Interestingly, our study revealed no significant differences in autophagy (LC3-II, p62, Beclin-1; p-values: 0.76, 0.52, 0.81, respectively) or ER stress markers (GRP78, p-eIF2α, ATF6; p-values: 0.81, 0.79, 0.96, respectively) between diabetic and non-diabetic HD patients, suggesting that the uremic environment, rather than diabetes itself, is the primary driver of these alterations. The gene discussed is HSPA5; the disease is diabetes mellitus.