This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Diabetes, Subject name: Pathology
[{'content': 'A 55-year-old obese woman complains of declining visual acuity. Funduscopic examination shows peripheral retinal microaneurysms. Urinalysis reveals 3+ proteinuria and 3+ glucosuria. Serum albumin is 3 g/dL, and serum cholesterol is 350 mg/dL. These clinicopathologic findings are best explained by which of the following mechanisms of disease? \nSelect and explain. \nA. Peripheral insulin resistance, B. Increased peripheral insulin uptake, C. Irregular insulin secretion, D. none of the above', 'role': 'user'}, {'content': 'Answer: A \nExplanation: - Given clinical features point towards nephropathy & retinopathy resulted as complication of type-2 DM - Type-2 diabetes mellitus results from complex interplay b/w Underlying insulin resistance in its metabolic target tissues (liver, skeletal muscle & adipose tissue) & Reduction in glucose-stimulated insulin secretion, which fails to compensate for increased demand for insulin. - In obese persons, release of inhibitory mediators from adipose tissue interferes with intracellular signaling by insulin. - Hyperinsulinemia secondary to insulin resistance also downregulates number of insulin receptors on plasma membrane. Other choices are not related to pathogenesis of type 2 diabetes.', 'role': 'assistant'}]