This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Endocrinology, Subject name: Medicine
A 64-year woman with Type II diabetes for 10 years now develops increasing fatigue, dyspnea, and pedal edema. On examination, her blood pressure is 165/90 mm Hg, pulse 90/min, JVP is 4 cm, heart sounds are normal, lungs are clear, and there is 3+ pedal edema. Her urinalysis is positive for 3 gm/L of protein and no casts. Which of the following renal diseases is the most likely diagnosis in this patient? 
Select and explain. 
A. acute glomerulonephritis, B. obstructive uropathy, C. glomerulosclerosis with mesangial thickening, D. renal infarction
C: glomerulosclerosis with mesangial thickening
Answer: C: glomerulosclerosis with mesangial thickening 
Explanation: The patient is most likely to develop glomerulosclerosis. This can be diffuse or nodular (Kimmelstiel-Wilson nodules). Poor metabolic control is probably a major factor in the progression of diabetic nephropathy.