Final answer:
Diabetic retinopathy is caused by high blood sugar levels damaging the retina's blood vessels, not by hypoglycemic episodes, insulin resistance, or as an inevitable outcome of diabetes.
Step-by-step explanation:
Diabetic retinopathy occurs primarily because of hyperglycemic peaks, which damage the blood vessels feeding the retina. High levels of glucose in the blood can harm the retinal blood vessels, leading to this condition. It is not an inevitable result of diabetes but is more likely when blood sugar control is poor, contributing to various complications.