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I have mentioned earlier four types of potential self-sustained inflammatory loops , one formed by the T cell, B cell and monocyte triangle, a second one due to the fact that microglial cells can both produce and be activated by inflammatory cytokines, a third one due to excessive unbuffered ROS levels and damaged mitochondria, leading to less ATP and more ROS production, and a fourth one to bacterial translocation through a damaged gut mucosa, which may sustain mucosal inflammation and permeability

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Interdisciplinary Takeaway This consensus emphasizes the value of shared care between diabetologists and ophthalmologists integrating retinal assessments into initiation protocols, similar to renal or hepatic baseline checks