{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:58:11Z","timestamp":1790704691406,"version":"4.1.0"},"reference-count":76,"publisher":"IMR Press","issue":"9","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Huadong Medicine Joint Funds of the Zhejiang Provincial Natural Science Foundation of China","award":["LHDMZ24H070001"],"award-info":[{"award-number":["LHDMZ24H070001"]}],"id":[{"id":"https:\/\/ror.org\/04aqat463","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Diabetic lower extremity peripheral artery disease (PAD) is a complex and multifactorial complication of diabetes mellitus, characterized by extensive distal disease burden, accelerated progression, and a markedly elevated risk of major adverse limb events. Despite considerable advances in endovascular and surgical revascularization, limb salvage rates in this population remain suboptimal, largely due to the limited efficacy of current pharmacological options in improving microvascular perfusion, accelerating wound healing, or preventing re-occlusion. In recent years, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as a transformative therapeutic class, demonstrating cardiovascular protective effects beyond glycemic control. Large-scale real-world studies have generated encouraging signals regarding their potential to reduce amputation risk and promote wound healing. However, the current evidence base remains limited, and the precise molecular mechanisms by which GLP-1 RAs may protect the diabetic lower extremity require further elucidation. This review systematically examines the epidemiology and pathophysiology of diabetic lower extremity PAD, elucidates the molecular mechanisms of GLP-1 RA-mediated vascular protection, critically evaluates clinical and real-world evidence, and discusses key challenges and future directions for optimizing therapeutic outcomes in this high risk population.<\/jats:p>","DOI":"10.31083\/bjhm55884","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:59:52Z","timestamp":1790701192000},"source":"Crossref","is-referenced-by-count":0,"title":["GLP-1 Receptor Agonists in Diabetic Lower Extremity Peripheral Artery Disease: From Mechanisms to Clinical Practice"],"prefix":"10.31083","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8901-520X","authenticated-orcid":true,"given":"Jie","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Second Af\ufb01liated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2275-3575","authenticated-orcid":true,"given":"Chengnan","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Second Af\ufb01liated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuwei","family":"Huang","sequence":"additional","affiliation":[{"name":"School of Medicine, Zhejiang Chinese Medical University, 310053 Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9785-8625","authenticated-orcid":true,"given":"Yikai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Second Af\ufb01liated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimin","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Second Af\ufb01liated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caiyun","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ningbo University Affiliated Yangming Hospital, 315400 Ningbo, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Fitridge R, Chuter V, Mills J, Hinchliffe R, Azuma N, Behrendt CA, et al. Editor's Choice - The Intersocietal IWGDF, ESVS, SVS Guidelines on Peripheral Artery Disease in People With Diabetes Mellitus and a Foot Ulcer. European Journal of Vascular and Endovascular Surgery. 2023; 66: 454\u2013483.","DOI":"10.1016\/j.ejvs.2023.07.020"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, et al. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation. 2024; 149: e347\u2013e913.","DOI":"10.1161\/CIR.0000000000001209"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2002; 287: 2570\u20132581.","DOI":"10.1001\/jama.287.19.2570"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JFE, Nauck MA, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. The New England Journal of Medicine. 2016; 375: 311\u2013322.","DOI":"10.1056\/NEJMoa1603827"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Marso SP, Bain SC, Consoli A, Eliaschewitz FG, J\u00f3dar E, Leiter LA, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. The New England Journal of Medicine. 2016; 375: 1834\u20131844.","DOI":"10.1056\/NEJMoa1607141"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Lin DSH, Lee JK, Chen WJ. Major adverse cardiovascular and limb events in patients with diabetes treated with GLP-1 receptor agonists vs DPP-4 inhibitors. Diabetologia. 2021; 64: 1949\u20131962.","DOI":"10.1007\/s00125-021-05497-1"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Lewis JE, Omenge DK, Patterson AR, Anwaegbu O, Tabukum NN, Lewis JE 3rd, et al. The impact of semaglutide on wound healing in diabetes related foot ulcer patients: A TriNetX database study. Diabetes & Vascular Disease Research. 2025; 22: 14791641251322909.","DOI":"10.1177\/14791641251322909"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Song P, Rudan D, Zhu Y, Fowkes FJI, Rahimi K, Fowkes FGR, et al. Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and analysis. The Lancet. Global Health. 2019; 7: e1020\u2013e1030.","DOI":"10.1016\/S2214-109X(19)30255-4"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Fowkes FGR, Rudan D, Rudan I, Aboyans V, Denenberg JO, McDermott MM, et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet. 2013; 382: 1329\u20131340.","DOI":"10.1016\/S0140-6736(13)61249-0"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Fowkes FGR, Aboyans V, Fowkes FJI, McDermott MM, Sampson UKA, Criqui MH. Peripheral artery disease: epidemiology and global perspectives. Nature Reviews. Cardiology. 2017; 14: 156\u2013170.","DOI":"10.1038\/nrcardio.2016.179"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005; 54: 1615\u20131625.","DOI":"10.2337\/diabetes.54.6.1615"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Paneni F, Beckman JA, Creager MA, Cosentino F. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part I. European Heart Journal. 2013; 34: 2436\u20132443.","DOI":"10.1093\/eurheartj\/eht149"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Geraldes P, King GL. Activation of protein kinase C isoforms and its impact on diabetic complications. Circulation Research. 2010; 106: 1319\u20131331.","DOI":"10.1161\/CIRCRESAHA.110.217117"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Tang WH, Martin KA, Hwa J. Aldose reductase, oxidative stress, and diabetic mellitus. Frontiers in Pharmacology. 2012; 3: 87.","DOI":"10.3389\/fphar.2012.00087"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Srivastava S, Ramana KV, Tammali R, Srivastava SK, Bhatnagar A. Contribution of aldose reductase to diabetic hyperproliferation of vascular smooth muscle cells. Diabetes. 2006; 55: 901\u2013910.","DOI":"10.2337\/diabetes.55.04.06.db05-0932"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Du XL, Edelstein D, Rossetti L, Fantus IG, Goldberg H, Ziyadeh F, et al. Hyperglycemia-induced mitochondrial superoxide overproduction activates the hexosamine pathway and induces plasminogen activator inhibitor-1 expression by increasing Sp1 glycosylation. Proceedings of the National Academy of Sciences of the United States of America. 2000; 97: 12222\u201312226.","DOI":"10.1073\/pnas.97.22.12222"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Yan SF, Ramasamy R, Naka Y, Schmidt AM. Glycation, inflammation, and RAGE: a scaffold for the macrovascular complications of diabetes and beyond. Circulation Research. 2003; 93: 1159\u20131169.","DOI":"10.1161\/01.RES.0000103862.26506.3D"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Schmidt AM, Yan SD, Yan SF, Stern DM. The multiligand receptor RAGE as a progression factor amplifying immune and inflammatory responses. The Journal of Clinical Investigation. 2001; 108: 949\u2013955.","DOI":"10.1172\/JCI14002"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Goldin A, Beckman JA, Schmidt AM, Creager MA. Advanced glycation end products: sparking the development of diabetic vascular injury. Circulation. 2006; 114: 597\u2013605.","DOI":"10.1161\/CIRCULATIONAHA.106.621854"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Ceriello A, Ihnat MA, Thorpe JE. Clinical review 2: The \"metabolic memory\": is more than just tight glucose control necessary to prevent diabetic complications? The Journal of Clinical Endocrinology and Metabolism. 2009; 94: 410\u2013415.","DOI":"10.1210\/jc.2008-1824"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HAW. 10-year follow-up of intensive glucose control in type 2 diabetes. The New England Journal of Medicine. 2008; 359: 1577\u20131589.","DOI":"10.1056\/NEJMoa0806470"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Boyko EJ, Zelnick LR, Braffett BH, Pop-Busui R, Cowie CC, Lorenzi GM, et al. Risk of Foot Ulcer and Lower-Extremity Amputation Among Participants in the Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications Study. Diabetes Care. 2022; 45: 357\u2013364.","DOI":"10.2337\/dc21-1816"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Fadini GP, Sartore S, Albiero M, Baesso I, Murphy E, Menegolo M, et al. Number and function of endothelial progenitor cells as a marker of severity for diabetic vasculopathy. Arteriosclerosis, Thrombosis, and Vascular Biology. 2006; 26: 2140\u20132146.","DOI":"10.1161\/01.ATV.0000237750.44469.88"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Batchuluun B, Inoguchi T, Sonoda N, Sasaki S, Inoue T, Fujimura Y, et al. Metformin and liraglutide ameliorate high glucose-induced oxidative stress via inhibition of PKC-NAD(P)H oxidase pathway in human aortic endothelial cells. Atherosclerosis. 2014; 232: 156\u2013164.","DOI":"10.1016\/j.atherosclerosis.2013.10.025"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Li Q, Lin Y, Wang S, Zhang L, Guo L. GLP-1 Inhibits High-Glucose-Induced Oxidative Injury of Vascular Endothelial Cells. Scientific Reports. 2017; 7: 8008.","DOI":"10.1038\/s41598-017-06712-z"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Jude EB, Oyibo SO, Chalmers N, Boulton AJ. Peripheral arterial disease in diabetic and nondiabetic patients: a comparison of severity and outcome. Diabetes Care. 2001; 24: 1433\u20131437.","DOI":"10.2337\/diacare.24.8.1433"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Waltenberger J. Impaired collateral vessel development in diabetes: potential cellular mechanisms and therapeutic implications. Cardiovascular Research. 2001; 49: 554\u2013560.","DOI":"10.1016\/s0008-6363(00)00228-5"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Jia J, Lu Q, Zhang Y, Zhao Y. Hypoxia-Inducible Factor 1\u03b1 in Type 2 Diabetes Mellitus: Mechanisms and Therapeutic Perspectives. Biology. 2026; 15: 1241.","DOI":"10.3390\/biology15151241"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"Sch\u00f6nborn M, Gregorczyk-Maga I, Batko K, Maga M, Bogucka K, Gawlik K, et al. Angiogenic and Microvascular Status Alterations after Endovascular Revascularization of Lower Limb Arteries among Patients with Diabetic Foot Syndrome: A Prospective 12-Month Follow-Up Study. Journal of Clinical Medicine. 2023; 12: 5581.","DOI":"10.3390\/jcm12175581"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"Mohammedi K, Woodward M, Hirakawa Y, Zoungas S, Williams B, Lisheng L, et al. Microvascular and Macrovascular Disease and Risk for Major Peripheral Arterial Disease in Patients With Type 2 Diabetes. Diabetes Care. 2016; 39: 1796\u20131803.","DOI":"10.2337\/dc16-0588"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"LoGerfo FW, Coffman JD. Current concepts. Vascular and microvascular disease of the foot in diabetes. Implications for foot care. The New England Journal of Medicine. 1984; 311: 1615\u20131619.","DOI":"10.1056\/NEJM198412203112506"},{"key":"ref32","doi-asserted-by":"publisher","unstructured":"Boulton AJM, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. Lancet. 2005; 366: 1719\u20131724.","DOI":"10.1016\/S0140-6736(05)67698-2"},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"Criqui MH, Aboyans V. Epidemiology of peripheral artery disease. Circulation Research. 2015; 116: 1509\u20131526.","DOI":"10.1161\/CIRCRESAHA.116.303849"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"Hap K, Biernat K, Konieczny G. Patients with Diabetes Complicated by Peripheral Artery Disease: the Current State of Knowledge on Physiotherapy Interventions. Journal of Diabetes Research. 2021; 2021: 5122494.","DOI":"10.1155\/2021\/5122494"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"Mohammedi K, Woodward M, Hirakawa Y, Zoungas S, Colagiuri S, Hamet P, et al. Presentations of major peripheral arterial disease and risk of major outcomes in patients with type 2 diabetes: results from the ADVANCE-ON study. Cardiovascular Diabetology. 2016; 15: 129.","DOI":"10.1186\/s12933-016-0446-x"},{"key":"ref36","doi-asserted-by":"publisher","unstructured":"Selvin E, Wattanakit K, Steffes MW, Coresh J, Sharrett AR. HbA1c and peripheral arterial disease in diabetes: the Atherosclerosis Risk in Communities study. Diabetes Care. 2006; 29: 877\u2013882.","DOI":"10.2337\/diacare.29.04.06.dc05-2018"},{"key":"ref37","doi-asserted-by":"publisher","unstructured":"Prompers L, Schaper N, Apelqvist J, Edmonds M, Jude E, Mauricio D, et al. Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE Study. Diabetologia. 2008; 51: 747\u2013755.","DOI":"10.1007\/s00125-008-0940-0"},{"key":"ref38","doi-asserted-by":"publisher","unstructured":"Barnes JA, Eid MA, Creager MA, Goodney PP. Epidemiology and Risk of Amputation in Patients With Diabetes Mellitus and Peripheral Artery Disease. Arteriosclerosis, Thrombosis, and Vascular Biology. 2020; 40: 1808\u20131817.","DOI":"10.1161\/ATVBAHA.120.314595"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"Secemsky EA, Kirksey L, Quiroga E, King CM, Martinson M, Hasegawa JT, et al. Impact of Intensity of Vascular Care Preceding Major Amputation Among Patients With Chronic Limb-Threatening Ischemia. Circulation. Cardiovascular Interventions. 2024; 17: e012798.","DOI":"10.1161\/CIRCINTERVENTIONS.122.012798"},{"key":"ref40","doi-asserted-by":"publisher","unstructured":"Bhandari N, Newman JD, Berger JS, Smilowitz NR. Diabetes mellitus and outcomes of lower extremity revascularization for peripheral artery disease. European Heart Journal. Quality of Care & Clinical Outcomes. 2022; 8: 298\u2013306.","DOI":"10.1093\/ehjqcco\/qcaa095"},{"key":"ref41","doi-asserted-by":"publisher","unstructured":"Mehdi SF, Pusapati S, Anwar MS, Lohana D, Kumar P, Nandula SA, et al. Glucagon-like peptide-1: a multi-faceted anti-inflammatory agent. Frontiers in Immunology. 2023; 14: 1148209.","DOI":"10.3389\/fimmu.2023.1148209"},{"key":"ref42","doi-asserted-by":"publisher","unstructured":"Wang X, Yang X, Qi X, Fan G, Zhou L, Peng Z, et al. Anti-atherosclerotic effect of incretin receptor agonists. Frontiers in Endocrinology. 2024; 15: 1463547.","DOI":"10.3389\/fendo.2024.1463547"},{"key":"ref43","doi-asserted-by":"publisher","unstructured":"Krasner NM, Ido Y, Ruderman NB, Cacicedo JM. Glucagon-like peptide-1 (GLP-1) analog liraglutide inhibits endothelial cell inflammation through a calcium and AMPK dependent mechanism. PloS One. 2014; 9: e97554.","DOI":"10.1371\/journal.pone.0097554"},{"key":"ref44","doi-asserted-by":"publisher","unstructured":"Yamanouchi D. The Roles of Incretin Hormones GIP and GLP-1 in Metabolic and Cardiovascular Health: A Comprehensive Review. International Journal of Molecular Sciences. 2026; 27: 27.","DOI":"10.3390\/ijms27010027"},{"key":"ref45","doi-asserted-by":"publisher","unstructured":"Rroji M, Spahia N, Figurek A, Spasovski G. Targeting Diabetic Atherosclerosis: The Role of GLP-1 Receptor Agonists, SGLT2 Inhibitors, and Nonsteroidal Mineralocorticoid Receptor Antagonists in Vascular Protection and Disease Modulation. Biomedicines. 2025; 13: 728.","DOI":"10.3390\/biomedicines13030728"},{"key":"ref46","doi-asserted-by":"publisher","unstructured":"Dong Z, Chai W, Wang W, Zhao L, Fu Z, Cao W, et al. Protein kinase A mediates glucagon-like peptide 1-induced nitric oxide production and muscle microvascular recruitment. American Journal of Physiology. Endocrinology and Metabolism. 2013; 304: E222\u20138.","DOI":"10.1152\/ajpendo.00473.2012"},{"key":"ref47","doi-asserted-by":"publisher","unstructured":"Li P, Tang Z, Wang L, Feng B. Glucagon-like peptide-1 analogue liraglutide ameliorates atherogenesis via inhibiting advanced glycation end product-induced receptor for advanced glycosylation end product expression in apolipoprotein-E deficient mice. Molecular Medicine Reports. 2017; 16: 3421\u20133426.","DOI":"10.3892\/mmr.2017.6978"},{"key":"ref48","doi-asserted-by":"publisher","unstructured":"Gruzmark FS, Beraja GE, Jozic I, Lev-Tov HA. Exploring the Role of GLP-1 Agents in Managing Diabetic Foot Ulcers: A Narrative and Systematic Review. Wound Repair and Regeneration. 2025; 33: e70085.","DOI":"10.1111\/wrr.70085"},{"key":"ref49","doi-asserted-by":"publisher","unstructured":"Caruso P, Maiorino MI, Longo M, Porcellini C, Matrone R, Digitale Selvaggio L, et al. Liraglutide for Lower Limb Perfusion in People With Type 2 Diabetes and Peripheral Artery Disease: The STARDUST Randomized Clinical Trial. JAMA Network Open. 2024; 7: e241545.","DOI":"10.1001\/jamanetworkopen.2024.1545"},{"key":"ref50","doi-asserted-by":"publisher","unstructured":"Aung MM, Slade K, Freeman LAR, Kos K, Whatmore JL, Shore AC, et al. Locally delivered GLP-1 analogues liraglutide and exenatide enhance microvascular perfusion in individuals with and without type 2 diabetes. Diabetologia. 2019; 62: 1701\u20131711.","DOI":"10.1007\/s00125-019-4918-x"},{"key":"ref51","doi-asserted-by":"publisher","unstructured":"Lovshin J, Cherney D. GLP-1R Agonists and Endothelial Dysfunction: More Than Just Glucose Lowering? Diabetes. 2015; 64: 2319\u20132321.","DOI":"10.2337\/db15-0366"},{"key":"ref52","doi-asserted-by":"publisher","unstructured":"Xie XY, Mo ZH, Chen K, He HH, Xie YH. Glucagon-like peptide-1 improves proliferation and differentiation of endothelial progenitor cells via upregulating VEGF generation. Medical Science Monitor. 2011; 17: BR35\u2013BR41.","DOI":"10.12659\/msm.881383"},{"key":"ref53","doi-asserted-by":"publisher","unstructured":"Dennis CJ, He AZ, Krishnaraj A, Quan A, Teoh H, Connelly KA, et al. Prevention of Vascular Aging as a Novel Paradigm for GLP-1 Receptor Agonist-Mediated Cardioprotection. Circulation Research. 2026; 139: e327425.","DOI":"10.1161\/CIRCRESAHA.126.327425"},{"key":"ref54","doi-asserted-by":"publisher","unstructured":"Yan X, Su Y, Fan X, Chen H, Lu Z, Liu Z, et al. Liraglutide Improves the Angiogenic Capability of EPC and Promotes Ischemic Angiogenesis in Mice under Diabetic Conditions through an Nrf2-Dependent Mechanism. Cells. 2022; 11: 3821.","DOI":"10.3390\/cells11233821"},{"key":"ref55","doi-asserted-by":"publisher","unstructured":"Ghebrehiwet-Kuflom J, Mehta A, Lim P, Dahle S, Isseroff RR. GLP-1 Receptor Agonists as Emerging Modulators of Inflammation and Angiogenesis in Chronic Cutaneous Wound Healing. The Journal of Investigative Dermatology. 2025; 145: 2981\u20132988.","DOI":"10.1016\/j.jid.2025.08.045"},{"key":"ref56","doi-asserted-by":"publisher","unstructured":"Li Q, Yu S, Rui S, Lin X, Yuan Y, Armstrong DG, et al. Novel glucose-lowering agents that benefit diabetic foot: icing on the cake. Frontiers in Endocrinology. 2025; 16: 1581403.","DOI":"10.3389\/fendo.2025.1581403"},{"key":"ref57","doi-asserted-by":"publisher","unstructured":"Yaribeygi H, Maleki M, Atkin SL, Jamialahmadi T, Sahebkar A. Impact of Incretin-Based Therapies on Adipokines and Adiponectin. Journal of Diabetes Research. 2021; 2021: 3331865.","DOI":"10.1155\/2021\/3331865"},{"key":"ref58","doi-asserted-by":"publisher","unstructured":"Petrovic A, Igrec D, Rozac K, Bojanic K, Kuna L, Kolaric TO, et al. The Role of GLP1-RAs in Direct Modulation of Lipid Metabolism in Hepatic Tissue as Determined Using In Vitro Models of NAFLD. Current Issues in Molecular Biology. 2023; 45: 4544\u20134556.","DOI":"10.3390\/cimb45060288"},{"key":"ref59","doi-asserted-by":"publisher","unstructured":"Moiz A, Zolotarova T, Filion KB, Eisenberg MJ. GLP-1 Receptor Agonists and Blood Pressure: A State-of-the-Art Review of Mechanisms, Evidence, and Clinical Implications. American Journal of Hypertension. 2026; 39: 611\u2013622.","DOI":"10.1093\/ajh\/hpaf205"},{"key":"ref60","doi-asserted-by":"publisher","unstructured":"Hong AT, Lin F, Luu IY, Shin L, Han SM, Armstrong DG, et al. Risk of lower extremity complications with GLP-1 receptor agonists, SGLT2 inhibitors, and DPP-4 inhibitors in peripheral artery disease. Diabetes Research and Clinical Practice. 2025; 230: 112982.","DOI":"10.1016\/j.diabres.2025.112982"},{"key":"ref61","doi-asserted-by":"publisher","unstructured":"Hong AT, Luu IY, Lin F, Shin L, Hsu CH, Shih CD, et al. Differential Effect of GLP-1 Receptor Agonists and SGLT2 Inhibitors on Lower-Extremity Amputation Outcomes in Type 2 Diabetes: A Nationwide Retrospective Cohort Study. Diabetes Care. 2025; 48: 1728\u20131736.","DOI":"10.2337\/dc25-0292"},{"key":"ref62","doi-asserted-by":"publisher","unstructured":"Goldenberg RM, Verma S. GLP-1 Receptor Agonists Help Legs. Diabetes Care. 2025; 48: 1713\u20131715.","DOI":"10.2337\/dci25-0070"},{"key":"ref63","doi-asserted-by":"publisher","unstructured":"Dhatariya K, Bain SC, Buse JB, Simpson R, Tarnow L, Kaltoft MS, et al. The Impact of Liraglutide on Diabetes-Related Foot Ulceration and Associated Complications in Patients With Type 2 Diabetes at High Risk for Cardiovascular Events: Results From the LEADER Trial. Diabetes Care. 2018; 41: 2229\u20132235.","DOI":"10.2337\/dc18-1094"},{"key":"ref64","doi-asserted-by":"publisher","unstructured":"Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. The New England Journal of Medicine. 2017; 377: 644\u2013657.","DOI":"10.1056\/NEJMoa1611925"},{"key":"ref65","doi-asserted-by":"publisher","unstructured":"Badjatiya A, Merrill P, Buse JB, Goodman SG, Katona B, Iqbal N, et al. Clinical Outcomes in Patients With Type 2 Diabetes Mellitus and Peripheral Artery Disease: Results From the EXSCEL Trial. Circulation. Cardiovascular Interventions. 2019; 12: e008018.","DOI":"10.1161\/CIRCINTERVENTIONS.119.008018"},{"key":"ref66","doi-asserted-by":"publisher","unstructured":"Holman RR, Bethel MA, Mentz RJ, Thompson VP, Lokhnygina Y, Buse JB, et al. Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes. The New England Journal of Medicine. 2017; 377: 1228\u20131239.","DOI":"10.1056\/NEJMoa1612917"},{"key":"ref67","doi-asserted-by":"publisher","unstructured":"Bonaca MP, Catarig AM, Houlind K, Ludvik B, Nordanstig J, Ramesh CK, et al. Semaglutide and walking capacity in people with symptomatic peripheral artery disease and type 2 diabetes (STRIDE): a phase 3b, double-blind, randomised, placebo-controlled trial. Lancet. 2025; 405: 1580\u20131593.","DOI":"10.1016\/S0140-6736(25)00509-4"},{"key":"ref68","doi-asserted-by":"publisher","unstructured":"Das SR, Bonaca MP, Creager MA, Maruthur N, Nordanstig J, Pop-Busui R, et al. Management of Peripheral Artery Disease in Adults With Diabetes: 2025 ACC Scientific Statement: A Report of the American College of Cardiology. Journal of the American College of Cardiology. 2025; 88: 891\u2013906.","DOI":"10.1016\/j.jacc.2025.11.027"},{"key":"ref69","doi-asserted-by":"publisher","unstructured":"Zelniker TA, Wiviott SD, Raz I, Im K, Goodrich EL, Bonaca MP, et al. SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet. 2019; 393: 31\u201339.","DOI":"10.1016\/S0140-6736(18)32590-X"},{"key":"ref70","doi-asserted-by":"publisher","unstructured":"Battistoni A, Piras L, Tartaglia N, Carrano FM, De Vitis C, Barbato E. Glucagon-like peptide-1 receptor agonists and the endothelium: molecular and clinical insights into cardiovascular protection. Frontiers in Medicine. 2025; 12: 1669685.","DOI":"10.3389\/fmed.2025.1669685"},{"key":"ref71","doi-asserted-by":"publisher","unstructured":"American Diabetes Association Professional Practice Committee for Diabetes. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2026. Diabetes Care. 2026; 49: S216\u2013S245.","DOI":"10.2337\/dc26-S010"},{"key":"ref72","doi-asserted-by":"publisher","unstructured":"Marx N, Federici M, Sch\u00fctt K, M\u00fcller-Wieland D, Ajjan RA, Antunes MJ, et al. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. European Heart Journal. 2023; 44: 4043\u20134140.","DOI":"10.1093\/eurheartj\/ehad192"},{"key":"ref73","doi-asserted-by":"publisher","unstructured":"Gornik HL, Aronow HD, Goodney PP, Arya S, Brewster LP, Byrd L, et al. 2024 ACC\/AHA\/AACVPR\/APMA\/ABC\/SCAI\/SVM\/SVN\/SVS\/SIR\/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024; 149: e1313\u2013e1410.","DOI":"10.1161\/CIR.0000000000001251"},{"key":"ref74","doi-asserted-by":"publisher","unstructured":"Guzauskas GF, Rind DM, Fazioli K, Chapman RH, Pearson SD, Hansen RN. Cost-effectiveness of oral semaglutide added to current antihyperglycemic treatment for type 2 diabetes. Journal of Managed Care & Specialty Pharmacy. 2021; 27: 455\u2013468.","DOI":"10.18553\/jmcp.2021.27.4.455"},{"key":"ref75","doi-asserted-by":"publisher","unstructured":"McGuire DK, Marx N, Mulvagh SL, Deanfield JE, Inzucchi SE, Pop-Busui R, et al. Oral Semaglutide and Cardiovascular Outcomes in High-Risk Type 2 Diabetes. The New England Journal of Medicine. 2025; 392: 2001\u20132012.","DOI":"10.1056\/NEJMoa2501006"},{"key":"ref76","doi-asserted-by":"publisher","unstructured":"Fr\u00edas JP, Davies MJ, Rosenstock J, P\u00e9rez Manghi FC, Fern\u00e1ndez Land\u00f3 L, Bergman BK, et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. The New England Journal of Medicine. 2021; 385: 503\u2013515.","DOI":"10.1056\/NEJMoa2107519"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/9\/10.31083\/BJHM55884","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:00:15Z","timestamp":1790701215000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/9\/10.31083\/BJHM55884"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":76,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1759-7390(26)04768-0"],"URL":"https:\/\/doi.org\/10.31083\/bjhm55884","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"article-number":"55884"}}