Peripheral artery disease (PAD) often limits mobility in people with type 2 diabetes, yet therapies that improve walking capacity remain scarce. The STRIDE trial, published in Diabetes Care, evaluated whether functional benefits of semaglutide extend across diabetes-related subgroups, including body mass index (BMI), HbA1c, diabetes duration, and medication use.

The study included 792 participants with symptomatic PAD and type 2 diabetes (median diabetes duration 12.2 years; HbA1c 7.1%; BMI 28.7 kg/m²). At 52 weeks, once-weekly semaglutide 1.0 mg significantly improved maximum walking distance (MWD) compared with placebo. The effect was consistent across subgroups: ETR 1.15 versus 1.13 for diabetes duration <10 vs ≥10 years (P = 0.80), 1.12 vs 1.16 for BMI <30 vs ≥30 kg/m² (P = 0.58), and 1.13 for HbA1c <7% vs ≥7% (P = 0.99). Pain-free walking distance (PFWD) also improved uniformly, with no significant treatment-by-subgroup interactions.

Weight reduction correlated weakly with MWD gains, suggesting functional improvements were not solely mediated by BMI changes. Safety outcomes remained consistent across subgroups.