacetylase SIRT3 during diabetes-induced cardiac impairment and preserved cardiac functions by promoting the AMPK/SIRT3 pathway (Jin L. et al., 2022), SIRT3 deficiency exacerbates diabetic cardiomyopathy by activating NLRP3 and promoting the accumulation of mtROS (Song et al., 2021).