ALB and nutritional deficiency disease: Albumin is considered a marker for systemic inflammation and malnutrition.43,44 Serum albumin levels alone have been associated with incident diabetes and diabetic microvascular complications.51 Furthermore, malnourished patients have a higher risk of both DN and DR and albumin may be an efficient marker of the baseline nutritional status.52,53 Given the small number of studies on RAR, further research is needed to establish its superiority over RDW particularly in predicting diabetic complications.