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First Online: 26 August 2026

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Competing interests: J.V.L. acknowledges serving in the unremunerated role of director of the Global Think-tank on Steatotic Liver Disease and has received research grants to his institutions from Boehringer Ingelheim, Echosens, Gilead Sciences, Madrigal Pharmaceuticals, MSD, Novo Nordisk and Pfizer; consulting fees from Echosens, GSK, Madrigal Pharmaceuticals, Novo Nordisk, Pfizer, Sonic Incytes and Takeda; and honoraria for lectures from Echosens, GSK and Novo Nordisk; outside of the submitted work. B.H. has served as a consultant for Novo Nordisk, AstraZeneca, Merck, Eli Lilly and Company, Boehringer Ingelheim and Currax; and gave paid lectures for Novo Nordisk, Eli Lilly and Company, Merck, Boehringer Ingelheim and Novartis. P.E.H.S. acknowledges serving as the President of the International Diabetes Federation (IDF). He has received grant or research support from Deutsches Zentrum für Diabetesforschung (DZD), the National Institutes of Health, the European Commission, the EU Directorate Public Health, BMBF, BZgA, European Public Health Authorities, SAB, Bayer Vital, Ascensia, Novartis, Astra, Eli Lilly and Company, Sanofi, AOK, the German Diabetes Organisation (DDG), the University of Dresden, MSD, Emperra Health Care, Bodytel, Impeto Health Care, Vitadio, Mebix, VIDEAmedical and UNA. He has received speaker honoraria from the European Commission, AOKplus, AOK, MDK, Ascensia, Novartis, Merck, Novo Nordisk, Johnson & Johnson, Lifescan, Eli Lilly and Company, MSD, Boehringer Ingelheim, REHASAN, Servier, Sanofi, Leo Pharma, GSK, TUMAINI Institut für Präventionsmanagement, the German Diabetes Organisation (DDG), Emperra, Zanadio, Vitadio, DiaExpert, Dexcom, the International Diabetes Federation, Janssen, USB and Protina. He has served on advisory boards for the European Commission, Ascensia, Eli Lilly and Company, GSK, Boehringer Ingelheim, Novartis, REHASAN, Zanadio, Novo Nordisk, Servier, AOKplus, CCM International, Astra, DDG, EASD, EUDF, IDF, VIDEAmedical, Dexcom, Abbott and Emperra AG. He has acted as a consultant for the European Commission, IDF, AOKplus, TUMAINI Institut für Präventionsmanagement, Deutsche Herzstiftung, REHASAN, Emperra, Impeto Health Care, Ascensia, Eli Lilly and Company, Philips, GWT, GLG, IT Industry, Infomedica, TK, Hapag-Lloyd, PwC, Pathways Public Health, Novo Nordisk, Lifescan, Vitadio, Perfood, LIVA, ONETWO, Zanadio, Mebix, VIDEAmedical, DIA Expert, UNA Health, HEDIA, Signal Iduna, GRO Health, Diaxilo, Oviva, Mementor and DiaNow. His family own the TUMAINI Institut für Präventionsmanagement and ISA Investment, and operate the portals ‘ambulantesfasten’ and ‘profschwarzfastet’ on Patreon. All this is outside of the submitted work. V.M. declares grant payments made to the Forum for Collaborative Research from the Gates Foundation to support salary. H.G.C.V.S. receives salary support from the Population Health Research Institute Mid-Career Award and research funding from Canadian Institutes of Health Research; and speaker’s honoraria or clinical trial consulting fees from Bayer, Novo Nordisk, Medtronic, Pfizer, Cardiovascular Research Foundation, Baim Institute of Clinical Research and CPC Clinical Research. A.D. declares no competing interests.