A 58-year-old male with type 2 diabetes presents with a painless, punched-out ulcer on the plantar surface of his foot. Pedal pulses are intact and monofilament testing shows loss of sensation. What is the primary pathophysiology?
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A
Peripheral arterial disease
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B
Peripheral neuropathy
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C
Venous insufficiency
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D
Charcot arthropathy