Figure 2: Appetite regulation in diabetes involve the maintenance of the heat shock gene Sirtuin 1 that is essential for thermo regulation function and hepatic lipid metabolism. The repression of the anti-aging gene Sirt 1 involves p53/mTOR dysregulation of the other anti-aging genes (klotho, p66shc, FOXO3a) associated with hepatic lipid, heat shock protein and amyloid beta metabolism. FGF 21 treatment in diabetes has become important to NAFLD [38] and myocardial infarction treatment [39,40] but defective cell transcriptional ontogeny in the liver and brain related to mi-34a inhibition of Sirtuin 1/transcription factors interactions inactivates hepatic lipid metabolism with the induction of NAFLD, defective amyloid beta metabolism and neurodegenerative disease.