The activation of the mechanistic target of rapamycin (mTOR) (87, 88) and the reduction of 5′ AMP-activated protein kinase (89) and Sirtuin 1 (SIRT1) (90) attenuate autophagy-related activities, and this attenuation has been linked to the pathogenesis of DN; (8) Exosomes and extracellular vesicles. Here, SIRT1 is linked to liver dysplastic nodule.