To support early diagnosis and treatment of DKD, the American Diabetes Association (ADA) recommends screening for diabetic nephropathy with urine albumin-to-creatinine ratios (UACR) at diagnosis and yearly after that.14 At this mid-sized academic children’s hospital, there was no standard process for ensuring nephropathy screening with UACR in youth with T2D, contributing to delayed identification of microalbuminuria in our pediatric patients with T2D. This evidence concerns the gene ALB and diabetic kidney disease.