The next generation of diagnostic biomarkers for type 2 diabetes

Diabetes is a major cause of morbidity and mortality in both the United States and Asia. The greatest public health impact of diabetes is its vascular complications, which include both microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular (ischemic heart disease, cerebrovascular disease, peripheral vascular disease) processes. Given that the diabetes epidemic continues to grow worldwide, there is a clear need for improvements in the management of the disease and its complications. The identifi cation of biomarkers and pathogenic determinants of progression not only could provide tools physicians could use to monitor disease progression but could also give important insights into the mechanisms behind diabetic vascular complications, thus potentially opening new avenues for treatment. The roles played by circulating miRNAs in diabetes mellitus (DM) and its vascular complications, both as biomarkers of disease and as critical contributors to disease progression, are not very clear. Recently, researchers have identifi ed powerful roles for circulating miRNAs and their potential therapeutic implications, partly by advances in various technologies with which researchers can identify circulating miRNAs (next-generation sequencing, RNA Seq, digital qPCR, etc.) and then successfully isolate and study them. Circulating miRNAs play a role in the metabolic, infl ammatory, and antiangiogenic pathways in type 2 diabetes (T2D).