Dr. G interviews Emmy winning journalist Kym Nicholas, CEO and co‑founder of the Global PAD Association, about peripheral arterial disease (PAD), its strong link to diabetes, common misdiagnoses, and why early vascular evaluation can prevent unnecessary amputations.

They discuss patient stories, systemic gaps in care, lifestyle interventions like supervised walking programs, global best practices, and resources to get help at padhelp.org.

In this episode of Diabetic Foot Files, Dr. G explores how existing medications — from metformin and insulin to statins, fentanyl, sildenafil, doxycycline and nitric oxide donors — are being repurposed to help heal stubborn diabetic foot ulcers. We review the biology behind each drug, early clinical evidence, and why topical formulations may offer targeted benefits with minimal systemic exposure.

Listeners will learn which agents show the strongest signals (topical insulin, topical metformin, topical statins), which remain promising but mixed (topical phenytoin), and how repurposed therapies fit as adjuncts to standard wound care rather than replacements. Practical takeaways include safety considerations, off-label use discussions, and the need for larger trials.

This episode explores new randomized evidence that semaglutide, a GLP-1 receptor agonist used for diabetes and weight loss, can improve walking distance and quality of life for people with type 2 diabetes and symptomatic peripheral arterial disease (PAD).

The landmark STRID trial showed median gains of about 26 meters (mean ~40 m) in walking distance over a year, along with better pain scores and daily function. Large real-world studies also suggest fewer PAD-related hospitalizations and amputations.

Benefits likely come from multiple effects: weight loss and improved glucose control, anti-inflammatory actions, better endothelial function and muscle metabolism, all combining to improve perfusion and exercise capacity.

Semaglutide is an adjunct to standard PAD care (exercise, smoking cessation, statins, antiplatelets, revascularization when needed). Common side effects include GI symptoms; monitor eye health, pancreatitis risk, and avoid use in patients with MEN2 or medullary thyroid cancer history.