A 65-year-old obese man (body mass index =32 kg/m2) presents with a 2-year history of difficulty walking. Physical examination reveals chronic ulcers in the lower extremities. Funduscopic examination reveals proliferative retinopathy. Thickening of small vessel basement membranes in the patient is most likely related to abnormalities in which of the following cellular and biochemical processes?

Increased deposition and glycosylation of basement membrane proteins contribute to the pathogenesis of diabetic microvascular disease. Thus, control of blood glucose remains the major means by which the development of microvascular diabetic complications can be minimized. The other choices do not preferentially accumulate in small vessels affected by diabetes.Diagnosis: Diabetic microvascular disease