How does type 2 diabetes result in chronic renal failure?

Choice A reason: Type 2 diabetes involves insulin resistance, not excessive insulin production, which declines over time. Insulin does not cause renal toxicity; hyperglycemia damages kidneys, making this choice incorrect for the mechanism of renal failure.

Choice B reason: Glucose crystals do not form in type 2 diabetes to obstruct ureters. Hyperglycemia damages renal vasculature, not urine flow, leading to diabetic nephropathy, making this choice incorrect for chronic renal failure’s mechanism.

Choice C reason: An autoimmune process destroying renal tissue is not typical of type 2 diabetes. Autoimmune damage occurs in type 1 diabetes or glomerulonephritis, not type 2-related renal failure, making this choice incorrect.

Choice D reason: High blood sugar in type 2 diabetes damages renal microvasculature, particularly glomerular capillaries, causing diabetic nephropathy. This leads to proteinuria, glomerulosclerosis, and chronic renal failure, making this the correct mechanism for kidney damage.

Choice A reason: Warm skin indicates adequate blood flow and perfusion, often seen in normal or hyperemic states. Poor perfusion, due to reduced blood flow, typically causes cool skin as less warm blood reaches tissues, making this choice incorrect for poor perfusion.

Choice B reason: Pink nailbeds reflect good oxygenation and perfusion, as hemoglobin carries oxygen effectively to capillaries. Poor perfusion leads to pale or cyanotic nailbeds due to reduced blood flow or oxygen delivery, making this choice incorrect for indicating poor perfusion.

Choice C reason: Strong pulses indicate robust blood flow and adequate perfusion, as the heart pumps blood effectively to peripheral tissues. Poor perfusion is associated with weak or thready pulses due to low cardiac output, making this choice incorrect.

Choice D reason: Pale lips indicate poor perfusion, as reduced blood flow to peripheral tissues results in less hemoglobin delivering oxygen, causing pallor. This is a classic sign of hypoperfusion, often seen in shock or circulatory compromise, making this the correct choice.