The time at which patients with type 2 diabetes (T2D) develop into DKD still remains unknown; however, these findings may lead to a breakthrough in future clinical practice regarding whether early treatment with renin-angiotensin-system inhibitors (RASi) or SGLT2 inhibitors (SGLT2i) should be initiated before microalbuminuria develops in patients with diabetes. This evidence concerns the gene MMP19 and type 2 diabetes mellitus.