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Article History

Received: 11 February 2025

Accepted: 27 May 2025

First Online: 22 July 2025

Acknowledgements

: The authors are grateful to the participants of this study as well as members of the Center for Diabetes, Endocrinology and Metabolism at Kansai Electric Power Hospital, who engaged in fruitful discussions, and the hospital staff. In particular, we would like to give special thanks to Y. Fujiwara of the Kansai Electric Power Medical Research Institute for technical support.

: Some or all datasets generated or analysed during the current study are not publicly available but are available from the corresponding author on reasonable request.

: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

: HK received grants from Ono Pharmaceutical Co., Taisho Pharmaceutical Co. and Novo Nordisk Pharma Ltd, and honoraria for lectures from Sanofi K.K. and Taisho Pharmaceutical Co. YH received grants from Sumitomo Pharma Co. and Nippon Boehringer Ingelheim Co. Ltd, and honoraria for lectures from Novo Nordisk Pharma Ltd, Eli Lilly Japan K.K., Daiichi Sankyo Company, Mitsubishi Tanabe Pharma Corporation, Taisho Pharmaceutical Co., MSD K.K. and Sumitomo Pharma Co. YuiY has received honoraria for lectures from Ono Pharmaceutical Co. Ltd, Sumitomo Pharma Co., Novo Nordisk Pharma Ltd and Teijin Pharma Ltd. YS has received grants from Nippon Boehringer Ingelheim Co. Ltd, ARKRAY Marketing Inc., Taisho Pharmaceutical Co. Ltd, Novo Nordisk Pharma Ltd, Terumo Corporation and Sumitomo Pharma Co., and honoraria for lectures from Taisho Pharmaceutical Co. Ltd, Nippon Becton Dickinson Company Ltd, Novo Nordisk Pharma Ltd, Eli Lilly Japan K.K., Sumitomo Pharma Co. Ltd and Ono Pharmaceutical Co. Ltd. YujY received honoraria for lectures from Sumitomo Pharma Co, Eli Lilly Japan K.K. and Mitsubishi Tanabe Pharma Corporation. The remaining authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

: YukY and HK designed the study, collected and analysed data, and drafted the article. MI and SM collected data and reviewed the article critically for important intellectual content. RU analysed the collected data and reviewed the article critically for important intellectual content. MM, YH and YuiY contributed to the design of the work and reviewed the article critically for important intellectual content. YS supervised the design of this project and reviewed the manuscript critically for important intellectual content. YujY supervised the design of this project, and edited and reviewed the article critically for important intellectual content. All authors approved the version to be published. YujY and YukY are responsible for the integrity of the work as a whole.