INS and metabolic disease: Interestingly, several miRNAs such as miR-9, miR-181a, and miR-132, are capable of regulating insulin pathways through sirtuin 1 (SIRT1) [75,76], a nicotinamide adenosine dinucleotide (NAD) that regulates energy homeostasis, inflammation, and metabolic disease associated with obesity [77,78].