Abstract: A method for detecting and treating Type II Diabetes includes the use of hsa_piR_020485, a PIWI-interacting RNA isolated from urinary extracellular vesicles (ECVs), as a biomarker for the diagnosis and treatment of Type 2 diabetes mellitus (T2DM). The method is non-invasive, utilizing the differential expression of hsa_piR_020485 in diabetic versus non-diabetic subjects to identify subjects in need of treatment for T2DM. The method includes obtaining a urine sample from a subject, isolating urinary ECVs from the urine sample, extracting total RNA from the isolated urinary ECVs, quantifying hsa_piR_020485 levels from the total RNA, determining if the hsa_piR_020485 expression level exceeds a threshold, and administering one or more T2DM treatments.