Semaglutide and Walking Capacity: What the STRIDE Trial Means for People with PAD and Type 2 Diabetes
For millions of people, living with Type 2 Diabetes (T2D) and Peripheral Artery Disease (PAD) presents a daily challenge. These conditions, often intertwined, can cast a long shadow over quality of life, with one of the most debilitating symptoms being a sharp, cramping pain in the legs while walking. This pain, known as intermittent claudication, can turn a simple walk to the shops into a gruelling ordeal, severely limiting mobility and independence.
According to Diabetes UK, over 4.3 million people are now living with a diagnosis of diabetes in the UK, while the British Heart Foundation estimates that PAD affects a significant portion of the population, often going undiagnosed.
Semaglutide, a medication well-known under brand names like Wegovy for its powerful effects on blood sugar control and weight management, has emerged as a subject of intense interest. Researchers hypothesised that its benefits might extend beyond metabolic health, potentially improving blood flow and reducing inflammation in the legs of those with PAD. This led to a crucial clinical investigation: the STRIDE (Semaglutide Treatment on Walking Distance in Peripheral Artery Disease) trial.
This article provides a comprehensive analysis of the STRIDE trial and explores the mechanism of Semaglutide, and breaks down the trial's methodology and results.
Understanding PAD and Type 2 Diabetes
Before exploring the trial itself, it's essential to understand the two conditions at its core. Peripheral Artery Disease and Type 2 Diabetes are distinct diagnoses, but their relationship is deeply interconnected, creating a complex clinical picture for many patients.
What Is Peripheral Artery Disease (PAD)
Peripheral Artery Disease is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs, most commonly the legs.
According to the NHS, this narrowing is caused by atherosclerosis, a process where fatty deposits, or plaques, build up on the artery walls. When the arteries supplying blood to your legs become partially or fully blocked, the leg muscles don't receive enough oxygen-rich blood to meet the demands of physical activity.
The classic symptom of this oxygen deficit is intermittent claudication. This is characterised by:
- Pain on exertion: A painful aching, cramping, or feeling of fatigue in the muscles of the calves, thighs, or buttocks that appears during walking or climbing stairs.
- Relief with rest: The pain consistently subsides after a few minutes of rest, only to return when activity is resumed.
The severity of intermittent claudication can vary widely, from a mild nuisance to debilitating pain that severely restricts how far a person can walk.
If left unmanaged, PAD can progress, leading to pain even at rest, non-healing sores, and in severe cases, the risk of amputation.
The Link Between Type 2 Diabetes and PAD
The connection between T2D and PAD is not coincidental; it is a dangerous synergy. Individuals with Type 2 Diabetes are at a significantly higher risk of developing PAD, and when they do, it is often more severe and progresses more rapidly.
This heightened risk is driven by several factors linked to diabetes:
- Accelerated Atherosclerosis: High blood glucose levels can damage the inner lining of the arteries (the endothelium), making them more susceptible to the buildup of fatty plaques.
- Inflammation: T2D is associated with chronic low-grade inflammation throughout the body, which is a key driver of the atherosclerotic process.
- Nerve Damage (Neuropathy): Diabetes can damage the nerves in the feet and legs, which can mask the early warning signs of PAD, such as claudication pain. This means the disease can advance to a more critical stage before it is even detected.
Research published in journals like Diabetes Care has consistently shown that people with diabetes are two to four times more likely to develop PAD than those without. The two conditions feed off each other, creating a vicious cycle of vascular damage.
Managing blood sugar is just as crucial as managing cholesterol and blood pressure in these individuals. Therefore, any treatment that effectively manages T2D is also a critical component of managing PAD risk.
Semaglutide: Mechanism, Usage, and Potential Benefits
Semaglutide or Wegovy has become a popular in diabetes care and, more recently, in weight management. Its role in the STRIDE trial, however, was to test its potential to go beyond these established benefits.
What is Semaglutide?
Semaglutide is a medication known as a GLP-1 receptor agonist. It works by mimicking a hormone that stimulates insulin release, suppresses appetite, and slows stomach emptying. It is widely used for managing Type 2 Diabetes. Wegovy, a higher-dose version, is also approved for weight management. Researchers hypothesised that beyond its proven benefits for blood sugar and weight control, Semaglutide's potential anti-inflammatory and direct vascular benefits might improve blood flow and, consequently, walking capacity in people with PAD.
Semaglutide is approved by the MHRA and is available on the NHS and via private weight loss providers like SheMed.
Beyond Blood Sugar Control: The Potential Benefits for PAD
The hypothesis for the STRIDE trial was rooted in growing evidence that the benefits of GLP-1 receptor agonists like Semaglutide are not limited to glucose control. Pre-clinical and cardiovascular outcome trials have suggested these drugs may have direct protective effects on the vascular system.
Researchers believed Semaglutide could potentially help with PAD through:
- Anti-inflammatory Effects: As mentioned, inflammation is a key driver of atherosclerosis. Studies published in journals accessible suggest GLP-1 agonists can reduce markers of systemic inflammation.
- Improved Endothelial Function: These drugs may help restore the health of the inner lining of blood vessels, allowing them to dilate more effectively and improve blood flow.
- Reduction in Oxidative Stress: They may help combat the cellular damage caused by oxidative stress, a process implicated in vascular disease.
The central question was whether these potential vascular benefits would translate into a tangible, real-world improvement for patients: could Semaglutide help people with PAD and T2D walk further and with less pain?
The STRIDE Trial: Design and Methodology
The STRIDE Trial (Semaglutide Treatment on Walking Capacity in Patients With Peripheral Artery Disease and Type 2 Diabetes) was designed as a rigorous Randomised Controlled Trial (RCT), the gold standard for clinical evidence. The study enrolled a specific cohort of patients: those suffering from both symptomatic PAD and Type 2 Diabetes. Participants were randomly assigned to receive either Semaglutide or a placebo.
STRIDE Trial Results: The Impact on Walking Capacity
The STRIDE trial results delivered a clear and positive message. The study demonstrated that Semaglutide significantly improved walking distance compared to the placebo. Patients in the Semaglutide group experienced a substantial increase in their Maximal Walking Distance, allowing them to walk further without debilitating pain. This translates directly to a tangible improvement in daily life and functional capacity.
Furthermore, the benefits extended beyond mobility. As expected, the Semaglutide group showed significant improvements in key secondary outcomes, including better blood sugar control (lower HbA1c) and reductions in body weight. The trial also reinforced the cardiovascular safety profile of Semaglutide in this high-risk patient population. In summary, Semaglutide improves claudication and overall metabolic health in individuals with PAD and T2D.
Primary and Secondary Endpoints from Trial
In any clinical trial, the "endpoints" are the key outcomes measured to determine if the treatment works.
- Primary Endpoint: The main outcome of interest in the STRIDE trial was the change in Maximal Walking Distance (MWD). This was measured using a standardised graded treadmill test, where participants walk at a set speed and incline until claudication pain forces them to stop. The total distance walked is the MWD.
- Secondary Endpoints: The trial also measured several other important outcomes, including:
- Pain-Free Walking Distance (PFWD): The distance a participant could walk on the treadmill before the onset of leg pain.
- HbA1c: A measure of average blood sugar control over the previous three months.
- Body Weight: Changes in weight from the beginning to the end of the trial.
- Cardiovascular Events: The occurrence of events like heart attacks or strokes.
- Quality of Life: Measured using validated patient questionnaires.
Adverse Events and Tolerability
The safety profile of Semaglutide observed in the STRIDE trial was consistent with its known side effects. The most commonly reported adverse events were gastrointestinal in nature, including:
- Nausea
- Vomiting
- Diarrhoea
These side effects were more common in the Semaglutide group than in the placebo group and are a well-documented aspect of initiating treatment with GLP-1 receptor agonists. For most patients, these effects are mild to moderate and tend to decrease over time as the body adjusts to the medication.
Conclusion
The STRIDE Trial provides strong evidence that Semaglutide like Wegovy can significantly improve walking capacity in people living with both Peripheral Artery Disease and Type 2 Diabetes. Future research will need to explore other pathways for improving blood flow and muscle function in PAD. The limitations of the STRIDE trial, such as its duration, might also prompt longer-term studies to see if any benefits emerge over time. For now, the focus for patients and clinicians in the UK must remain on the pillars of PAD care: exercise, lifestyle modification, and optimal medical management of risk factors.
Key Takeaways
- Significant Improvement in Walking Ability: The trial demonstrated that Semaglutide provides a direct and meaningful benefit for mobility. Patients experienced a substantial increase in their maximal walking distance, reducing the debilitating pain of intermittent claudication.
- Dual Benefit for Metabolic Health: Beyond improving walking capacity, Semaglutide delivers its established benefits of better blood sugar control (HbA1c reduction) and weight loss, addressing two key risk factors for PAD progression.
- A Potential New Therapeutic Approach: This trial positions Semaglutide as more than just a diabetes drug. It suggests a dual-purpose therapy that could simultaneously manage Type 2 Diabetes and its vascular complications, like PAD in future.
- A Manageable Safety Profile: The safety findings were consistent with the known profile of GLP-1 drugs. The main side effects were gastrointestinal (e.g., nausea) and were generally transient, reinforcing that the drug is a viable option for this patient group.
Frequently Asked Questions (FAQs)
1. What was the main finding of the STRIDE trial?
The STRIDE trial found that Semaglutide significantly improved walking distance for people with Peripheral Artery Disease (PAD) and Type 2 Diabetes. Patients taking Semaglutide could walk much further without pain compared to those on a placebo.
2. What are the common side effects of Semaglutide?
The most common side effects are gastrointestinal, including nausea, vomiting, diarrhoea, and constipation. These are often mild to moderate and tend to decrease over time as the body adjusts to the medication.
References
- Diabetes UK. (n.d.). Diabetes prevalence. Retrieved from https://www.diabetes.org.uk/professionals/position-statements-reports/statistics
- British Heart Foundation. (n.d.). BHF UK Factsheet. Retrieved from https://www.bhf.org.uk/what-we-do/our-research/heart-statistics
- NHS. (n.d.). Peripheral arterial disease (PAD). Retrieved from https://www.nhs.uk/conditions/peripheral-arterial-disease-pad/
- Iqbal, Z., et al. (2023). Semaglutide and walking capacity in patients with peripheral artery disease and type 2 diabetes (STRIDE): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial. The Lancet Diabetes & Endocrinology, 11(12), 914-924. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00509-4/abstract
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The content on the SheMed blog is provided for general informational and educational purposes only. While SheMed provides professional weight loss services and strives to ensure the information shared is accurate and up to date, we make no representations or guarantees as to its accuracy, completeness, or timeliness. This content should not be taken as personal medical advice or a substitute for consultation with a qualified healthcare provider. Always speak with your doctor or licensed medical professional about your individual health or medical needs before starting any new treatment or programme. Never disregard or delay seeking professional medical advice because of something you have read on this site. SheMed is not responsible for any actions you may take based on the information provided in this blog.
If you have been using Wegovy® as part of your weight-loss journey, you may have heard some exciting news: a new 7.2mg dose is now available in the UK.
At SheMed, we know that many of our patients make incredible progress but eventually hit a "plateau" - that frustrating point where weight loss slows down or stops. In the past, some patients felt they had to switch to other medications like Mounjaro® to keep seeing results.
That has now changed. With the arrival of the 7.2mg dose, you can achieve powerful weight loss results while staying on the Wegovy medication you already know and trust.
What is the 7.2mg dose?
In the past, the highest dose of Wegovy® was 2.4mg per week. For many people, this works perfectly. However, new research shows that some people benefit from a higher dose to help them feel full for longer and improve their metabolism.
The 7.2mg dose is a "step up" for patients who are already doing well on the 2.4mg dose but need a little extra help to see further results.
Why this is a "Game Changer" for Weight Loss
- No Need to Switch: You no longer have to worry about the hassle of switching brands or starting over with a different medication to get a stronger effect.
- Match the Competition: This higher dose allows Wegovy to offer the same high-level weight loss power that was previously only seen with other leading treatments.
- Beat the Plateau: If your weight loss has stalled at the 2.4mg dose, this "step up" helps restart your progress and keeps you moving toward your goal.
Important Safety Information
It is important to remember that 7.2mg is not for beginners. * Follow the Steps: Everyone must still start at the lowest dose (0.25mg) and slowly work their way up.
- Build Tolerance: You can only move to 7.2mg if you have been on the 2.4mg dose for a while and your body is handling it well.
- Side Effects: Just like with your current dose, moving up can sometimes cause a bit of nausea or an upset stomach. Our team at SheMed will be here to support you and give you tips on how to manage this.
Wegovy® 7.2mg: Stronger Results Without Switching Medications
If you have been using Wegovy® as part of your weight-loss journey, we have some exciting news: a new 7.2mg dose has officially arrived in the UK.
At SheMed, we know many of our patients make incredible progress but eventually hit a "plateau"—that frustrating point where weight loss slows down or stops. In the past, some people felt they had to switch to different medications like Mounjaro® to keep seeing results.
That has now changed. With the 7.2mg dose, Wegovy now offers powerful results that match the top doses of other medications. This means you can reach your goals while staying on the medication you already know and trust.
Why this is a "Game Changer" for You
- No Need to Switch: You can get stronger results without the hassle of changing brands or learning a different injection system.
- Top-Tier Weight Loss: Clinical trials showed that people on the 7.2mg dose lost an average of 21% of their body weight. This puts Wegovy’s power right alongside the strongest weight-loss treatments available today.
- Beat the Plateau: If you’ve been on the 2.4mg dose for a while and your weight has stopped moving, this "extra push" can help restart your journey.
How much does Wegovy 7.2mg cost?
Because the 7.2mg dose contains more of the active ingredient (semaglutide) to provide that extra strength, the price is higher than the lower doses.
- Current estimated price: The Wegovy prices start from £75at SheMed as new year offer. Price for 7.2mg is yet to be announned.
More Than Just a Weekly Jab
At SheMed, we believe that Wegovy® is a powerful tool, but it works best when combined with healthy habits. The 7.2mg dose is here to support the hard work you are already doing with your food choices and daily activity.
Our goal is to help you achieve lasting change, not just a quick fix.
Is the 7.2mg dose right for you?
Because this is a much stronger dose, it is handled carefully by our clinical team:
- For Existing Users: You must have already reached the 2.4mg dose and be tolerating it well before moving up.
- Medical Supervision: As always, our SheMed clinical team will oversee your transition to ensure you stay hydrated and manage any temporary side effects like nausea.
- Maximum Support: This dose is designed for those who need that extra "metabolic push" to reach their final target weight.
Ready to reach the next level?
If you feel your current dose isn't giving you the results you need, or if you were considering switching medications to get a stronger effect, let’s talk.
Contact the SheMed Support Team today to discuss if moving to the 7.2mg Wegovy dose is the right next step for your health journey.
Feeling constantly hungry, battling random cravings, or feeling like your body is “working against you” is not a personal failing. GLP-1, a key hormone that regulates appetite, fullness, and blood sugar, plays an important role in these experiences.
It is released from intestinal L-cells after eating and helps stimulate insulin, reduce glucagon, slow stomach emptying, and promote satiety, making it central to metabolic health and a major target in obesity and type 2 diabetes care.
Medications like semaglutide and tirzepatide are designed to mimic or enhance GLP-1 activity, but everyday dietary choices can also help support your body’s own GLP-1 response.
Research suggests that people with higher natural GLP-1 responses may eat around 20–30% fewer calories after a meal, highlighting how powerful this hormone can be in shaping appetite. The following article focuses on six food categories rich in specific nutrients that may naturally stimulate GLP-1 release and help you feel more satisfied throughout the day.
Six Everyday Foods That May Naturally Boost GLP-1 Levels
Supporting your body’s natural GLP-1 response may be simpler than many people expect. Below are six food categories that research has linked with GLP-1 activity, along with practical ways they are commonly included in everyday diets.
Eggs
Starting the day with eggs is a common dietary choice in many balanced eating patterns. Eggs provide a source of high-quality protein and fats, nutrients that have been studied for their potential role in supporting feelings of fullness after meals.
Some research suggests that meals higher in protein, including those containing eggs, may be associated with improved post-meal blood sugar responses and increased satiety when compared with higher-carbohydrate breakfasts. These effects are thought to involve appetite-regulating hormones such as GLP-1 and peptide YY (PYY), which play a role in signalling fullness.
Including eggs as part of breakfast may help some people feel more satisfied for longer and support overall dietary balance. As with all foods, individual responses can vary, and eggs are best consumed as part of a varied, nutritious diet.
Certain Types of Nuts
Nuts such as almonds, pistachios, and peanuts provide a combination of protein, unsaturated fats, and dietary fibre that slows gastric emptying, supports insulin sensitivity, and is associated with increased GLP-1 release and satiety.
Regular nut intake has been linked with improved glycaemic control, greater fullness, and reduced risk markers for type 2 diabetes and cardiovascular disease in clinical and epidemiological studies.
Fermentation of nut fibre by gut bacteria produces short-chain fatty acids, which can stimulate GLP-1 secretion from intestinal L-cells through dedicated receptors and related metabolic pathways.
If you are not allergic to nuts, include a small handful of nuts as a snack or add them to meals like yoghurt, salads, or porridge as a practical way to support natural GLP-1 activity and promote fullness. Evidence suggests that nut-based snacks can enhance satiety and modulate appetite-regulating hormones, including GLP-1, compared with refined-carbohydrate options.
High Fibre Grains
Whole grains such as oats, barley, and whole wheat are rich in soluble fibre, which helps smooth out post-meal rises in blood glucose and is associated with increased GLP-1 secretion and improved satiety. Soluble fibre forms a gel-like texture in the gut that slows digestion and glucose absorption, providing a more gradual stimulus for appetite-regulating hormones like GLP-1 and PYY.
A key part of this effect comes from fermentation of fibre by gut bacteria into short-chain fatty acids (SCFAs) such as acetate, propionate, and butyrate, which can activate receptors on intestinal L-cells and promote GLP-1 release. Randomised controlled trials have shown that high-fibre, oat-based meals can increase GLP-1 and PYY levels, enhance fullness, and reduce subsequent energy intake compared with low-fibre cereals.
Choosing high-fibre grains like oats and barley in place of refined grains (for example, white bread or sugary cereals) is a practical, research-supported way to support natural GLP-1 activity and appetite regulation. People with coeliac disease or gluten intolerance should select certified gluten-free whole-grain options and seek personalised dietary advice where needed.
Avocado
Avocado is a source of monounsaturated fats and soluble fibre, nutrients that are commonly associated with supporting satiety and digestive comfort. Soluble fibre can contribute to slower digestion and more gradual nutrient absorption, while unsaturated fats are often included in dietary patterns linked with metabolic health.
Some research has explored the relationship between avocado consumption and post-meal hormonal responses, including appetite-regulating hormones such as GLP-1 and peptide YY (PYY). These studies suggest that meals containing avocado may be associated with greater feelings of fullness and more stable post-meal insulin responses in some individuals.
Including avocado in meals such as salads or sandwiches may help support satiety as part of a balanced diet. Individual responses can vary, and avocado is best consumed alongside a variety of other nutrient-rich foods.
Olive Oil
Olive oil is a key component of Mediterranean-style eating patterns and is a source of monounsaturated and polyunsaturated fats. Diets that include higher proportions of unsaturated fats are commonly associated with cardiometabolic health and may influence post-meal satiety responses.
Research examining Mediterranean dietary patterns has explored their relationship with appetite-regulating hormones, including GLP-1. Some studies suggest that meals rich in unsaturated fats, such as those containing olive oil, may be associated with differences in post-meal hormonal responses and markers of glycaemic control when compared with lower-fat dietary approaches. These effects are thought to involve interactions between dietary fats and gut-derived hormones, although the exact mechanisms are still being studied.
Using olive oil in cooking or as a salad dressing can be a practical way to include unsaturated fats as part of a balanced diet. As with all dietary choices, individual responses may vary, and olive oil is best consumed in moderation alongside a variety of nutrient-rich foods.
Vegetables
Non-starchy vegetables such as Brussels sprouts, broccoli, and carrots provide dietary fibre, vitamins, and a range of plant compounds that support overall nutritional quality. Fibre-rich foods are commonly associated with digestive health and may influence feelings of fullness after meals.
Some research has examined how the order in which foods are consumed -such as eating vegetables before carbohydrate-rich foods-may affect post-meal glucose responses and appetite-related hormones, including GLP-1. These studies suggest that prioritising vegetables earlier in a meal may be associated with more gradual rises in blood glucose and differences in satiety signals, particularly in certain populations. The underlying mechanisms are still being explored and may involve interactions between dietary fibre, digestion, and gut-derived signals.
Including non-starchy vegetables as part of the first course of a meal can be a practical way to increase fibre intake and support balanced blood sugar responses as part of an overall healthy eating pattern. Individual responses may vary.
How Food May Actually Trigger GLP-1?
The secretion of GLP-1 is closely linked to nutrient sensing by L-cells in the distal small intestine and colon. Specific nutrients, including proteins, peptides, fatty acids, and monosaccharides, interact with G-protein coupled receptors and transporters on L-cells, triggering intracellular signalling cascades that culminate in GLP-1 exocytosis.
Protein ingestion, for example, leads to the generation of peptides and amino acids that bind to calcium-sensing receptors and other nutrient sensors on L-cells, directly stimulating GLP-1 release. Similarly, mono- and polyunsaturated fats activate free fatty acid receptors (FFAR1 and FFAR4), while fibre-derived SCFAs interact with FFAR2 and FFAR3 to promote GLP-1 secretion.
Overall, protein, healthy fats, and dietary fibre represent the three main dietary triggers for endogenous GLP-1 release. Their combined presence in whole, minimally processed foods accounts for the satiety-enhancing and glucose-lowering effects observed in dietary intervention studies.
Fibre and Gut Health Synergy
The interplay between dietary fibre, gut microbiota, and GLP-1 secretion exemplifies the complex synergy underlying metabolic health. Fibre that escapes digestion in the upper gastrointestinal tract is fermented by colonic bacteria, resulting in the production of SCFAs such as acetate, propionate, and butyrate. These SCFAs serve as signalling molecules that activate FFAR2 and FFAR3 on L-cells, directly inducing GLP-1 release.
This gut microbiota-mediated mechanism not only enhances GLP-1 secretion but also confers additional metabolic benefits, including improved insulin sensitivity, reduced inflammation, and maintenance of gut barrier integrity. The inclusion of high-fibre foods such as whole grains, nuts, vegetables, and legumes thus represents a cornerstone of dietary strategies aimed at boosting GLP-1 and supporting overall metabolic health.
Conclusion
Dietary patterns that include adequate protein, fibre, and unsaturated fats are commonly associated with satiety, balanced blood sugar responses, and overall metabolic health. Foods such as eggs, nuts, high-fibre grains, avocado, olive oil, and non-starchy vegetables provide a range of nutrients that have been studied for their potential association with appetite-regulating hormones, including GLP-1. These foods contribute to feelings of fullness and may support steadier post-meal glucose responses as part of a balanced diet.
Research exploring GLP-1 has primarily focused on its role in appetite regulation and glucose metabolism. While diet alone is not a treatment for metabolic conditions, nutritional approaches that prioritise whole, fibre-rich, and protein-containing foods are widely recommended to support long-term health. Individual responses can vary, and dietary strategies are most effective when tailored to personal needs, preferences, and medical guidance.
For those exploring structured weight-management support, clinically supervised programmes can help integrate nutrition, lifestyle, and medical considerations in a safe and evidence-informed way.
If you would like to learn more about medically supported weight-management options, SheMed offers personalised programmes designed to align with individual health goals. Eligibility assessment is available online to help determine whether a programme may be suitable.
References
- Holst, J. J. (2007). The physiology of glucagon-like peptide 1. Physiological Reviews, 87(4), 1409-1439. https://doi.org/10.1152/physrev.00034.2006
- Ratliff J, Leite JO, de Ogburn R, Puglisi MJ, VanHeest J, Fernandez ML. Consuming eggs for breakfast influences plasma glucose and ghrelin, while reducing energy intake during the next 24 hours in adult men. Nutrition Research. 2010 Feb 1;30(2):96-103.https://www.sciencedirect.com/science/article/abs/pii/S0271531710000035
- Li TY, Brennan AM, Wedick NM, Mantzoros C, Rifai N, Hu FB. Regular consumption of nuts is associated with a lower risk of cardiovascular disease in women with type 2 diabetes. The Journal of Nutrition. 2009 Jul 1;139(7):1333-8.https://www.sciencedirect.com/science/article/pii/S00223166
- Esposito K, Maiorino MI, Ciotola M, et al. Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: a randomised trial. Ann Intern Med. 2009;151(5):306-314. doi:10.7326/0003-4819-151-5-200909010-00004.
- Indarto D, Rochmah DN, Wiboworini B, Pratama YM, Wibowo YC. Effects of Vegetables Consumption Before Carbohydrates on Blood Glucose and GLP-1 Levels Among Diabetic Patients in Indonesia. Int J Prev Med. 2022;13:144. Published 2022 Nov 23. doi:10.4103/ijpvm.IJPVM_704_20
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