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Article History

Received: 27 August 2025

Accepted: 26 November 2025

First Online: 3 March 2026

Acknowledgements

: This research was conducted using the UK Biobank Resource under UK Biobank project number 9072. The Wellcome Trust, MRC and NIHR had no role in the design and conduct of the study. collection, management, analysis or interpretation of the data, preparation, review or approval of the manuscript, or the decision to submit the manuscript for publication. The views expressed are those of the author(s) and not necessarily those of the Wellcome Trust, UK Department of Health, NHS or NIHR.

: Data on the MODY cohort are available through collaboration to experienced teams working on approved studies examining the mechanisms, diagnosis and treatment of diabetes and other beta cell disorders. Requests for collaboration will be considered by a steering committee following an application to the Genetic Beta Cell Research Bank ( ). Contact by email should be directed to the corresponding author. Data from the UK Biobank are available to approved researchers ( ). GnomAD data are publicly available ( ).

: This study was funded by the European Foundation for the Study of Diabetes. In addition, KAP is funded by the Wellcome Trust (219606/Z/19/Z). TWL is supported by the Academy of Medical Sciences, the Wellcome Trust, the UK Government Department of Science Innovation and Technology, the British Heart Foundation and a Diabetes UK Springboard Award (SBF009\1135). ATH is supported by a Wellcome Trust Senior Investigator award (WT098395/Z/12/Z). FK is supported by Investissements d'Avenir (ANR-10-LABX-73-01) and the Dutch Diabetes Research Foundation (Stichting Diabetes Onderzoek Nederland [DON]). The work was also supported by the UK National Institute for Health Research (NIHR) Exeter Biomedical Research Centre, Exeter, UK, and the NIHR Exeter Clinical Research Facilities.

: The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

: TWL and AS are joint first authors. The study was conceptualised by KAP and TWL, with methodology design contributions from FK, MNWa, MNWe and OK. ATH, EDF, KC, SF, KAP and ZS recruited patients and contributed to the acquisition of the data. KAP, TWL, AS, FK and OK undertook data analysis. All authors contributed to the data interpretation. The original draft was prepared by AS, KAP and TWL, and AS, ATH, EDF, KC, KAP, MNWa, FK, MNWe, OK, SF, TWL and ZS critically reviewed, edited and provided crucial intellectual comments. Supervision was provided by KAP, and funding acquisition was undertaken by KAP, MNWe and TWL. All authors approved the final version for publication. KAP is the guarantor of this work, and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.