AKT1 and nephrosclerosis: In the early stage of DKD, macrophages are recruited and differentiated by inflammatory factors after being stimulated by HG through various signaling pathways (such as phosphatidylinositol 3-kinase (PI3K) / protein kinase B (AKT) and Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB)), and secrete inflammatory and fibrotic factors, resulting in a series of reactions such as activation, polarization, migration and adhesion, transformation, and autophagy, causing fibrosis of intrinsic renal cells and ultimately leading to renal sclerosis and proteinuria30, 38.