A 54-year-old obese man with hypertension and dyslipidemia presents with fatigue. Vital signs show BP 148/92 mmHg, HR 88/min, RR 16/min, temperature 37°C, and SpO2 98% on room air. Fasting glucose is 168 mg/dL; hemoglobin A1c is 8.1%. Random urinalysis shows no ketones. He takes lisinopril and atorvastatin but denies polyuria or polydipsia. Which of the following best describes the pathophysiology of his most likely disease?

1. A)Peripheral insulin resistance with progressive beta cell dysfunctionGABARITO
2. B)Excess cortisol secretion causing acute ketoacidosis
3. C)Autoimmune destruction of beta cells causing absolute insulin deficiency
4. D)Lack of ADH secretion from the posterior pituitary
5. E)Mutation in the RET proto-oncogene