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Article History

Received: 26 March 2025

Revised: 12 November 2025

Accepted: 5 December 2025

First Online: 31 January 2026

Competing interests

: FZ has received consulting fees from Servier, Menarini, and Daiichi Sankyo, unrelated to this study, as well as honoraria from the European Association for the Study of Diabetes for providing methodological support in the development of clinical guidelines, also not related to this study. KK has acted as a consultant, speaker or received grants for investigator-initiated studies for Astra Zeneca, Bayer, Novo Nordisk, Sanofi-Aventis, Servier, Lilly and Merck Sharp & Dohme, Boehringer Ingelheim, Oramed Pharmaceuticals, Pfizer, Roche, Daiichi-Sankyo, Applied Therapeutics, Embecta and Nestle Health Science. DP has been funded by the Royal College of Surgeons of England. He receives consulting fees from Johnson and Johnson, GSK, Novo Nordisk and Pfizer and payments for lectures, presentations, and educational events from Johnson and Johnson, Medtronic, Novo Nordisk and Sandoz. JV was the national clinical director for diabetes and obesity at NHS England from April 2013 to September 2023.

: Ethical approval was obtained from the National Statistician’s Data Ethics Advisory Committee (NSDEC23[ ]). All methods were performed in accordance with the relevant guidelines and regulations. This study does not include experiments involving human participants.