In G6PD deficiency (XR), we have increased oxidative damage to RBCs, leading to intravascular hemolysis with decreased serum haptoglobin. We have decreased NADPH production, which means decreased conversion of oxidized ( S S ) glutathione Diabetes causes inhibition of glucose 6 phosphate dehydrogenase via activation of PKA, which contributes to oxidative stress in rat kidney cortex American Journal of Physiology Renal Physiology American Physiological Society HMP Pathway Simplified: NADPH Role & G6PD Deficiency Explained G6PD Deficiency causes Haemolytic Anaemia Glucose 6 phosphate dehydrogenase is an enzyme in the hexose monophosphate shunt that synthesizes NADPH. The NADPH is used to convert oxidized glutathione (GSSG) to reduced glutathione ( Glucose 6 Phosphate Dehydrogenase (G6PD) Deficiency The Medical Biochemistry Page