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Article History

Received: 6 October 2025

Accepted: 9 February 2026

First Online: 1 April 2026

Data availability

: The data that support the findings of this study are not openly available for reasons of sensitivity and are available from the corresponding author on reasonable request. Data are located in controlled access data storage at King’s College London.

: This work was supported by a research grant from Guy’s and St Thomas’ Charity and by a King’s British Heart Foundation (BHF) Centre for Excellence Award (RE/18/2/34213). SA was funded/supported by the National Institute for Health Research Biomedical Research Centre based at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the National Health Service, the National Institute for Health Research or the Department of Health.

: JK is a member of the editorial board of Diabetologia . The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.

: JK conceived the study. All authors made substantial contributions to the acquisition of data, and developed and designed the methodology and performed the literature investigation. MO, PP and SA performed the statistical analysis. JK, VK, MO, KIA and PP drafted and wrote the manuscript. All authors critically reviewed and edited the manuscript for important intellectual content. JK supervised the study. All authors read and approved the final manuscript. JK and PP are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.