Lower albumin has been associated with DKD [10] and frailty in older people with type 2 diabetes [39] and albumin levels are inversely associated with CVD or mortality in people with CKD [40], suggesting that as a marker linked with malnutrition, liver and kidney dysfunction and inflammation, albumin may partly capture the integrated altered metabolic signature in diabetes and thus associates with adverse outcomes. Here, ALB is linked to malnutrition.