{"id":6543,"date":"2019-04-05T00:39:07","date_gmt":"2019-04-04T17:39:07","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=6543"},"modified":"2019-04-09T00:42:01","modified_gmt":"2019-04-08T17:42:01","slug":"cac-thac-mac-tu-theo-doi-thuong-quy-benh-dai-thao-duong-type-2","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/cac-thac-mac-tu-theo-doi-thuong-quy-benh-dai-thao-duong-type-2\/","title":{"rendered":"C\u00e1c th\u1eafc m\u1eafc t\u1ef1 theo d\u00f5i th\u01b0\u1eddng quy b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2"},"content":{"rendered":"<h2>C\u1eadp nh\u1eadt h\u01b0\u1edbng d\u1eabn c\u1ee7a ADA v\u1ec1 c\u00e1c th\u1eafc m\u1eafc t\u1ef1 theo d\u00f5i th\u01b0\u1eddng quy b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2<\/h2>\n<p>H\u1eb1ng n\u0103m, Hi\u1ec7p h\u1ed9i \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng Hoa K\u1ef3(ADA) \u0111\u01b0a ra b\u1ea3n c\u1eadp nh\u1eadt h\u01b0\u1edbng d\u1eabn trong vi\u1ec7c qu\u1ea3n l\u00fd <strong>b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/strong> \u201cTi\u00eau chu\u1ea9n ch\u0103m s\u00f3c y t\u1ebf trong b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u2013 2019\u201d, xu\u1ea5t b\u1ea3n tr\u00ean Diabetes Care, bao g\u1ed3m 16 ph\u1ea7n, v\u1edbi ph\u1ea7n m\u1edbi d\u00e0nh ri\u00eang cho<strong> c\u00f4ng ngh\u1ec7 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/strong> Nhi\u1ec1u s\u1eeda \u0111\u1ed5i \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n trong su\u1ed1t qu\u00e1 tr\u00ecnh c\u1eadp nh\u1eadt c\u00e1c h\u01b0\u1edbng d\u1eabn, v\u1edbi c\u00e1c s\u1eeda \u0111\u1ed5i ch\u00ednh t\u1eadp trung v\u00e0o c\u1eadp nh\u1eadt c\u00e1c ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n, thay \u0111\u1ed5i trong qu\u1ea3n l\u00fd d\u01b0\u1ee3c l\u00fd c\u1ee7a b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 v\u00e0 t\u1ea7m quan tr\u1ecdng c\u1ee7a nh\u00f3m ch\u0103m s\u00f3c t\u00edch h\u1ee3p c\u0169ng nh\u01b0 s\u1edf th\u00edch c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<h2>C\u00f4ng ngh\u1ec7 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/h2>\n<p>Ph\u1ea7n c\u00f4ng ngh\u1ec7 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng m\u1edbi (Ph\u1ea7n 7) bao g\u1ed3m th\u00f4ng tin v\u1ec1 t\u1ef1 theo d\u00f5i \u0111\u01b0\u1eddng huy\u1ebft (SMBG) v\u00e0 m\u1ed9t \u0111\u00e1nh gi\u00e1 v\u1ec1 c\u00e1c thi\u1ebft b\u1ecb ph\u00e2n ph\u1ed1i insulin v\u00e0 m\u00e1y \u0111o \u0111\u01b0\u1eddng huy\u1ebft. Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng SMBG \u0111\u00e3 b\u1ecb thay \u0111\u1ed5i v\u1edbi tuy\u00ean b\u1ed1 cho r\u1eb1ng theo d\u00f5i th\u01b0\u1eddng quy \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng insulin s\u1ebd c\u00f3 l\u1ee3i \u00edch l\u00e2m s\u00e0ng h\u1ea1n ch\u1ebf.<\/p>\n<p>\u201c C\u00e1c d\u01b0\u1ee3c s\u0129 v\u00e0 c\u00e1c chuy\u00ean gia y t\u1ebf kh\u00e1c \u0111\u00e3 \u0111\u01b0\u1ee3c d\u1ea1y m\u1ed9t c\u00e1ch truy\u1ec1n th\u1ed1ng r\u1eb1ng SMBG l\u00e0 m\u1ed9t c\u00f4ng c\u1ee5 c\u00f3 gi\u00e1 tr\u1ecb trong vi\u1ec7c qu\u1ea3n l\u00fd b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng\u201d, theo Charles D. Ponte, BS, PharmD, BC-ADM, BCPS, CDE, CPE, FAPhA, gi\u00e1o s\u01b0 d\u01b0\u1ee3c l\u00e2m s\u00e0ng, y h\u1ecdc gia \u0111\u00ecnh t\u1ea1i \u0110\u1ea1i h\u1ecdc West Virginia \u1edf Morgantown.<\/p>\n<p>\u201cN\u00f3 c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 glucose trong th\u1eddi gian th\u1ef1c t\u1ebf v\u00e0 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 theo d\u00f5i s\u1ef1 hi\u1ec7u qu\u1ea3 c\u1ee7a m\u1ed9t k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb, c\u1ee7ng c\u1ed1 s\u1ef1 tu\u00e2n th\u1ee7 ho\u1eb7c kh\u00f4ng tu\u00e2n th\u1ee7 v\u1ec1 vi\u1ec7c \u0111i\u1ec1u ch\u1ec9nh l\u1ed1i s\u1ed1ng v\u00e0 c\u00e1c can thi\u1ec7p tr\u1ecb li\u1ec7u, v\u00e0 th\u1eadm ch\u00ed x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c c\u00e1c \u0111\u1ee3t h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft nghi ng\u1edd\u201d, \u00f4ng Ponte n\u00f3i.<\/p>\n<p>Ponte l\u01b0u \u00fd r\u1eb1ng gi\u00e1 tr\u1ecb c\u1ee7a SMBG l\u00e0 kh\u00f4ng c\u1ea7n ph\u1ea3i b\u00e0n c\u00e3i trong vi\u1ec7c qu\u1ea3n l\u00fd b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 1, nh\u01b0ng v\u1ecb tr\u00ed c\u1ee7a n\u00f3 trong b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 th\u00ec \u00edt r\u00f5 r\u00e0ng h\u01a1n. \u201cB\u1eb1ng ch\u1ee9ng m\u1edbi \u1ee7ng h\u1ed9 quan \u0111i\u1ec3m cho r\u1eb1ng SMBG c\u00f3 th\u1ec3 kh\u00f4ng c\u1ea7n thi\u1ebft v\u00e0 kh\u00f4ng ti\u1ebft ki\u1ec7m chi ph\u00ed \u1edf h\u1ea7u h\u1ebft nh\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t, kh\u00f4ng s\u1eed d\u1ee5ng insulin ho\u1eb7c d\u00f9ng thu\u1ed1c h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft b\u1eb1ng \u0111\u01b0\u1eddng u\u1ed1ng.\u201d<\/p>\n<h2>C\u00e1c s\u1eeda \u0111\u1ed5i quan tr\u1ecdng kh\u00e1c<\/h2>\n<p>Trong ph\u1ea7n ph\u00e2n lo\u1ea1i v\u00e0 ch\u1ea9n \u0111o\u00e1n (Ph\u1ea7n 2), ti\u00eau ch\u00ed ch\u1ea9n \u0111o\u00e1n b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u00e3 \u0111\u01b0\u1ee3c thay \u0111\u1ed5i \u0111\u1ec3 bao g\u1ed3m hai k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m b\u1ea5t th\u01b0\u1eddng t\u1eeb c\u00f9ng m\u1ed9t m\u1eabu ho\u1eb7c trong hai m\u1eabu ri\u00eang bi\u1ec7t, ch\u1eb3ng h\u1ea1n nh\u01b0 glucose huy\u1ebft t\u01b0\u01a1ng l\u00fac \u0111\u00f3i v\u00e0 A1C t\u1eeb c\u00f9ng m\u1ed9t m\u1eabu. Trong ph\u1ea7n \u0111\u00e1nh gi\u00e1 y t\u1ebf to\u00e0n di\u1ec7n v\u00e0 \u0111\u00e1nh gi\u00e1 c\u00e1c b\u1ec7nh k\u00e8m theo (Ph\u1ea7n 4), m\u1ed9t khuy\u1ebfn ngh\u1ecb m\u1edbi \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a ra \u0111\u1ec3 ch\u1ec9 ra t\u1ea7m quan tr\u1ecdng c\u1ee7a nh\u00f3m ch\u0103m s\u00f3c b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n<p>ADA l\u01b0u \u00fd r\u1eb1ng nh\u00f3m n\u00e0y n\u00ean bao g\u1ed3m c\u00e1c b\u00e1c s\u0129 ch\u0103m s\u00f3c ch\u00ednh, b\u00e1c s\u0129 chuy\u00ean s\u00e2u, y t\u00e1 th\u1ef1c h\u00e0nh, tr\u1ee3 l\u00fd b\u00e1c s\u0129, y t\u00e1, chuy\u00ean gia dinh d\u01b0\u1ee1ng, chuy\u00ean gia luy\u1ec7n t\u1eadp th\u1ec3 l\u1ef1c, d\u01b0\u1ee3c s\u0129, nha s\u0129, b\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh v\u1ec1 ch\u00e2n v\u00e0 chuy\u00ean gia s\u1ee9c kh\u1ecfe t\u00e2m th\u1ea7n. M\u1ed9t chu tr\u00ecnh quy\u1ebft \u0111\u1ecbnh \u0111\u1ec3 qu\u1ea3n l\u00fd \u0111\u01b0\u1eddng huy\u1ebft t\u1eadp trung v\u00e0o b\u1ec7nh nh\u00e2n trong b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 c\u0169ng \u0111\u01b0\u1ee3c th\u00eam v\u00e0o ph\u1ea7n n\u00e0y \u0111\u1ec3 nh\u1ea5n m\u1ea1nh t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c ra quy\u1ebft \u0111\u1ecbnh chung.<\/p>\n<p>Ph\u1ea7n 9, bao g\u1ed3m c\u00e1c ph\u01b0\u01a1ng ph\u00e1p d\u01b0\u1ee3c l\u00fd trong \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1eddng huy\u1ebft, \u0111\u00e3 thay \u0111\u1ed5i \u0111\u00e1ng k\u1ec3 \u0111\u1ec3 ki\u1ec3m so\u00e1t b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type2. ADA l\u01b0u \u00fd r\u1eb1ng c\u00e1c quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb n\u00ean xem x\u00e9t b\u1ec7nh \u0111i k\u00e8m c\u1ee7a b\u1ec7nh nh\u00e2n, nguy c\u01a1 h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft, c\u00e1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3, t\u00e1c d\u1ee5ng ph\u1ee5, chi ph\u00ed v\u00e0 s\u1edf th\u00edch c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<p>M\u1ed9t ch\u1ea5t ch\u1ee7 v\u1eadn th\u1ee5 th\u1ec3 peptide 1 gi\u1ed1ng glucagon m\u1edbi \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u00e0 l\u1ef1a ch\u1ecdn ban \u0111\u1ea7u tr\u01b0\u1edbc insulin \u1edf h\u1ea7u h\u1ebft c\u00e1c b\u1ec7nh nh\u00e2n c\u1ea7n d\u00f9ng thu\u1ed1c ti\u00eam \u0111\u1ec3 ki\u1ec3m so\u00e1t b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2. Nh\u1eefng thay \u0111\u1ed5i c\u0169ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n cho c\u00e1c ph\u1ea7n kh\u00e1c, bao g\u1ed3m ph\u1ea7n qu\u1ea3n l\u00fd l\u1ed1i s\u1ed1ng.<\/p>\n<h2>Khuy\u1ebfn c\u00e1o c\u00f3 gi\u00e1 tr\u1ecb<\/h2>\n<p>D\u01b0\u1ee3c s\u0129 l\u00e0 th\u00e0nh vi\u00ean ch\u1ee7 ch\u1ed1t c\u1ee7a nh\u00f3m ch\u0103m s\u00f3c b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 \u0111\u01b0\u1ee3c \u0111\u00e0o t\u1ea1o ph\u00f9 h\u1ee3p \u0111\u1ec3 gi\u00e1o d\u1ee5c b\u1ec7nh nh\u00e2n v\u1ec1 thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng, ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb d\u01b0\u1ee3c l\u00fd v\u00e0 s\u1ef1 ph\u00f9 h\u1ee3p c\u1ee7a SMBG, theo ADA.<\/p>\n<p>D\u01b0\u1ee3c s\u0129 c\u1ed9ng \u0111\u1ed3ng \u0111ang \u1edf m\u1ed9t v\u1ecb tr\u00ed \u0111\u1ed9c nh\u1ea5t \u201cv\u00ec kh\u00f4ng c\u00f3 nh\u00e0 cung c\u1ea5p y t\u1ebf n\u00e0o kh\u00e1c g\u1eb7p ng\u01b0\u1eddi m\u1eafc b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng th\u01b0\u1eddng xuy\u00ean h\u01a1n\u201d, \u00f4ng Ponte n\u00f3i. C\u00e1c d\u01b0\u1ee3c s\u0129 \u0111\u01b0\u1ee3c trang b\u1ecb \u0111\u1ec3 th\u1ea3o lu\u1eadn v\u1ec1 vai tr\u00f2 th\u00edch h\u1ee3p c\u1ee7a SMBG v\u1edbi b\u1ec7nh nh\u00e2n v\u00e0 c\u00e1c nh\u00e0 cung c\u1ea5p y t\u1ebf kh\u00e1c v\u00e0 ph\u1ee5c v\u1ee5 nh\u01b0 m\u1ed9t ngu\u1ed3n gi\u00e1o d\u1ee5c v\u1ec1 SMBG m\u1edbi nh\u1ea5t c\u0169ng nh\u01b0 c\u00f4ng ngh\u1ec7 theo d\u00f5i glucose li\u00ean t\u1ee5c. D\u01b0\u1ee3c s\u0129 c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c h\u01b0\u1edfng l\u1ee3i t\u1eeb SMBG, do \u0111\u00f3 gi\u00fap ti\u1ebft ki\u1ec7m chi ph\u00ed \u0111\u00e1ng k\u1ec3 cho b\u1ec7nh nh\u00e2n (ph\u1ea7n l\u1edbn chi ph\u00ed c\u1ee7a SMBG c\u00f3 li\u00ean quan \u0111\u1ebfn chi ph\u00ed c\u1ee7a que th\u1eed).<\/p>\n<p>T\u01b0\u01a1ng t\u1ef1 nh\u01b0 v\u1eady, d\u01b0\u1ee3c s\u0129 c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c h\u01b0\u1edfng l\u1ee3i t\u1eeb SMBG, \u0111\u00f3ng vai tr\u00f2 l\u00e0 ng\u01b0\u1eddi \u0111\u1ea5u tranh\/\u1ee7ng h\u1ed9 c\u1ee7a h\u1ecd, [v\u00e0] c\u1ee7ng c\u1ed1 k\u1ef9 thu\u1eadt ph\u00f9 h\u1ee3p, nhu c\u1ea7u l\u01b0u tr\u1eef h\u1ed3 s\u01a1 ch\u00ednh x\u00e1c v\u00e0 c\u00e1ch s\u1eed d\u1ee5ng x\u00e9t nghi\u1ec7m \u0111\u1ec3 b\u1ed5 sung v\u00e0o c\u00e1c chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb\u201d, Ponte n\u00f3i th\u00eam.<\/p>\n<p>Ng\u01b0\u1eddi d\u1ecbch: Tr\u1ea7n Th\u1ecb Thanh Ng\u00e2n \u2013 sinh vi\u00ean D\u01b0\u1ee3c \u2013 \u0110\u1ea1i h\u1ecdc Y khoa Ph\u1ea1m Ng\u1ecdc Th\u1ea1ch.<\/p>\n<p>Ng\u01b0\u1eddi hi\u1ec7u \u0111\u00ednh: D\u01b0\u1ee3c s\u0129 Nguy\u1ec5n Qu\u1ef3nh Anh, BVQT Ph\u01b0\u01a1ng Ch\u00e2u &#8211; Nh\u1ecbp C\u1ea7u D\u01b0\u1ee3c L\u00e2m S\u00e0ng.<\/p>\n<p>Ngu\u1ed3n t\u00e0i li\u1ec7u: Maria G.Tanzi (c\u1eadp nh\u1eadt l\u1ea7n cu\u1ed1i th\u00e1ng 3\/2019). Updated ADA guidelines question routine self-monitoring in type 2 diabetes. Link\u00a0<a href=\"https:\/\/www.pharmacytoday.org\/article\/S1042-0991(19)30237-3\/fulltext\" rel=\"noopener\">https:\/\/www.pharmacytoday.org\/article\/S1042-0991(19)30237-3\/fulltext<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>C\u1eadp nh\u1eadt h\u01b0\u1edbng d\u1eabn c\u1ee7a ADA v\u1ec1 c\u00e1c th\u1eafc m\u1eafc t\u1ef1 theo d\u00f5i th\u01b0\u1eddng quy b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 H\u1eb1ng n\u0103m, Hi\u1ec7p h\u1ed9i \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng Hoa K\u1ef3(ADA) \u0111\u01b0a ra b\u1ea3n c\u1eadp nh\u1eadt h\u01b0\u1edbng d\u1eabn trong vi\u1ec7c qu\u1ea3n l\u00fd b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. \u201cTi\u00eau chu\u1ea9n ch\u0103m s\u00f3c y t\u1ebf trong b\u1ec7nh \u0111\u00e1i th\u00e1o [&#8230;]\n","protected":false},"author":1,"featured_media":6545,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6543","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/6543","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=6543"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/6543\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/6545"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=6543"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=6543"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=6543"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}