MicroRNAs in type 2 diabetes mellitus and its cardiovascular complications: mechanistic insights and translational potential

Diabetes mellitus (DM) is a multifactorial disease driven by genetic and environmental factors, with type 2 diabetes mellitus (T2DM) constituting the majority of cases. A major cause of morbidity and mortality in diabetic patients is cardiovascular disease (CVD), which is closely linked to epigenetic mechanisms such as microRNA (miRNA) regulation. MiRNAs are small, non-coding RNA molecules that modulate gene expression at the post-transcriptional level, influencing key metabolic and inflammatory pathways. In T2DM, dysregulated miRNA expression contributes to insulin resistance, beta cell dysfunction, endothelial impairment, and vascular complications. Specific miRNAs, including miR-126, miR-375, and miR-21, have been identified as biomarkers for early diagnosis and disease progression. Moreover, miRNA-targeted therapies hold potential for novel therapeutic interventions in T2DM and associated CVD. This review explores the role of miRNAs in T2DM pathogenesis and their implications for cardiovascular complications, emphasizing their potential as biomarkers and therapeutic targets for precision medicine.