A 65-year-old man with diabetes presents with muscle wasting and neurological symptoms. What is the likely impaired nerve pair?

In this scenario, the patient exhibiting muscle wasting and neurological symptoms suggests peripheral neuropathy, which is common in individuals with diabetes. The specific symptoms can indicate damage to particular nerve pairs.

The ulnar nerve is responsible for innervating muscles in the forearm and hand (such as the intrinsic muscles of the hand), while the tibial nerve innervates muscles in the lower leg and foot. When both the ulnar and tibial nerves are affected, it can lead to muscle weakness and atrophy in areas supplied by these nerves.

In diabetic neuropathy, it is common for patients to experience both sensory and motor deficits. The involvement of the ulnar nerve might result in problems like claw hand, while tibial nerve involvement may lead to issues with foot drop or weakness in the plantar flexors. Thus, the combination of neurological symptoms, particularly in a patient with diabetes, points to an impairment in both ulnar and tibial nerve function.

Therefore, recognizing the roles of the ulnar and tibial nerves in motor control and considering the typical manifestations of diabetic neuropathy help to confirm why this answer is the most fitting choice for this patient case.