A study published by Medscape has found that higher concentrations of two urine metabolites, choline and dimethylglycine, are independently associated with an increased risk of renal events and all-cause mortality among patients with type 2 diabetes (T2D). These metabolites are part of the choline oxidation pathway. The findings suggest that measuring the levels of choline and dimethylglycine in urine could help predict which patients with T2D are at greater risk for kidney complications and death. The study also presents evidence that tubular stress, a condition affecting the kidney's tubules, may contribute to these associations. This research adds to the understanding of metabolic markers in T2D and their potential role in early identification and management of patients at risk for adverse renal outcomes.