microRNA  abundance has been explored to predict the progression of Type 2 diabetes in youth. The specific microRNAs in the study are involved in insulin resistance and other actions that can stress beta cells or cause their death. The research is significant because it points to a process that is necessary to understand in order to ultimately design a strategy for prevention.Type 2 diabetes in youth is so aggressive, and the decline of beta cell function in youth is much more than we see in adults. microRNAs, at baseline, were nearly as effective as A1C measurement (average level of blood sugar) when predicting who would fail to respond to treatment for Type 2 diabetes. Treatment failure was defined as having an A1C of greater than 8% for six months or a circumstance that caused the study participant to go back on insulin without the ability to come back off. Circulating microRNAs  also predicted a 20% decrease in beta cell function during the first six months of the study. Currently, microRNAs  can be measured only in a research setting, not in a clinic, but that may change in the future.The study’s implications are important not only for the predictive potential of microRNAs, but because they represent a mechanism, or part of the process by which Type 2 diabetes develops and worsens.Glucose and A1C are relevant to me as a clinician, but as a clinician-researcher, it’s important to have this additional piece of information about microRNAs  because it points us toward a mechanism. It’s the mechanism that we need to understand to design a prevention. It adds a layer of understanding that we haven’t had before.

Source: https://www.ou.edu/news/articles/2024/june/circulating-micrornas-likely-as-effective-asa1c-for-predicting-type-2-diabetes-in-youth