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Authors
Sandforth, Leontine https://orcid.org/0009-0005-7136-6397
Veit, Ralf https://orcid.org/0000-0001-9860-642X
Machann, Jürgen https://orcid.org/0000-0002-4458-5886
Dannecker, Corinna https://orcid.org/0000-0001-5689-9084
Miller, Gregor https://orcid.org/0000-0002-4281-4905
Jiménez-Muñoz, Marina https://orcid.org/0000-0002-4543-2929
Peter, Andreas https://orcid.org/0000-0001-5732-2287
Jumpertz von Schwartzenberg, Reiner https://orcid.org/0000-0002-5544-099X
Fritsche, Andreas https://orcid.org/0000-0002-4987-1961
Heni, Martin https://orcid.org/0000-0002-8462-3832
Birkenfeld, Andreas L. https://orcid.org/0000-0003-1407-9023
Preissl, Hubert https://orcid.org/0000-0002-8859-4661
Kullmann, Stephanie https://orcid.org/0000-0001-9951-923X
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Funding
Funding for this research was provided by:
Federal Ministry of Education and Research
German Research Foundation (GRK2816)
Helmholtz Society and the Cluster of Excellence Controlling Microbes to Fight Infections (03.007)
German Center for Diabetes Research (01GI0925)
German Research Association (Clinician Scientist Program)
Helmholtz Young Investigator Group (VH-NG-1619)
Universitätsklinikum Tübingen
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Article History
Received: 20 March 2026
Accepted: 5 May 2026
First Online: 3 July 2026
Ethics
Acknowledgements: We thank M. Borutta and D. Loeffler (both Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen; Tübingen, Germany) for recruitment of study participants and excellent technical assistance. Parts of the data were presented at the 60th EASD Annual Meeting in 2024. We acknowledge support by Open Access Publishing Fund of University of Tübingen.
Data availability: Data are under the supervision of the Data Access Steering Committee of the Institute for Diabetes Research and Metabolic Diseases; Tübingen, Germany. Data can be made available upon reasonable request in a pseudonymised form. Requests should include a brief research proposal, intended use of the data and research plan. Access is subject to applicable data protection regulations and institutional data-sharing agreements. No custom code was used in this study.
Funding: This project was supported by the German Center for Diabetes Research (DZD, 01GI0925) via the Federal Ministry of Education and Research, and Helmholtz Munich. LS is supported by the German Research Foundation (Deutsche Forschungsgemeinschaft) as a clinician scientist.
Authors’ relationships and activities: RJvS and LS serve as clinical investigators for studies funded by Eli Lilly and Boehringer Ingelheim, and all compensations go to the University Hospital Tübingen. LS receives honoraria from Sciarc GmbH; all compensations go to the University Hospital Tübingen. ALB declines all personal compensation from pharma or device companies; all compensations go to the University Hospital Tübingen. ALB received unrestricted research support from AstraZeneca and Daiichi Sankyo. He has served as principal investigator for studies funded by Novo Nordisk and Boehringer Ingelheim. MH reports lecture fees from Chiesi/Amryt, AstraZeneca, Boehringer Ingelheim, Lilly, Novartis, Novo Nordisk and Sanofi. SK reports lecture fees from Eli Lilly and Novo Nordisk. The remaining authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.
Contribution statement: SK and LS conceptualised the work. Acquisition of data was performed by SK, RV, JM and AP and data analysis was performed by LS, GM, MJ-M and SK. LS, SK, JM, CD, AP, RJvS, AF, MH, ALB and HP interpreted the data. LS drafted the article. LS, RV, JM, CD, GM, MJ-M, AP, RJvS, AF, MH, ALB, HP and SK reviewed the article critically for important intellectual content and approved the final version of the work. SK and LS are the guarantors of the current work and take full responsibility for the data presented.
