SIRT1 and diabetes mellitus: Thus, in the early stage of diabetic retinal feedback, the upregulation of circKMT2E may be involved in the pathogenesis of DM on the basis of activating the SIRT1 signaling pathway to protect the retina by the sponge function to miR-204-5p, just as the augment of Sirt1 is also defensive against diverse ocular diseases such as cataract, retinal degeneration, as well as optic neuritis [39, 42].