A 56-year-old man comes to the physician for a 2-week history of increased thirst and urination. During this time he describes his distance vision as acutely worsening, where road signs seem more blurry than normal. He does not wear eyeglasses. He has also lost 5 pounds despite no change in his diet. BMI is 36. Which of the following is most likely to be seen in this patient?
A) Decreased glomerular filtration
B) Decreased polyubiquitination
C) Decreased pyruvate carboxylase activity
D) Increased aldose reductase activity
E) Increased glucokinase activity
