In diabetes, activation of gelatinase MMPs (MMP-2 and MMP-9) in the retina is an early event, and activated MMPs, by damaging the mitochondria, activate the apoptotic machinery, culminating in the loss of capillary cells, a phenomenon seen before histopathology characteristic of diabetic retinopathy can be observed.6,27,28 Regulation of MMP activation is mediated via many different mechanisms including regulation of their tissue inhibitors, and their gene expressions by transcriptional factors and epigenetic modifications. This evidence concerns the gene MMP9 and diabetes mellitus.