SIRT1 and Hyperglycemia: (2) In addition to AGE formation, hyperglycemia inhibits nuclear factor erythroid 2-related factor 2 (Nrf2) and Sirtuin 1 (Sirt1)-mediated antioxidant signaling and activates NF-κB-mediated inflammatory pathways, creating a vicious cycle of oxidative stress and inflammation interaction causing further damage of the cardiac muscle [3,10].