🏥 USMLE Exam Prep

A 62-year-old patient with long-standing Type 2 diabetes mellitus and poorly controlled hyperglycemia complains of numbness and tingling in his feet that has progressed to his hands in a "stocking-glove" distribution. He also reports lightheadedness upon standing and erectile dysfunction. What is the most likely underlying mechanism causing these symptoms?

A Ischemic damage to peripheral nerves
B Autoimmune demyelination of nerve fibers
C Microvascular damage and axonal degeneration
D Vitamin B12 deficiency

✓ Correct Answer: Option C

Diabetic neuropathy results primarily from chronic hyperglycemia leading to microvascular damage, oxidative stress, and accumulation of advanced glycation end products, which cause axonal degeneration and demyelination of peripheral nerves.

Related USMLE Exam Prep Questions