La Sala L, et al. - In 115 subjects enrolled in the DIAPASON Study (diabetes prediction and screening observational), who were selected on American Diabetes Association (ADA) criteria for 2-hour plasma glucose (2hPG), researchers assessed the value of microRNA-21 in the prognostication and prediction of the risk of developing diabetes in adults with impaired glucose tolerance (IGT). Its downstream impacts as the generation of reactive oxygen species (ROS), the induction of manganese-superoxide dismutase-2 (SOD2), and the circulating levels of 4-HNE (4-hydroxynonenal) were also determined. Diagnostic accuracy, as well as positive and negative predictive values of the tests were assessed. They also assessed ROS, SOD2 and 4-HNE. Findings highlighted a link between microRNA-21 and prediabetic status. microRNA-21 showed utility as a predictor for early detection of glucose imbalances. High and accurate diagnostic performance of microRNA-21 was evident. In IGT and newly diagnosed, drug-naïve type 2 diabetes patients, significant overproduction of ROS by electron paramagnetic resonance, significant accumulation of the lipid peroxidation marker 4-HNE, and defective SOD2 antioxidant response were observed.