High RDW has been linked with the development of diabetic ketoacidosis, cardiovascular mortality as well as all-cause mortality in DM patients.41,42 RDW has also been combined with albumin to generate RAR which is postulated to further improve the prediction of outcomes.17,18 Research shows that RAR could be a suitable indicator for peripheral artery disease and lower extremity ulcers in diabetic patients.43,44. This evidence concerns the gene ALB and diabetic ketoacidosis.