{"id":20859,"date":"2023-04-18T13:58:06","date_gmt":"2023-04-18T06:58:06","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20859"},"modified":"2023-04-18T14:35:18","modified_gmt":"2023-04-18T07:35:18","slug":"phan-loai-dai-thao-duong-tren-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/phan-loai-dai-thao-duong-tren-lam-sang\/","title":{"rendered":"Ph\u00e2n lo\u1ea1i b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng tr\u00ean l\u00e2m s\u00e0ng"},"content":{"rendered":"<p><strong>B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 b\u1ec7nh do r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a, c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m t\u0103ng glucose huy\u1ebft m\u1ea1n t\u00ednh do khi\u1ebfm khuy\u1ebft v\u1ec1 ti\u1ebft insulin, v\u1ec1 t\u00e1c \u0111\u1ed9ng c\u1ee7a insulin, ho\u1eb7c c\u1ea3 hai. T\u0103ng glucose m\u1ea1n t\u00ednh trong th\u1eddi gian d\u00e0i g\u00e2y n\u00ean nh\u1eefng r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a carbohydrate, protide, lipide, g\u00e2y t\u1ed5n th\u01b0\u01a1ng \u1edf nhi\u1ec1u c\u01a1 quan kh\u00e1c nhau, \u0111\u1eb7c bi\u1ec7t \u1edf tim v\u00e0 m\u1ea1ch m\u00e1u, th\u1eadn, m\u1eaft, th\u1ea7n kinh.<\/strong><\/p>\n<h2><strong>1. C\u00e1c th\u1ec3 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng tr\u00ean l\u00e2m s\u00e0ng<\/strong><\/h2>\n<p><strong>1.1. Type 1:<\/strong><\/p>\n<ul>\n<li>T\u1ef1 mi\u1ec5n (1A)<\/li>\n<li>V\u00f4 c\u0103n (1B)<\/li>\n<\/ul>\n<p><strong>1.2. LADA: <\/strong>Type 1.5<\/p>\n<p><strong>1.3. Type 2<\/strong><\/p>\n<p><strong>1.4. Type 3C: <\/strong>Pancreatic Diabetes<\/p>\n<p><strong>1.5. \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng thai ngh\u00e9n (Gestational Diabetes)<\/strong><\/p>\n<p><strong>1.6. \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01a1n gen<\/strong><br \/>\n&#8211; MODY (Maturity Onset Diabetes of the Young)<br \/>\n&#8211; Neonatal Diabetes<\/p>\n<h2>2. \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type\u00a01<\/h2>\n<p>\u0110\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/cac-khang-tu-mien-trong-chan-doan-dai-thao-duong-tu-mien-dich-tiem-o-nguoi-lon-lada\/\">h\u1ee7y ho\u1ea1i t\u1ebf b\u00e0o beta c\u1ee7a \u0111\u1ea3o langherhans t\u1ee5y<\/a>( t\u1ef1 mi\u1ec5n ho\u1eb7c v\u00f4 c\u0103n) v\u00e0 thi\u1ebfu h\u1ee5t g\u1ea7n nh\u01b0 tuy\u1ec7t \u0111\u1ed1i insulin, v\u00ec th\u1ebf d\u1ec5 b\u1ecb nhi\u1ec5m toan ceton n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb<\/p>\n<p>B\u1ec7nh c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i nh\u01b0ng ch\u1ee7 y\u1ebfu \u1edf tr\u1ebb em v\u00e0 thanh thi\u1ebfu ni\u00ean c\u00f3 th\u1ec3 hay g\u1eb7p \u1edf ng\u01b0\u1eddi l\u1edbn<\/p>\n<p>\u0110\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 hi\u1ec7n di\u1ec7n kh\u00e1ng th\u1ec3 GAD65, kh\u00e1ng th\u1ec3 kh\u00e1ng t\u1ebf b\u00e0o \u0111\u1ea3o t\u1ee5y (ICA) hay kh\u00e1ng th\u1ec3 kh\u00e1ng insulin IAA, kh\u00e1ng th\u1ec3 kh\u00e1ng tyrosine phosphatse IA-2, IA-2B<\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter\" src=\"https:\/\/i.imgur.com\/fL947lI.png\" width=\"585\" height=\"429\" \/><\/p>\n<h2>3. \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type\u00a02<\/h2>\n<p><strong>\u0110\u1ecbnh ngh\u0129a:<\/strong> \u201c L\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft do thay \u0111\u1ed5i t\u1eeb \u0111\u1ec1 kh\u00e1ng Insulin chi\u1ebfm \u01b0u th\u1ebf, \u0111\u1ebfn giai \u0111o\u1ea1n thi\u1ebfu h\u1ee5t thi\u1ebfu h\u1ee5t Insulin chi\u1ebfm \u01b0u th\u1ebf&#8221;<\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter\" src=\"https:\/\/i.imgur.com\/fL947lI.png\" width=\"536\" height=\"393\" \/><\/p>\n<p><strong>Theo ADA 2023<\/strong><\/p>\n<p>\u0110T\u0110 type 2 l\u00e0 do ti\u1ebft insulin c\u1ee7a t\u1ebf b\u00e0o beta tuy\u1ebfn t\u1ee5y suy gi\u1ea3m d\u1ea7n tr\u00ean n\u1ec1n \u0111\u1ec1 kh\u00e1ng insulin v\u00e0 h\u1ed9i ch\u1ee9ng chuy\u1ec3n ho\u00e1<br \/>\n(American Association of Clinical Endocrinology Clinical Practice)<\/p>\n<p><strong>Guidelines:<\/strong><br \/>\n\u2022 \u0110\u1eb7c tr\u01b0ng b\u1edfi qu\u00e1 tr\u00ecnh b\u00e0i ti\u1ebft insulin c\u1ee7a t\u1ebf b\u00e0o beta tuy\u1ebfn t\u1ee5y b\u1ecb suy gi\u1ea3m v\u00e0 gi\u1ea3m nh\u1ea1y c\u1ea3m v\u1edbi insulin (g\u1ecdi l\u00e0 \u0111\u1ec1 kh\u00e1ng insulin).<br \/>\n\u2022 \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n trong nhi\u1ec1u n\u0103m, do \u0111\u00f3 t\u1ea5t c\u1ea3 ng\u01b0\u1eddi \u2265 35 tu\u1ed5i c\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ph\u1ea3i \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m t\u1ea7m so\u00e1t b\u1ec7nh.<br \/>\n\u2022 \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 l\u00e0 b\u1ec7nh do nhi\u1ec1u gen t\u00e1c \u0111\u1ed9ng, g\u00e2y ra t\u00ecnh tr\u1ea1ng thi\u1ebfu h\u1ee5t insulin v\u00e0 \u0111\u1ec1 kh\u00e1ng insulin \u1edf nhi\u1ec1u m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau\u2026 chi\u1ebfm 90% c\u00e1c tr\u01b0\u1eddng h\u1ee3p m\u1eafc b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<br \/>\n\u2022 Ph\u1ea7n l\u1edbn b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 c\u00f3 th\u1eeba c\u00e2n, b\u00e9o ph\u00ec hay c\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<br \/>\n\u2022 C\u01a1 ch\u1ebf g\u00e2y b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 ch\u1ee7 y\u1ebfu l\u00e0 do \u0111\u1ec1 kh\u00e1ng insulin \u0111\u1ed3ng th\u1eddi thi\u1ebfu h\u1ee5t insulin t\u01b0\u01a1ng \u0111\u1ed1i v\u00e0 r\u1ed1i lo\u1ea1n c\u01a1 ch\u1ebf \u0111i\u1ec1u h\u00f2a c\u1ee7a glucagon.<\/p>\n<h2><strong>4. \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01a1n gen\u00a0(MONOGENTIC DIABETES)<\/strong><\/h2>\n<p><strong>Kh\u00e1i ni\u1ec7m:<\/strong> L\u00e0 b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng do c\u00e1c r\u1ed1i lo\u1ea1n di truy\u1ec1n g\u00e2y ra, th\u01b0\u1eddng g\u1eb7p l\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng s\u01a1 sinh v\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng kh\u1edfi ph\u00e1t \u1edf tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh tr\u00ean ng\u01b0\u1eddi tr\u1ebb.<\/p>\n<h3><strong>&#8211; B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u1edf tr\u1ebb s\u01a1 sinh tr\u00ean l\u00e2m s\u00e0ng<\/strong><\/h3>\n<p>B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng x\u1ea3y ra d\u01b0\u1edbi 6 th\u00e1ng tu\u1ed5i \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u201cs\u01a1 sinh\u201d ho\u1eb7c \u201cb\u1ea9m sinh\u201d, v\u00e0 kho\u1ea3ng 80\u201385% c\u00e1c tr\u01b0\u1eddng h\u1ee3p nguy\u00ean nh\u00e2n l\u00e0 do \u0111\u01a1n gen, c\u00f3 th\u1ec3 tho\u00e1ng qua ho\u1eb7c v\u0129nh vi\u1ec5n.<\/p>\n<p>B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng s\u01a1 sinh tho\u00e1ng qua th\u01b0\u1eddng l\u00e0 do bi\u1ec3u hi\u1ec7n qu\u00e1 m\u1ee9c c\u1ee7a c\u00e1c gen tr\u00ean nhi\u1ec5m s\u1eafc th\u1ec3 6q24, b\u1ec7nh t\u00e1i ph\u00e1t trong kho\u1ea3ng m\u1ed9t n\u1eeda s\u1ed1 tr\u01b0\u1eddng h\u1ee3p v\u00e0 c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c b\u1eb1ng c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c ngo\u00e0i insulin.<\/p>\n<p>B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng s\u01a1 sinh v\u0129nh vi\u1ec5n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 do \u0111\u1ed9t bi\u1ebfn gen tr\u1ed9i t\u1ef1 ph\u00e1t trong c\u00e1c gen m\u00e3 h\u00f3a ti\u1ec3u \u0111\u01a1n v\u1ecb Kir6.2 (KCNJ11) v\u00e0 ti\u1ec3u \u0111\u01a1n v\u1ecb SUR1 (ABCC8) c\u1ee7a k\u00eanh KATP t\u1ebf b\u00e0o beta. \u0110\u1ed9t bi\u1ebfn gen insulin (INS) l\u00e0 nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn th\u1ee9 hai g\u00e2y ra b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u0129nh vi\u1ec5n \u1edf tr\u1ebb s\u01a1 sinh. \u0110i\u1ec1u tr\u1ecb b\u1eb1ng ph\u00e1c \u0111\u1ed3 insulin t\u00edch c\u1ef1c hi\u1ec7n l\u00e0 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u01b0u ti\u00ean, c\u1ea7n \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n v\u1ec1 di truy\u1ec1n, v\u00ec h\u1ea7u h\u1ebft c\u00e1c \u0111\u1ed9t bi\u1ebfn g\u00e2y ra b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 di truy\u1ec1n tr\u1ed9i.<\/p>\n<p><strong>&#8211; B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng kh\u1edfi ph\u00e1t \u1edf tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh tr\u00ean ng\u01b0\u1eddi tr\u1ebb (MODY)<\/strong><\/p>\n<p>MODY th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 kh\u1edfi \u0111\u1ea7u c\u1ee7a t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft \u1edf \u0111\u1ed9 tu\u1ed5i s\u1edbm (\u0111a s\u1ed1 tr\u01b0\u1edbc 25 tu\u1ed5i) v\u00e0 s\u1ef1 gi\u1ea3m ti\u1ebft insulin, trong khi ch\u1ee9c n\u0103ng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a insulin kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng ( kh\u00f4ng c\u00f3 b\u00e9o ph\u00ec \u0111i k\u00e8m).<br \/>\nB\u1ec7nh di truy\u1ec1n theo ki\u1ec3u tr\u1ed9i c\u1ee7a NST, c\u00f3 \u00edt nh\u1ea5t 13 gen b\u1ea5t th\u01b0\u1eddng tr\u00ean c\u00e1c nhi\u1ec5m s\u1eafc th\u1ec3 kh\u00e1c nhau.<br \/>\nC\u00e1c ki\u1ec3u ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 GCK-MODY (MODY2), HNF1A-MODY (MODY3) v\u00e0 HNF4A- MODY (MODY1).<\/p>\n<h3><strong>Ch\u1ea9n \u0111o\u00e1n:<\/strong><\/h3>\n<p>\u2022 B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n trong v\u00f2ng 6 th\u00e1ng \u0111\u1ea7u \u0111\u1eddi.<br \/>\n\u2022 B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng kh\u00f4ng c\u00f3 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m \u0111i\u1ec3n h\u00ecnh c\u1ee7a b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 1 ho\u1eb7c type 2 (c\u00e1c t\u1ef1 kh\u00e1ng th\u1ec3 li\u00ean quan \u0111\u1ebfn b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u00e2m t\u00ednh, kh\u00f4ng b\u00e9o ph\u00ec, thi\u1ebfu c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m chuy\u1ec3n h\u00f3a kh\u00e1c, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh m\u1eafc b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng r\u00f5 r\u00e0ng).<br \/>\n\u2022 T\u0103ng \u0111\u01b0\u1eddng huy\u1ebft l\u00fac \u0111\u00f3i nh\u1eb9, \u1ed5n \u0111\u1ecbnh (100\u2013150 mg\/dL [5,5\u20138,5 mmol\/L]), c\u00f3 HbA1C \u1ed5n \u0111\u1ecbnh t\u1eeb 5,6% \u0111\u1ebfn 7,6% (t\u1eeb 38 \u0111\u1ebfn 60 mmol\/mol), \u0111\u1eb7c bi\u1ec7t n\u1ebfu kh\u00f4ng b\u00e9o ph\u00ec.<\/p>\n<p><strong>C\u00e1c khuy\u1ebfn c\u00e1o m\u1edbi c\u1ee7a ADA 2023:<\/strong><\/p>\n<p>\u2022 M\u1ed9t \u0111\u1ee9a tr\u1ebb s\u01a1 sinh d\u01b0\u1edbi 6 th\u00e1ng tu\u1ed5i v\u00e0 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng th\u00ec c\u1ea7n ph\u1ea3i cho l\u00e0m x\u00e9t nghi\u1ec7m Gene \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng s\u01a1 sinh ho\u1eb7c g\u1ee3i \u00fd \u0111\u1ee9a tr\u1ebb n\u00e0y sang m\u1ed9t chuy\u00ean gia t\u01b0 v\u1ea5n di truy\u1ec1n (B\u1eb1ng ch\u1ee9ng A)<br \/>\n\u2022 Nh\u1eefng \u0111\u1ee9a tr\u1ebb v\u00e0 ng\u01b0\u1eddi l\u1edbn, n\u1ebfu \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u0110T\u0110 type 1 or 2 nh\u01b0ng m\u00e0 kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u \u0111i\u1ec3n h\u00ecnh c\u1ee7a 2 b\u1ec7nh l\u00fd tr\u00ean v\u00e0 \u0111\u1eb7c bi\u1ec7t n\u1ebfu h\u1ecd c\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh b\u1ecb \u0110T\u0110 qua nhi\u1ec1u th\u1ebf h\u1ec7 (kh\u1ea3 n\u0103ng di truy\u1ec1n tr\u1ed9i tr\u00ean NST th\u01b0\u1eddng). Th\u00ec nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng tr\u00ean c\u0169ng c\u1ea7n cho l\u00e0m x\u00e9t nghi\u1ec7m Gene ho\u1eb7c chuy\u1ec3n sang chuy\u00ean gia t\u01b0 v\u1ea5n di truy\u1ec1n \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n \u0110T\u0110 th\u1ec3 MODY (B\u1eb1ng ch\u1ee9ng A)<\/p>\n<h2><strong>5. \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng thai k\u1ef3<\/strong><\/h2>\n<p>\u0110T\u0110 thai k\u1ef3: \u0110T\u0110 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0o qu\u00fd 2 ho\u1eb7c qu\u00fd 3 c\u1ee7a thai k\u1ef3 m\u00e0 ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh tr\u01b0\u1edbc khi mang thai, th\u01b0\u1eddng s\u1ebd bi\u1ebfn m\u1ea5t sau th\u1eddi k\u1ef3 h\u1eadu s\u1ea3n<\/p>\n<h3><strong>S\u00e0ng l\u1ecdc v\u00e0 ch\u1ea9n \u0111o\u00e1n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng thai k\u1ef3<\/strong><\/h3>\n<p>Quy tr\u00ecnh m\u1ed9t b\u01b0\u1edbc:<br \/>\n\u2022 Th\u1ef1c hi\u1ec7n nghi\u1ec7m ph\u00e1p dung n\u1ea1p glucose \u0111\u01b0\u1eddng u\u1ed1ng v\u1edbi 75g glucose l\u00fac \u0111\u00f3i, \u0111o glucose m\u00e1u \u0111\u00f3i, sau 1h v\u00e0 2h l\u00e0m l\u1ea1i nghi\u1ec7m ph\u00e1p, t\u1ea1i tu\u1ea7n thai 24-28 \u1edf thai ph\u1ee5 ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u0110T\u0110 tr\u01b0\u1edbc \u0111\u00f3<br \/>\n\u2022 Nghi\u1ec7m ph\u00e1p dung n\u1ea1p glucose \u0111\u01b0\u1eddng u\u1ed1ng n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u00e0o bu\u1ed5i s\u00e1ng sau khi nh\u1ecbn \u0103n \u00edt nh\u1ea5t 8h<br \/>\n\u2022 Ch\u1ea9n \u0111o\u00e1n \u0110T\u0110 thai k\u1ef3 khi c\u00f3 \u00edt nh\u1ea5t 1 trong c\u00e1c ti\u00eau chu\u1ea9n sau: G0 \u2265 92 mg\/dl (5,1 mmol\/l), G1 \u2265 180 mg\/dl (10 mmol\/l), G2 \u2265 153 mg\/dl (8,5 mmol\/l)<\/p>\n<p><strong>Quy tr\u00ecnh hai b\u01b0\u1edbc:<\/strong><br \/>\n\u2022 B\u01b0\u1edbc 1: Th\u1ef1c hi\u1ec7n nghi\u1ec7m ph\u00e1p dung n\u1ea1p glucose \u0111\u01b0\u1eddng u\u1ed1ng v\u1edbi 50g glucose t\u1ea1i th\u1eddi \u0111i\u1ec3m b\u1ea5t k\u00ec, \u0111o glucose sau 1h l\u00e0m nghi\u1ec7m ph\u00e1p, t\u1ea1i tu\u1ea7n thai 24-28 \u1edf thai ph\u1ee5 ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u0110T\u0110 tr\u01b0\u1edbc \u0111\u00f3. N\u1ebfu gi\u00e1 tr\u1ecb tr\u00ean \u0111o \u0111\u01b0\u1ee3c \u2265 130; 135 ho\u1eb7c 140 mg\/dl (7,2; 7,5 ho\u1eb7c 7,8 mmol\/l), ti\u1ebfp t\u1ee5c ti\u1ebfn th\u00e0nh NPDN glucose u\u1ed1ng 100g l\u00fac \u0111\u00f3i \u1edf b\u01b0\u1edbc 2<br \/>\n\u2022 B\u01b0\u1edbc 2: Ch\u1ea9n \u0111o\u00e1n \u0110T\u0110 thai k\u1ef3 khi c\u00f3 \u00edt nh\u1ea5t 2 trong 4 gi\u00e1 tr\u1ecb glucose m\u00e1u \u0111\u00f3i (sau 1h, 2h, 3h, 4h l\u00e0m nghi\u1ec7m ph\u00e1p) \u0111\u1ea1t ti\u00eau chu\u1ea9n (ti\u00eau chu\u1ea9n Carpenter &#8211; Coustan):<br \/>\n\u2022 G0 \u2265 95 mg\/dl (5,3 mmol\/l)<br \/>\n\u2022 G1 \u2265 180 mg\/dl (10 mmol\/l)<br \/>\n\u2022 G2 \u2265 155 mg\/dl (8,6 mmol\/l)<br \/>\n\u2022 G3 \u2265 140 mg\/dl (7,8 mmol\/l)<\/p>\n<p><strong>Ngu\u1ed3n Tham kh\u1ea3o<\/strong><br \/>\n1. Gi\u00e1o tr\u00ecnh b\u1ec7nh h\u1ecdc N\u1ed9i khoa 2019, NXB \u0110\u1ea1i h\u1ecdc Hu\u1ebf<br \/>\n2. ADA 2023<br \/>\n3. H\u01b0\u1edbng d\u1eabn\u00a0ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng &#8211; B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 b\u1ec7nh do r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a, c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m t\u0103ng glucose huy\u1ebft m\u1ea1n t\u00ednh do khi\u1ebfm khuy\u1ebft v\u1ec1 ti\u1ebft insulin, v\u1ec1 t\u00e1c \u0111\u1ed9ng c\u1ee7a insulin, ho\u1eb7c c\u1ea3 hai. T\u0103ng glucose m\u1ea1n t\u00ednh trong th\u1eddi gian d\u00e0i g\u00e2y n\u00ean nh\u1eefng r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a carbohydrate, protide, lipide, g\u00e2y t\u1ed5n th\u01b0\u01a1ng \u1edf [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[80,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ph\u00e2n lo\u1ea1i b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng tr\u00ean l\u00e2m s\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng tr\u00ean l\u00e2m s\u00e0ng l\u00e0 b\u1ec7nh do r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a, c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m t\u0103ng glucose huy\u1ebft m\u1ea1n t\u00ednh do khi\u1ebfm khuy\u1ebft v\u1ec1 ti\u1ebft insulin,\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ph\u00e2n lo\u1ea1i b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng tr\u00ean l\u00e2m s\u00e0ng - 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