A routine urine marker commonly used for kidney risk assessment may also help identify future diabetes risk. In a prospective cohort study published in Diabetes Research and Clinical Practice, higher urine albumin-to-creatinine ratio (UACR) levels predicted a greater risk of incident type 2 diabetes mellitus (T2DM) in adults without known diabetes at baseline.

The analysis included 411,389 participants from the UK Biobank with baseline UACR measurements. Cox proportional hazards models and restricted cubic spline analyses were used to assess the longitudinal association between UACR and new-onset T2DM over a mean follow-up of 13.8 years.

During follow-up, 15,942 participants developed T2DM. After adjustment for potential confounders, participants with UACR 3 to 30 mg/mmol had a 31% higher risk of incident T2DM compared with those with UACR <3 mg/mmol (hazard ratio [HR] 1.31; 95% confidence interval [CI] 1.17-1.45).

Those with UACR >30 mg/mmol had more than double the risk of future T2DM versus the reference group (HR 2.20; 95% CI 1.58-3.06). Results remained stable in multiple sensitivity analyses that accounted for body mass index, insulin resistance, uric acid, and estimated glomerular filtration rate using the creatinine-cystatin C equation.

The findings suggest that microalbuminuria may serve as an early clinical marker of elevated T2DM risk. Routine UACR assessment in high-risk populations may help support earlier detection and preventive intervention.