This is consistent with our previous SIRT1-related findings (Wachal et al., 2020): SIRT1 inactivates NFkB and PARP1 physiologically; however, in diabetes, SIRT1 is downregulated leading to over-transactivation of detrimental genes in the diabetic eye, such as MMP9, an enzyme known to be involved in the development of mitochondrial damage in diabetic retinopathy (Kowluru et al., 2014a). This evidence concerns the gene MMP9 and diabetes mellitus.