Sirtuins in diabetes mellitus and diabetic kidney disease

Sirtuins are a group of NAD-dependent enzymes that consist of seven different structural subtypes, SIRT1 to SIRT7. Sir 2 was the first sirtuin identified in Saccharomyces cerevisae. After the discovery of Sir 2 in yeast, researchers showed that these enzymes could prolong life. After the discovery of the role of prolonging life, studies were initiated to identify the members of the sirtuin family in mammals and many articles have been published on this subject up to the present. Diabetes mellitus (DM) and its complications have been increasing worldwide during the last decades despite the advancing diagnostic tools and the therapeutic applications. Hence, DM has been accepted as an epidemic worldwide. In this chapter, I aim to focus on the physiological functions of sirtuins, and thereafter I comprehensively discuss the pathophysiological roles of sirtuins in DM and related diseases, including hypertension and diabetic kidney disease (DKD). In the last part, novel treatment options regarding sirtuin activators in DM and DKD will be discussed.