Circulating Exosomal MicroRNAs and Metabolomic Profiling as Predictive Biomarkers for Therapeutic Response in Type 2 Diabetes Mellitus
Updated: Jun 14
Original Research | 2026 | Volume 3 | Issue 3 | Page 55-64
1. Dr. Shahan Layek, Independent Researcher, West Bengal, India,
2. Dr. Manoj Kumar, Tutor, Department Physiology, JHMC, WB
Abstract
Background: Type 2 Diabetes Mellitus (T2DM) is a complex metabolic disorder characterized by insulin resistance, impaired glucose homeostasis, and heterogeneous responses to therapeutic interventions. Identifying reliable biomarkers capable of predicting treatment outcomes remains a major challenge in personalized diabetes management. Emerging evidence suggests that circulating exosomal microRNAs (miRNAs) and metabolomic signatures play critical roles in regulating metabolic pathways and may serve as valuable indicators of therapeutic efficacy.
Objective: This study explores the potential of circulating exosomal miRNAs and metabolomic profiling as predictive biomarkers for therapeutic response in patients with T2DM, with the aim of facilitating precision medicine approaches and improving clinical outcomes.
Methods: A comprehensive review and analytical assessment of current literature were conducted to evaluate the association between exosomal miRNA expression patterns, metabolomic alterations, and treatment responses in T2DM. Particular attention was given to miRNAs involved in insulin signaling, β-cell function, inflammation, and glucose metabolism, alongside metabolomic markers reflecting lipid, amino acid, and energy metabolism.
Results: Several exosomal miRNAs, including miR-126, miR-29 family, miR-375, and miR-21, demonstrated significant associations with glycemic control, insulin sensitivity, and response to antidiabetic therapies. Metabolomic analyses revealed distinct profiles characterized by altered branched-chain amino acids, acylcarnitines, fatty acids, and glycolytic intermediates among responders and non-responders to treatment. The integration of exosomal miRNA and metabolomic data provided enhanced predictive accuracy compared with conventional clinical biomarkers alone, enabling early identification of patients likely to benefit from specific therapeutic strategies.
Conclusion: Circulating exosomal miRNAs and metabolomic signatures represent promising non-invasive biomarkers for predicting therapeutic response in T2DM. Their combined application may support individualized treatment selection, improve disease monitoring, and advance precision medicine in diabetes care. Further large-scale longitudinal studies are warranted to validate these biomarkers and facilitate their translation into routine clinical practice.