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Article History

Received: 30 June 2025

Revised: 12 December 2025

Accepted: 27 January 2026

First Online: 14 February 2026

Competing interests

: RJG is supported in part by grants from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institute of Health (NIH) under award numbers P30DK111024, 1K23DK123384, 1R03DK138255 and 1U2CDK137135-01. RJG received research support from Novo Nordisk, Eli Lilly, Boehringer, and Dexcom, and consulting/advisory from Abbott Diabetes, AstraZeneca, Bayer, Boehringer, Dexcom, Eli Lilly, Novo Nordisk, and Medtronic, outside this work. GEU has received research support (to Emory University) from Abbott, Dexcom, Bayer, and Corcept; and has served as a member of advisory boards for Dexcom and GluCare Health, outside this work. AL has received lecture fees from AstraZeneca, Boehringer Ingelheim, Novo Nordisk, and Pronokal; fees for clinical trials from Amgen, AstraZeneca, Boehringer Ingelheim, Lilly, and Novo Nordisk; research grants from the Diputació de Lleida, the Instituto de Salud Carlos III (PI21/00462, PMP22/00073 and PI24/00852), and Pfizer; fees for participation in Advisory Boards for Boehringer Ingelheim, Eli Lilly, Novo Nordisk, and Pronokal; and is employed by the Institut Català de la Salut (ICS). He has also received support for attending meetings from the Spanish Society for Obesity. GA, ZZ, IF, DS, BM, and AR declared no conflict of interest.

: The project protocol received approval from both the University of Miami Institutional Review Board, approval number [20230720] and the Emory University Institutional Review Board, approval number [STUDY00004872]. Throughout this research, ethical guidelines outlined in the Declaration of Helsinki concerning the protection of personal records were strictly adhered to. Participants were invited to voluntarily contribute to the study, and all individuals who agreed to participate in the study provided written informed consent.