G6PD and hyperinsulinism: While increased aerobic glycolysis is implicated in the pathogenesis of non-vascular and vascular diseases, glucose-6-phosphate dehydrogenase (G6PD)—the key rate-limiting enzyme in the pentose shunt—expression and activity are increased in liver and adipose tissue by carbohydrate-rich diet, hyperinsulinemia, oxidants, glutathione redox, and NADPH (14, 15, 16).