A 40-year-old diabetic woman complains of flank pain and fever. Her temperature is 38.7degC (103degF), respirations are 25 per minute, and blood pressure is 150/90 mm Hg. Urinalysis reveals pyuria with WBC casts. Which of the following features of diabetes is the most impoant contributing factor in development of flank pain and fever in this patient?
Anti-insulin antibodies Glycosylation of hemoglobin Peripheral insulin resistance Hyperglycemia