CCL2 and Hyperglycemia: The persistent hyperglycemia state activates the inflammatory response through pathways, such as glycosylation end products (ACE), mediates the synthesis and secretion of pro-inflammatory factors, including TNF-α, intercellular adhesion molecule 1 (ICAM-1), IL-6, and MCP-1, and contributes to glomerular basement membrane thickening and fibrous proliferation of small renal arteries.