Received: 18 June 2026
Accepted: 12 October 2026
Published online: 30 October 2026
UDC: 616.379-008.64-085
DOI: 10.53511/pharmkaz.2026.5.5
Article type: Original Research Article
(Clinical Interventional Study)
TIME-DEPENDENT CHANGES IN CARDIOMETABOLIC MARKERS DURING A 24-WEEK STRUCTURED LIFESTYLE INTERVENTION IN ADULTS WITH TYPE 2 DIABETES
Viktoria Li1, Svetlana Kim2, Irina Kim2, Anna Bazarova1, Gulmira Zharmakhanova2
1“Astana Medical University”, Astana, Kazakhstan
2“West Kazakhstan Medical University”, Aktobe, Kazakhstan
Objective. To determine the optimal duration of a structured non-pharmacological program and evaluate its impact on glycemic control, metabolic parameters, and the stability of compensation in patients with type 2 diabetes mellitus (T2DM). The study focused on changes observed after 12 and 24 weeks of intervention.
Methods. A prospective, comparative, interventional study initially included 200 middle-aged patients (45–59 years) with compensated T2DM (HbA1c <7%), body mass index ≥26 kg/m², and metformin monotherapy. Participants were assigned to a main group (initial n=100), receiving a 24-week structured program of individualized dietary counseling, dosed physical activity using the valeokinetics method, and educational sessions alongside standard care, or a control group (initial n=100), receiving standard care (metformin, basic diet therapy, and optional physical therapy). Fasting glucose, HDL cholesterol, the atherogenicity coefficient, and systolic blood pressure (SBP) were assessed at baseline, 12 weeks, and 24 weeks. Results. After 12 weeks, the intervention group showed lower SBP (129.36 vs 133.03 mmHg; p=0.036) and fasting glucose (6.52 vs 6.73 mmol/L; p=0.007), together with higher HDL cholesterol (0.63 vs 0.56 mmol/L; p=0.015) compared with controls. After 24 weeks, a significant between-group difference in the atherogenicity coefficient was observed (9.30 vs 11.24; p=0.017); fasting glucose and HDL cholesterol also differed significantly (both p<0.001), while the between-group difference in SBP was not statistically significant (p=0.070). Discussion. The results suggest that the combined dietary, physical activity, and educational program may produce favorable changes in carbohydrate metabolism and individual cardiovascular risk markers as early as 12 weeks. The difference in the atherogenicity coefficient observed at 24 weeks is consistent with a possible later change in the lipid profile. However, comparisons at two follow-up time points cannot establish a minimum effective program duration or whether the benefits persist after the intervention ends.
Conclusions. A 24-week structured non-pharmacological program, combining diet therapy, dosed physical activity, and patient education, was associated with improvements in selected glycemic and lipid parameters in patients with compensated T2DM. Initial favorable differences were evident after 12 weeks, while a reduction in the atherogenicity coefficient relative to the control group was observed after 24 weeks. The findings support the potential value of longer-term integrated lifestyle interventions in diabetes management, although the optimal duration and long-term sustainability of the effects require further study.
Keywords: type 2 diabetes mellitus, non-pharmacological treatment, structured program, glycemic control, lipid profile, valeokinetics, duration of intervention.
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