TNF and Nephropathy: Upregulation of TGF-β in long-term hypoglycemic condition plays an important role in neovascularization by stimulating the expression of angiogenic factors such as VEGF and pro-inflammatory cytokines such as TNF-α.30 It is a pro-fibrotic mediator that enhances the formation of extracellular matrix in fibrotic diseases like retinopathy and nephropathy.