Pathology

A 14-year-old boy presents for a pre-summer camp physical examination. Routine urinalysis discloses 3+ glucosuria. He admits to thirst and frequent urination, accompanied by a 4-kg (9-lb) weight loss over past few months. His parents note that he had a flu-like illness 5 months ago. His blood glucose is 220 mg/dL. Which of the following best explains the pathogenesis of hyperglycemia in this patient?