<prompt> Osmotic damage is operative in all of the following complications of diabetes mellitus EXCEPTThe formation of cataractsInsulin receptor deficiencyMicroaneurysms in retinal vesselsPeripheral neuropathy  <response>: Osmotic damage is inoperative in insulin- receptor deficiency. Insulin-receptor deficiency is the result of an increase in adipose, which down regulates receptor synthesis, and chronic elevation of glucose glucose toxicity, which renders the receptors less receptive to insulin. 