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
The characteristic finding in diabetic nephropathy is- 
Select and explain. 
A. Diffuse glomerulosclerosis, B. Nodular glomerulosclerosis, C. Armani -Ebstein reaction, D. Fibrin caps
B: Nodular glomerulosclerosis
Answer: B: Nodular glomerulosclerosis 
Explanation: Pathologically, the first changes in diabetic nephropathy coincide with the onset of microalbuminuria and include thickening of the glomerular basement membrane and accumulation of matrix material in the mesangium. Subsequently, nodular deposits (Kimmelstiel-Wilson nodule), pathognomic of diabetic kidney disease, and glomerulosclerosis develops which worsens as heavy proteinuria develops, until glomeruli are progressively lost and renal function deteriorates. Reference : page 830 Davidson's Principles and practice of Medicine 22nd edition