Type 2 diabetes mellitus: the role of epigenetic modifications in pathophysiology and prospects for the use of epigenetic therapy

The increase in the incidence of type 2 diabetes mellitus (T2DM) in the world is becoming more and more threatening every year. To stop the T2DM epidemic, new knowledge is needed about the causes of the development of this disease and approaches to its prevention and treatment. In recent decades, with the development of high-throughput technologies, evidence has been obtained indicating epigenetic mechanisms of gene expression regulation, including DNA methylation, histone modifications, and noncoding microRNAs, changes in which play a key role in the pathophysiology of some diseases, including T2DM. Certain environmental factors such as diet, physical inactivity, exposure to microbes and pollutants, and lifestyle can trigger modifications to these epigenetic mechanisms. In turn, epigenetic modifications can alter the expression and function of some genes involved in insulin biosynthesis and glucose metabolism, leading to hyperglycemia and insulin resistance. Fortunately, epigenetic changes can be reversed by blocking or activating modulating enzymes. Thus, epigenetic reprogramming may be a new approach in the prevention and treatment of T2DM.