Under HG conditions, miR-221, miR-377, miR-34a, miR-30b, and miR-29b-3p are upregulated, leading to SIRT1 downregulation, pathological proliferation, migration, inflammation, apoptosis, senescence, oxidative stress, and angiogenesis in RMECs, contributing to the pathogenesis of diabetic retinopathy [27,38,42,129,186]. Here, SIRT1 is linked to diabetic retinopathy.