Type 2 diabetes is a major risk factor for peripheral artery disease (PAD), a leading cause of atherosclerotic morbidity. Depending on the severity of the disease, PAD treatment ranges from minimally invasive lifestyle modifications or medications to invasive surgical procedures.

In the symposium, Diabetes and Peripheral Artery Disease—Evolving Role of GLP-1 RA and New Insights from the STRIDE Trial, on Saturday, June 21, from 1:30–3:00 p.m., in Room W375 A of the McCormick Convention Center, experts will discuss the STRIDE trial of the glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide in patients with type 2 diabetes and PAD. On-demand access to recorded presentations will be available to registered participants following the conclusion of the 85^th Scientific Sessions, from June 25–August 25.

“The concept that GLP-1 receptor agonists could be potential therapies for treating people with PAD with comorbid diabetes is an entirely novel and previously unstudied area,” said Subodh Verma, MD, PhD, FRCSC, Cardiac Surgeon-Scientist and Professor at St. Michael’s Hospital and the University of Toronto, Canada, who is the principal investigator of STRIDE and senior author of the STRIDE article published recently in The Lancet. “Currently, there are no durable solutions for PAD, one of the most common cardiovascular manifestations of type 2 diabetes. PAD leads to significant limb-related mortality and limb loss/amputations, and it causes significant functional limitations for patients, in terms of their walking ability and quality of life. Moreover, patients with PAD and diabetes are at very high risk of adverse cardiovascular events, including myocardial infarction, stroke, and death.”

The primary analysis of STRIDE showed that semaglutide had a dramatic effect on PAD outcomes, including improved walking distance and quality-of-life parameters, as well as the composite outcome of mortality limb events and rescue therapy initiation.

“These data usher in the entirely new concept that GLP-1 receptor agonists are truly vascular medications,” Dr. Verma said. “Moreover, these benefits were not entirely explained by semaglutide-mediated weight loss, as the study population was not limited to patients with overweight or obesity. It is exciting for the field, and this is a new therapy for PAD.”

Alice Y.Y. Cheng, MD, FRCPC, Endocrinologist and Associate Professor at the University of Toronto, echoed the excitement.

“STRIDE is one of the first studies evaluating a GLP-1 receptor agonist in the PAD space, wherein there have been few targeted treatments which are not widely available. For an established diabetes therapy to demonstrate efficacy in improving PAD outcomes, especially improving patient quality of life, is a significant advancement,” she said.

Dr. Cheng, the recipient of the 2025 Outstanding Physician-Clinician in Diabetes Award from the American Diabetes Association® (ADA), was not involved in STRIDE but will discuss the implications of the study’s findings for endocrinologists.

Neda Rasouli, MD, Director of the Diabetes and Endocrinology Clinical Trial Program and Professor of Medicine at the University of Colorado, will present new analyses of STRIDE data focused on glycemic indices and PAD outcomes. Zaina Albalas, MD, MSc, FRCPC, Clinical Assistant Professor of Medicine, Memorial University of Newfoundland, Canada, will discuss the epidemiology and clinical consequences of diabetes and PAD.

“PAD has been almost forgotten to some extent in the diabetes space,” Dr. Cheng said. “While atherosclerotic cardiovascular disease (ASCVD), microvascular complications, and heart failure have been centered in recent discussions, PAD has received significantly less attention, if any. However, we all have patients who have PAD, and the prognosis for patients with PAD and comorbid type 2 diabetes is generally poor.”

Dr. Verma noted that within the natural history of PAD, GLP-1 receptor agonists may theoretically impinge upon different etiological processes such as reducing inflammation, improving endothelial and/or microvascular function, and/or modulating mitochondrial energetics. The improvement in ankle-brachial index (ABI) with semaglutide seen in STRIDE suggests that GLP-1 receptor agonists directly modulate vascular structure and function, both experts noted.

“The STRIDE data ushers in a completely new paradigm for individuals with PAD and underscores the need for ongoing clinical trials, expanding the trial population to include patients to all-comers, and not just those with diabetes,” Dr. Verma said.

For endocrinologists, primary care physicians, and other clinicians who care for patients with diabetes, Dr. Cheng said another important aspect of STRIDE, and the spotlight it places on PAD, is that it is a reminder for endocrinologists and other clinicians who care for patients with diabetes to screen patients for PAD.