Adults with early-onset type 2 diabetes (diagnosed <40 years) have high lifetime risk of complications, and are characterised by an extreme risk phenotype at diagnosis. Prevalence is rising, yet they remain under-represented in research. 
The 5-year “M3” Research Programme, which began in March 2021, will develop and evaluate a multifactorial management intervention to address diverse clinical outcomes in this high-risk group. We present an overview of the developed intervention built on our work to date, and the multi-site randomised controlled trial which opened in September 2023.