SERPINE1 and Insulin resistance: In type II DM, insulin resistance and hyperinsulinemia are tightly related to glutamine fructose-6-phosphate amidotransferase.Uridine-5-diphosphate-N-acetyl glucosamine, the end-product of this pathway, causes gene transcription factor to elevate which stimulates the transforming growth factor beta (TGF-β) and plasminogen activator inhibitor-1 (PAI-1) responsible for injuring the endothelial cells and stimulating smooth muscle cell division (Figure 3).