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Article History

Received: 11 December 2025

Revised: 23 March 2026

Accepted: 28 April 2026

First Online: 1 May 2026

Declarations

:

: Ethical approval for the study was granted by the London-Bromley Research Ethics Committee (ref 21/LO/004). The study was registered in the ISRCTN registry (ISRCTN 17674908). All study procedures were carried out in accordance with good clinical practice guidelines and the Declaration of Helsinki (1964).

: All participants provided written informed consent prior to being enrolled onto the study.

: I. Podesta, J. Henson, S. Katsarova-Harrison, A. Tziannou, H. Waller, A. V. Rowlands, D. Bowery, O Anyiam, D. J. Stensel, D. R. Webb, A. Zalin, and L. Y. Herring declare no competing financial interests. D. Papamargaritis has received honoraria for acting as a speaker for Novo Nordisk, Eli Lilly, Boehringer Ingelheim, and Johnson & Johnson. He has received consultancy fees from Regeneron. He has also received research funding from Novo Nordisk, the Novo Nordisk UK Research Foundation, the Academy of Medical Sciences/Diabetes UK, Health Education East Midlands, and the National Institute for Health and Care Research (NIHR). I. Idris has received honoraria/funding for acting as a speaker and researcher for Novo Nordisk, Eli Lilly, Boehringer Ingelheim, Sanofi, Abbott, and Johnson & Johnson. T. Yates has received investigator-initiated funding from AstraZeneca, contracted research funding from the Reinsurance Group of America and has acted as a consultant for Regeneron. Professor Choudhary has served as a consultant for Cambridge Mechatronics Ltd, as well as an advisory board member and speaker for Medtronic, Novo Nordisk, Sanofi, Lilly, Abbott, Insulet, AstraZeneca, Dexcom, Glooko, and Roche. Advisory board member for Ypsomed, Embecta, Tandem and Vertex. He has received research support from Medtronic, Abbott, Novo Nordisk, Dexcom and Insulet. Professor Davies has acted as a consultant/advisor and speaker for Eli Lilly, Novo Nordisk and Sanofi, has attended advisory boards for AbbVie, Amgen, AstraZeneca, Biomea Fusion, Carmot/Roche, Daewoong Pharmaceutical, Sanofi, Zealand Pharma, Regeneron, GSK and EktaH and as a speaker for AstraZeneca, Boehringer Ingelheim and Zuellig Pharma. She has received grants from AstraZeneca, Boehringer Ingelheim and Novo Nordisk.