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Article History

Received: 15 December 2024

Accepted: 15 May 2025

First Online: 6 October 2025

Acknowledgements

: The authors acknowledge the hard work, skills and contributions of the radiographers at the University of Sheffield Magnetic Resonance Imaging Department. The authors also greatly appreciate the cooperation of the study participants who spent considerable time participating in this study. Dr Iain D. Wilkinson, who substantially contributed to this research, died on 22 October 2020 before publication of this work. Dr Wilkinson will be fondly remembered and is sadly missed.

: The datasets generated and/or analysed during the current study are available from the corresponding author upon reasonable request.

: This study was supported by the European Foundation for the Study of Diabetes European Research Programme in Microvascular Complications of Diabetes supported by Novartis; the Knowledge Exchange Support Fund, University of Sheffield (X/162218); the Efficacy and Mechanism Evaluation Programme (NIHR129921), a Medical Research Council and National Institute for Health and Care Research partnership; and Sheffield Teaching Hospitals Diabetes Charitable Trust. The views expressed in this publication are those of the authors and not those of the Medical Research Council, National Institute for Health and Care Research, the Department of Health and Social Care, nor the Sheffield Teaching Hospitals Charities. The study sponsor/funder was not involved in the design of the study; collection, analysis, and interpretation of data or writing of the report and did not impose any restrictions regarding publication of the report.

: ST has received lecture honoraria from Wörwag Pharma, Pfizer, Novo Nordisk, Merck, EVA Pharma, Hikma Pharmaceuticals, Grünenthal, Abbott Laboratories, AstraZeneca, Trigocare International, and Procter & Gamble and is on the medical advisory board of Bayer. GS has received honoraria from Procter & Gamble and Eli Lilly. DS is a member of the editorial board of Diabetologia. The remaining authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

: GS and DS recruited participants, undertook clinical and neurophysiological assessments and research, and analysed clinical and magnetic resonance data and wrote the manuscript. MG and PS undertook clinical and neurophysiological assessments. KT and IDW contributed to the design of the study, acquisition, analysis and interpretation of data. SC contributed to the design of the study, recruitment of patients and oversight of study procedures. ST contributed to the design of the study. GS, DS, KT, MG, PS, SC and ST all contributed to drafting of the manuscript and approved the final draft of the manuscript. DS is the guarantor of the work.