A 28-year-old woman with type 1 diabetes presents with fatigue and polyuria. Vital signs: BP 118/76, HR 92, RR 18, Temp 37°C, SpO2 98%. She requires 0.8 units/kg/day insulin. A 52-year-old man post-total pancreatectomy for chronic pancreatitis requires only 0.3 units/kg/day insulin. HbA1c is 7.2% in both patients. Neither patient has diabetic ketoacidosis. C-peptide level is undetectable in both. Which mechanism best explains the insulin requirement difference between these patients?

1. A)Insulin receptor-mediated increases in glucagon release
2. B)Production of insulin with abnormal structure
3. C)Insulin resistance
4. D)Additional post-receptor defects
5. E)Hyperglucagonemia in addition to insulin deficiencyGABARITO