In a weighted multivariate COX proportional model adjusted for age (continuous), gender, race, education, smoking status, alcohol consumption, Obesity, systolic blood pressure, anti-diabetic drugs, HDL cholesterol, albumin, fasting plasma glucose, eGFR, and CHF, frailty T2DM increased all-cause (HR, 1.86; 95% CI 1.55–2.24; P < 0.0001) and cardiovascular (HR 1.66; 95% CI 1.18–2.33; P = 0.03) mortality and compared to non-frailty T2DM (Tables 3 and 4). Here, ALB is linked to obesity due to melanocortin 4 receptor deficiency.