At the molecular level, intracellular signaling cascades—particularly the mitogen-activated protein kinase (MAPK), phosphoinositide 3-kinase/protein kinase B (PI3K/Akt), and glycogen synthase kinase-3β (GSK-3β) pathways—are deeply altered by hyperglycemia and insulin resistance, driving maladaptive cardiac remodeling and contractile dysfunction [81]. Here, AKT1 is linked to Hyperglycemia.