It is doing what it needs to do
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The angiogenesisinflammation hypothesis in diabetic retinopathy The AngiogenesisInflammation Hypothesis suggests that hyperglycemia promotes DR progression and DME formation by upregulating angiogenic growth factors and inflammatory cytokines, which act synergistically on the retinal NVU [14,15,16,17,18,19]
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Here's an honest look at how they compare on results, side effects, and cost, backed by FDA and NIH sources