<prompt> 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 gdL, and serum cholesterol is 350 mgdL. These clinicopathologic findings are best explained by which of the following mechanisms of disease?Peripheral insulin resistanceIncreased peripheral insulin uptakeIrregular insulin secretionnone of the above  <response>: - Given clinical features point towards nephropathy retinopathy resulted as complication of type-2 DM - Type-2 diabetes mellitus results from complex interplay bw 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. 