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Article History

Received: 13 March 2025

Accepted: 24 June 2025

First Online: 24 September 2025

Acknowledgements

: The authors would like to acknowledge J.A. Rinaudo and A. Unalp-Arida (NIH) for their ongoing support throughout the duration of the DETECT study, as well as L. Li (University of Texas MD Anderson Cancer Center), the developer of the MW PS analysis method, who provided advice.

: Samples and data will be available to the scientific community according to the NIH data-sharing policy and the NIDDK policy for data sharing in multicentre clinical studies after the completion of the DETECT study.

: Research reported in this publication was supported by the National Cancer Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) under the following award numbers: U01DK108306 (University of Pittsburgh), U01DK108288 (Mayo Clinic), U01DK108320 (University of Florida), U01DK108323 (Indiana University), U01DK108326 (Baylor College of Medicine), U01DK108327 (Ohio State University), U01DK108328 (University of Texas MD Anderson Cancer Center), U01DK108300 (Stanford University), U01DK108314, P30DK063491 (Cedars-Sinai Medical Center), U01DK126300 (University of Minnesota) and P30DK097512 (Indiana University). MOG was supported by the Eris M. Field Chair in Diabetes Research. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH.

: FGST discloses research support by Dompé and has served on advisory boards for Sanofi and Novo Nordisk. MDB discloses research support from Viacyte and Dexcom, is a member of the data safety monitoring boards for Vertex and Insulet and is an advisory board member for Ariel Precision Medicine. RB discloses research support from Immunovia and Freenome. YCK discloses research support from Dexcom; is an advisory board honoraria for Novo Nordisk Walter Park; is an advisory committee/board member for AbbVie, Ariel Medicine, Pfizer, Ionis, Horizon Therapeutics and Nestle; and is a consultant for Acumen, Olympus, Arctx Medical and Capsovision. DY discloses research support from Abbvie Pharmaceuticals and is an advisory board member for Pfizer. RVC receives research support from Adipo Therapeutics. MOG has served on advisory boards for Nestle Health Science and Organon. The other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

: FGST designed the concept and analysis plan and wrote the first draft of the manuscript. FGST, YL, MOG and PAH analysed the data and wrote the manuscript. YL and FW performed the statistical analyses. FGST, YL, FW, MDB, RB, KC, WF, YCK, WGP, ZIS, DY, RVC, SCG, DKA, JS, MOG and PAH contributed to the study design, data collection and recruitment. All authors provided critical input on the manuscript and approved the final version. FGST and YL are the guarantors of this work and take responsibility for the integrity of the data and the accuracy of the data analysis.