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?
Peripheral insulin resistance Increased peripheral insulin uptake Irregular insulin secretion none of the above