In patients with PDM, multiple logistic regression revealed that serum albumin was associated with DR (odds ratio [OR] = 0.92, 95% confidence interval [CI]: 0.87–0.96, p = 0.001) and DKD (OR = 0.93, 95% CI: 0.88–0.98, p = 0.005) after adjustment for STB, STB-related factors, and risk factors for DR and DKD. Here, ALB is linked to diabetic kidney disease.