{"id":30604,"date":"2023-05-02T15:08:51","date_gmt":"2023-05-02T08:08:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30604"},"modified":"2023-05-02T15:09:16","modified_gmt":"2023-05-02T08:09:16","slug":"quan-ly-tang-glucose-mau-o-benh-nhan-noi-tru-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/02\/quan-ly-tang-glucose-mau-o-benh-nhan-noi-tru-bo-y-te\/","title":{"rendered":"Qu\u1ea3n l\u00fd t\u0103ng glucose m\u00e1u \u1edf b\u1ec7nh nh\u00e2n n\u1ed9i tr\u00fa \u2013 B\u1ed9 Y t\u1ebf"},"content":{"rendered":"<p><strong>\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 b\u1ec7nh t\u0103ng glucose m\u00e1u suy gi\u1ea3m b\u00e0i ti\u1ebft insulin v\u00e0 n\u1ed3ng \u0111\u1ed9 s\u1ef1 \u0111\u1ec1 kh\u00e1ng insulin ngo\u1ea1i vi thay \u0111\u1ed5i d\u1eabn \u0111\u1ebfn t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft. Tri\u1ec7u ch\u1ee9ng s\u1edbm li\u00ean quan t\u1edbi t\u0103ng glucose m\u00e1u v\u00e0 bao g\u1ed3m u\u1ed1ng nhi\u1ec1u, kh\u00e1t nhi\u1ec1u, ti\u1ec3u nhi\u1ec1u v\u00e0 nh\u00ecn m\u1edd. Bi\u1ebfn ch\u1ee9ng mu\u1ed9n g\u1ed3m b\u1ec7nh m\u1ea1ch m\u00e1u, b\u1ec7nh th\u1ea7n kinh ngo\u1ea1i vi, b\u1ec7nh th\u1eadn v\u00e0 d\u1ec5 nhi\u1ec5m khu\u1ea9n.\u00a0<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-30605 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/ImageForNews_733883_16711528404605542-300x167.webp\" alt=\"tang-glucose-mau\" width=\"300\" height=\"167\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/ImageForNews_733883_16711528404605542-300x167.webp 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/ImageForNews_733883_16711528404605542-1024x570.webp 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/ImageForNews_733883_16711528404605542-768x427.webp 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/ImageForNews_733883_16711528404605542-1536x855.webp 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/ImageForNews_733883_16711528404605542.webp 2000w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h2>1. M\u1ee5c ti\u00eau<\/h2>\n<ul>\n<li>M\u1ee5c ti\u00eau glucose m\u00e1u t\u1eeb 7,8 &#8211; 10,0 mmol\/L (140 &#8211; 180 mg\/dL) \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho \u0111a s\u1ed1 b\u1ec7nh nh\u00e2n.<\/li>\n<li>M\u1ee5c ti\u00eau glucose m\u00e1u t\u00edch c\u1ef1c h\u01a1n t\u1eeb 6,1 &#8211; 7,8 mmol\/L (110 &#8211; 140 mg\/dL) cho b\u1ec7nh nh\u00e2n tr\u1ebb n\u1ebfu c\u00f3 th\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee5c ti\u00eau n\u00e0y m\u00e0 kh\u00f4ng c\u00f3 h\u1ea1 \u0110H \u0111\u00e1ng k\u1ec3.<\/li>\n<\/ul>\n<h2>2. Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb t\u0103ng glucose m\u00e1u cho b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh nguy k\u1ecbch<\/h2>\n<ul>\n<li>Truy\u1ec1n insulin t\u0129nh m\u1ea1ch l\u00e0 ph\u01b0\u01a1ng ph\u00e1p l\u1ef1a ch\u1ecdn \u0111\u1ec3 ki\u1ec3m so\u00e1t glucose m\u00e1u \u1edf b\u1ec7nh nh\u00e2n c\u00f3 t\u0103ng glucose m\u00e1u v\u00e0 t\u00ecnh tr\u1ea1ng nguy k\u1ecbch. S\u1eed d\u1ee5ng insulin nhanh, truy\u1ec1n b\u01a1m ti\u00eam \u0111i\u1ec7n (pha v\u1edbi dung d\u1ecbch natri clorua \u0111 ng tr\u01b0\u01a1ng \u0111\u1ec3 \u0111\u01b0\u1ee3c n\u1ed3ng \u0111\u1ed9 insulin 1 IU\/mL).<\/li>\n<li>C\u1ea7n c\u00f3 ph\u00e1c \u0111\u1ed3 truy\u1ec1n insulin t\u0129nh m\u1ea1ch tr\u00ean gi\u1ea5y ho\u1eb7c vi t\u00ednh h\u00f3a \u0111\u1ec3 th\u1ef1c hi\u1ec7n cho thu\u1eadn ti\u1ec7n.<\/li>\n<li>\u0110o glucose m\u00e1u mao m\u1ea1ch m\u1ed7i gi\u1edd l\u00fac b\u1eaft \u0111\u1ea7u, c\u00f3 th\u1ec3 gi\u1ea3m xu\u1ed1ng 2 gi\u1edd m\u1ed9t l\u1ea7n n\u1ebfu glucose m\u00e1u \u1ed5n trong trong kho\u1ea3ng m\u1ee5c ti\u00eau. L\u01b0u \u00fd nh\u1eefng y\u1ebfu t\u1ed1 g\u00e2y sai s\u1ed1 k\u1ebft qu\u1ea3 \u0111o glucose huy\u1ebft mao m\u1ea1ch. C\u00e1c m\u00e1y \u0111o Glucose (G) m\u00e1u mao m\u1ea1ch s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p glucose oxidase (v\u00ed d\u1ee5 One Touch): cho k\u1ebft qu\u1ea3 Glucose m\u00e1u t\u0103ng gi\u1ea3 n\u1ebfu BN b\u1ecb thi\u1ebfu oxy, v\u00e0 cho k\u1ebft qu\u1ea3 Glucose m\u00e1u gi\u1ea3m gi\u1ea3 n\u1ebfu n\u1ed3ng \u0111\u1ed9 acetaminophen t\u0103ng cao trong m\u00e1u.<\/li>\n<\/ul>\n<p>C\u00e1c m\u00e1y \u0111o <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/do-duong-mau-mao-mach-chi-dinh-va-chong-chi-dinh\/\">Glucose m\u00e1u mao m\u1ea1ch<\/a> s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p glucose dehydrogenase cho k\u1ebft qu\u1ea3 ch\u00ednh x\u00e1c h\u01a1n khi BN b\u1ecb thi\u1ebfu oxy, nh\u01b0ng s\u1ebd cho k\u1ebft qu\u1ea3 G m\u00e1u gi\u1ea3m gi\u1ea3 n\u1ebfu BN \u0111ang s\u1eed d\u1ee5ng dopamin chuy\u1ec1n t\u0129nh m\u1ea1ch ho\u1eb7c cho k\u1ebft qu\u1ea3 G m\u00e1u t\u0103ng gi\u1ea3 n\u1ebfu n\u1ed3ng \u0111\u1ed9 acetaminophen t\u0103ng cao trong m\u00e1u. Nh\u1eefng BN suy th\u1eadn m\u1ea1n \u0111\u01b0\u1ee3c l\u1ecdc m\u00e0ng b\u1ee5ng li\u00ean t\u1ee5c ngo\u1ea1i tr\u00fa: trong d\u1ecbch l\u1ecdc c\u00f3 icodextrin, ch\u1ea5t n\u00e0y \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a d\u1ea7n th\u00e0nh maltose d\u1eabn \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 maltose t\u0103ng cao trong m\u00e1u \u0111\u1ebfn 2 tu\u1ea7n sau l\u1ea7n l\u1ecdc m\u00e0ng b\u1ee5ng cu\u1ed1i c\u00f9ng; n\u1ebfu BN d\u00f9ng m\u00e1y \u0111o G mao m\u1ea1ch s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p glucose dehydrogenase, m\u00e1y s\u1ebd x\u00e1c \u0111\u1ecbnh nh\u1ea7m maltose th\u00e0nh glucose d\u1eabn \u0111\u1ebfn k\u1ebft qu\u1ea3 G m\u00e1u t\u0103ng gi\u1ea3.<\/p>\n<p>T\u1ea1i c\u00e1c Khoa Ch\u0103m s\u00f3c t\u00edch c\u1ef1c, ph\u00f2ng ph\u1eabu thu\u1eadt: s\u1ef1 thay \u0111\u1ed5i Hct, pH m\u00e1u, SaO<sub>2<\/sub>, s\u1ed1t, m\u1ea5t n\u01b0\u1edbc v\u00e0 t\u00ecnh tr\u1ea1ng nhi\u1ec5m ceton \u0111\u1ec1u \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn k\u1ebft qu\u1ea3 G mao m\u1ea1ch.<\/p>\n<p>Tr\u01b0\u1eddng h\u1ee3p c\u00f3 suy tu\u1ea7n ho\u00e0n, nh\u1ea5t l\u00e0 khi c\u00f3 nhi\u1ec5m toan hay s\u1ed1c gi\u1ea3m th\u1ec3 t\u00edch l\u00e0m thay \u0111\u1ed5i l\u01b0u l\u01b0\u1ee3ng m\u00e1u mao m\u1ea1ch d\u1eabn \u0111\u1ebfn k\u1ebft qu\u1ea3 G mm kh\u00f4ng ch\u00ednh x\u00e1c.<\/p>\n<p>N\u1ebfu s\u00e1t tr\u00f9ng ng\u00f3n tay kh\u00f4ng \u0111\u00fang c\u00e1ch tr\u01b0\u1edbc khi l\u1ea5y m\u00e1u: k\u1ebft qu\u1ea3 G m\u00e1u c\u00f3 th\u1ec3 cao h\u01a1n 35%, n\u1ebfu kh\u00f4ng \u0111\u1ec3 ng\u00f3n tay kh\u00f4 ho\u00e0n to\u00e0n: k\u1ebft qu\u1ea3 G m\u00e1u c\u00f3 th\u1ec3 th\u1ea5p h\u01a1n 25%.<\/p>\n<ul>\n<li>Trong tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd, c\u1ea7n \u0111o glucose huy\u1ebft t\u01b0\u01a1ng t\u0129nh m\u1ea1ch \u0111\u1ec3 \u0111\u1ed1i chi\u1ebfu.<\/li>\n<li>C\u0103n c\u1ee9 k\u1ebft qu\u1ea3 glucose m\u00e1u mao m\u1ea1ch \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh t\u1ed1c \u0111\u1ed9 truy\u1ec1n insulin.<\/li>\n<li>Th\u00eam insulin nhanh v\u00e0o d\u1ecbch truy\u1ec1n nu\u00f4i d\u01b0\u1ee1ng v\u1edbi li\u1ec1u 1 IU\/15 g carbohydrat. N\u1ebfu b\u1ec7nh nh\u00e2n \u0103n (qua sonde) ti\u00eam th\u00eam insulin nhanh d\u01b0\u1edbi da tr\u01b0\u1edbc \u0103n v\u1edbi li\u1ec1u 1 IU\/15 g carbohydrat.<\/li>\n<li>X\u1eed l\u00fd khi c\u00f3 glucose m\u00e1u th\u1ea5p &lt; 5,6 mmol\/L (100 mg\/dL):<\/li>\n<\/ul>\n<p>&#8211;\u00a0Ng\u1eebng truy\u1ec1n insulin v\u00e0 \u0111o glucose m\u00e1u m\u1ed7i 15 ph\u00fat cho \u0111\u1ebfn khi glucose m\u00e1u &gt; 6,0 mmol\/L (126 mg\/dL) th\u00ec \u0111o m\u1ed7i gi\u1edd 1 l\u1ea7n.<\/p>\n<p>&#8211;\u00a0Khi glucose m\u00e1u &lt; 3,9 mmol\/L (70 mg\/dL): ti\u00eam t\u0129nh m\u1ea1ch dung d\u1ecbch glucose \u01b0u tr\u01b0\u01a1ng li\u1ec1u 12,5 &#8211; 25g glucose.<\/p>\n<p>&#8211;\u00a0Sau khi glucose m\u00e1u \u2265 7,8 mmol\/L (140 mg\/dL): \u0111\u1ee3i th\u00eam 30 ph\u00fat r\u1ed3i b\u1eaft \u0111\u1ea7u truy\u1ec1n l\u1ea1i insulin t\u0129nh m\u1ea1ch v\u1edbi t\u1ed1c \u0111\u1ed9 b\u1eb1ng 50 &#8211; 75% t\u1ed1c \u0111\u1ed9 tr\u01b0\u1edbc khi ng\u1eebng insulin.<\/p>\n<ul>\n<li>Chuy\u1ec3n sang ph\u00e1c \u0111\u1ed3 ti\u00eam insulin d\u01b0\u1edbi da n\u1ec1n &#8211; nhanh\/ph\u00f3ng (basal &#8211; bolus)<\/li>\n<\/ul>\n<p>&#8211;\u00a0Khi b\u1ec7nh nh\u00e2n qua kh\u1ecfi t\u00ecnh tr\u1ea1ng nguy k\u1ecbch, glucose m\u00e1u \u1ed5n \u0111\u1ecbnh v\u00e0 c\u00f3 th\u1ec3 \u0103n \u0111\u01b0\u1ee3c.<\/p>\n<p>&#8211;\u00a0C\u1ea7n ti\u00eam insulin d\u01b0\u1edbi da \u00edt nh\u1ea5t 2 &#8211; 4 gi\u1edd tr\u01b0\u1edbc khi ng\u1eebng truy\u1ec1n insulin t\u0129nh m\u1ea1ch.<\/p>\n<p>&#8211;\u00a0T\u1ed5ng li\u1ec1u insulin d\u01b0\u1edbi da\/ng\u00e0y = 60 &#8211; 80% nhu c\u1ea7u insulin trong 24h t\u00ednh t\u1eeb t\u1ed5ng li\u1ec1u insulin d\u00f9ng trong 6 &#8211; 8h ngay tr\u01b0\u1edbc \u0111\u00f3, ph\u00e2n b\u1ed1 insulin n\u1ec1n v\u00e0 insulin nhanh nh\u01b0 trong ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n n\u1eb7ng d\u01b0\u1edbi \u0111\u00e2y.<\/p>\n<h2>3. Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb t\u0103ng glucose m\u00e1u \u1edf b\u1ec7nh nh\u00e2n n\u1eb7ng kh\u00f4ng nguy k\u1ecbch<\/h2>\n<ul>\n<li>\u0110i\u1ec1u tr\u1ecb b\u1eb1ng insulin b\u1eaft \u0111\u1ea7u khi c\u00f3 glucose m\u00e1u \u2265 10,0 mmol\/L (180 mg\/dL) l\u1eb7p l\u1ea1i.<\/li>\n<li>Ch\u1ebf \u0111\u1ed9 insulin n\u1ec1n &#8211; nhanh (ti\u00eam d\u01b0\u1edbi da) l\u00e0 l\u1ef1a ch\u1ecdn \u0111\u1ec3 ki\u1ec3m so\u00e1t glucose m\u00e1u \u1edf b\u1ec7nh nh\u00e2n c\u00f3 t\u0103ng glucose m\u00e1u k\u00e8m b\u1ec7nh n\u1eb7ng kh\u00f4ng nguy k\u1ecbch, insulin tr\u1ed9n kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng th\u01b0\u1eddng quy do t\u0103ng nguy c\u01a1 h\u1ea1 glucose huy\u1ebft.<\/li>\n<li>C\u1ea7n c\u00f3 ph\u00e1c \u0111\u1ed3 truy\u1ec1n insulin t\u0129nh m\u1ea1ch tr\u00ean gi\u1ea5y ho\u1eb7c vi t\u00ednh h\u00f3a \u0111\u1ec3 th\u1ef1c hi\u1ec7n cho thu\u1eadn ti\u1ec7n.<\/li>\n<li>Theo d\u00f5i glucose m\u00e1u: \u0111o glucose m\u00e1u (mao m\u1ea1ch) l\u00fac \u0111\u00f3i bu\u1ed5i s\u00e1ng, tr\u01b0\u1edbc m\u1ed7i l\u1ea7n ti\u00eam insulin nhanh v\u00e0 khi nghi ng\u1edd c\u00f3 h\u1ea1 glucose m\u00e1u.<\/li>\n<li>Insulin n\u1ec1n: s\u1eed d\u1ee5ng insulin t\u00e1c d\u1ee5ng trung gian NPH ho\u1eb7c insulin t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i (glargine, detemir, Degludec).<\/li>\n<li>Insulin nhanh (bolus): s\u1eed d\u1ee5ng insulin nhanh ng\u01b0\u1eddi ho\u1eb7c insulin nhanh analog (aspart, glulisine, lispro), bao g\u1ed3m 2 th\u00e0nh ph\u1ea7n:<\/li>\n<\/ul>\n<p>&#8211;\u00a0Insulin dinh d\u01b0\u1ee1ng cho b\u1ec7nh nh\u00e2n \u0103n qua mi\u1ec7ng t\u1eebng b\u1eefa.<\/p>\n<p>&#8211;\u00a0Insulin hi\u1ec7u ch\u1ec9nh: li\u1ec1u ph\u1ee5 thu\u1ed9c m\u1ee9c glucose m\u00e1u tr\u01b0\u1edbc khi ti\u00eam.<\/p>\n<ul>\n<li>\u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n \u0110T\u0110 t\u00edp 1, \u0110T\u0110 t\u00edp 2 \u0111i\u1ec1u tr\u1ecb insulin v\u00e0\/ho\u1eb7c ki\u1ec3m so\u00e1t glucose m\u00e1u k\u00e9m, t\u0103ng glucose m\u00e1u m\u1edbi ph\u00e1t hi\u1ec7n:<\/li>\n<\/ul>\n<p>&#8211;\u00a0N\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng \u0103n\/nu\u00f4i d\u01b0\u1ee1ng qua mi\u1ec7ng:<\/p>\n<p>*\u00a0Insulin n\u1ec1n li\u1ec1u d\u00f9ng \u1edf nh\u00e0 tr\u01b0\u1edbc \u0111\u00f3 ho\u1eb7c 0,2 &#8211; 0,3 IU\/kg c\u00e2n n\u1eb7ng, chia 2 l\u1ea7n\/24 gi\u1edd v\u1edbi insulin NPH, 1-2 l\u1ea7n\/24 gi\u1edd v\u1edbi insulin detemir v\u00e0 1 l\u1ea7n\/24 gi\u1edd v\u1edbi insulin glargine.<\/p>\n<p>*\u00a0Insulin hi\u1ec7u ch\u1ec9nh: insulin nhanh ng\u01b0\u1eddi ti\u00eam m\u1ed7i 6 gi\u1edd ho\u1eb7c insulin nhanh analog ti\u00eam m\u1ed7i 4 gi\u1edd; li\u1ec1u c\u0103n c\u1ee9 m\u1ee9c glucose m\u00e1u tr\u01b0\u1edbc khi ti\u00eam: khi glucose m\u00e1u &lt; 8,3 mmol\/L (150 mg\/dL) th\u00ec kh\u00f4ng ti\u00eam; n\u1ebfu glucose m\u00e1u tr\u00ean m\u1ee9c n\u00e0y th\u00ec c\u1ee9 2,8 mmol\/L (50 mg\/dL) tr\u00ean m\u1ee9c n\u00e0y ti\u00eam 1 &#8211; 4 \u0111\u01a1n v\u1ecb insulin nhanh t\u00f9y theo m\u1ee9c \u0111\u1ed9 kh\u00e1ng insulin c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<p>*\u00a0Th\u00eam insulin nhanh v\u00e0o d\u1ecbch truy\u1ec1n nu\u00f4i d\u01b0\u1ee1ng v\u1edbi li\u1ec1u ban ban \u0111\u1ea7u 1 IU\/10 g carbohydrat, \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u insulin sau \u0111\u00f3.<\/p>\n<p>&#8211;\u00a0N\u1ebfu b\u1ec7nh nh\u00e2n \u0103n\/nu\u00f4i d\u01b0\u1ee1ng qua mi\u1ec7ng:<\/p>\n<p>*\u00a0Insulin n\u1ec1n d\u00f9ng nh\u01b0 tr\u01b0\u1eddng h\u1ee3p tr\u00ean<\/p>\n<p>*\u00a0Insulin nhanh g\u1ed3m 2 th\u00e0nh ph\u1ea7n: insulin dinh d\u01b0\u1ee1ng li\u1ec1u 0,5 &#8211; 0,1 IU\/kg\/b\u1eefa \u0103n; insulin hi\u1ec7u ch\u1ec9nh d\u00f9ng nh\u01b0 tr\u01b0\u1eddng h\u1ee3p tr\u00ean.<\/p>\n<ul>\n<li>\u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n \u0110T\u0110 t\u00edp 2 ki\u1ec3m so\u00e1t glucose m\u00e1u t\u1ed1t b\u1eb1ng ch\u1ebf \u0111\u1ed9 \u0103n tr\u01b0\u1edbc \u0111\u00f3:<\/li>\n<\/ul>\n<p>&#8211;\u00a0B\u1ec7nh nh\u00e2n kh\u00f4ng \u0103n qua mi\u1ec7ng: ng\u1eebng c\u00e1c thu\u1ed1c u\u1ed1ng h\u1ea1 glucose m\u00e1u, ti\u00eam insulin hi\u1ec7u ch\u1ec9nh, th\u00eam insulin nhanh v\u00e0o d\u1ecbch truy\u1ec1n nu\u00f4i d\u01b0\u1ee1ng nh\u01b0 tr\u01b0\u1eddng h\u1ee3p tr\u00ean.<\/p>\n<p>&#8211;\u00a0B\u1ec7nh nh\u00e2n \u0103n qua mi\u1ec7ng:<\/p>\n<p>*\u00a0C\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c thu\u1ed1c u\u1ed1ng h\u1ea1 glucose m\u00e1u, tr\u1eeb sulfonylurea, \u1ee9c ch\u1ebf SGLT2, n\u1ebfu kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u00e0 glucose m\u00e1u \u1ed5n \u0111\u1ecbnh.<\/p>\n<p>*\u00a0D\u00f9ng insulin n\u1ec1n v\u00e0 insulin nhanh nh\u01b0 c\u00e1c tr\u01b0\u1eddng h\u1ee3p tr\u00ean.<\/p>\n<ul>\n<li>N\u1ebfu kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee5c ti\u00eau glucose m\u00e1u th\u00ec \u0111i\u1ec1u ch\u1ec9nh nh\u01b0 sau:<\/li>\n<\/ul>\n<p>&#8211;\u00a0Xem x\u00e9t v\u00e0 x\u1eed l\u00fd nh\u1eefng y\u1ebfu t\u1ed1 kh\u00e1c g\u00e2y t\u0103ng glucose m\u00e1u.<\/p>\n<p>&#8211;\u00a0\u0110i\u1ec1u ch\u1ec9nh insulin nh\u01b0 sau:<\/p>\n<p>*\u00a0\u0110i\u1ec1u ch\u1ec9nh insulin n\u1ec1n: t\u0103ng 10 &#8211; 20% li\u1ec1u m\u1ed7i 1 &#8211; 2 ng\u00e0y cho \u0111\u1ebfn khi \u0111\u1ea1t m\u1ee5c ti\u00eau.<\/p>\n<p>*\u00a0Th\u00eam insulin n\u1ec1n (n\u1ebfu ch\u01b0a d\u00f9ng) v\u1edbi li\u1ec1u 0,2 &#8211; 0,3 IU\/kg\/24 gi\u1edd v\u00e0 \u0111i\u1ec1u ch\u1ec9nh 10 &#8211; 20% li\u1ec1u m\u1ed7i 1 &#8211; 2 ng\u00e0y, lo\u1ea1i insulin v\u00e0 m\u0169i ti\u00eam nh\u01b0 c\u00e1c tr\u01b0\u1eddng h\u1ee3p tr\u00ean.<\/p>\n<p>*\u00a0\u0110i\u1ec1u ch\u1ec9nh insulin nhanh:t\u0103ng 1-2 IU\/L\u1ea7n ti\u00eam \u0111\u1ed1i v\u1edbi insulin dinh d\u01b0\u1ee1ng v\u00e0 insulin hi\u1ec7u ch\u1ec9nh m\u1ed7i 1 &#8211; 2 ng\u00e0y cho \u0111\u1ebfn khi \u0111\u1ea1t m\u1ee5c ti\u00eau.<\/p>\n<ul>\n<li>N\u1ebfu c\u00f3 h\u1ea1 glucose m\u00e1u (&lt; 3,9 mmol\/L hay 70 mg\/dL) : t\u00ecm nguy\u00ean nh\u00e2n v\u00e0 x\u1eed l\u00fd n\u1ebfu c\u00f3, n\u1ebfu kh\u00f4ng c\u00f3 nguy\u00ean nh\u00e2n r\u00f5 r\u00e0ng c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u insulin ph\u00f9 h\u1ee3p.<\/li>\n<li>Chuy\u1ec3n ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb t\u0103ng glucose m\u00e1u khi ra vi\u1ec7n: L\u1ef1a ch\u1ecdn ph\u00e1c \u0111\u1ed3 ph\u1ee5 thu\u1ed9c v\u00e0o t\u00ecnh tr\u1ea1ng ki\u1ec3m so\u00e1t glucose m\u00e1u tr\u01b0\u1edbc khi nh\u1eadp vi\u1ec7n qua ch\u1ec9 s\u1ed1 HbA1c, c\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi c\u00e1c thu\u1ed1c h\u1ea1 gluocose v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 c\u00e1 th\u1ec3 kh\u00e1c. N\u1ebfu HbA1c \u0111\u1ea1t m\u1ee5c ti\u00eau th\u00ec d\u00f9ng l\u1ea1i ph\u00e1c \u0111\u1ed3 tr\u01b0\u1edbc nh\u1eadp vi\u1ec7n. N\u1ebfu HbA1c tr\u00ean m\u1ee9c m\u1ee5c ti\u00eau th\u00ec c\u1ea7n t\u0103ng c\u01b0\u1eddng thu\u1ed1c h\u1ea1 glucose m\u00e1u theo ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb t\u0103ng glucose m\u00e1u chung cho b\u1ec7nh nh\u00e2n \u0110T\u0110.<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><strong>T\u00c0I LI\u1ec6U THAM KH\u1ea2O:<\/strong><\/p>\n<p>S\u1ed1 5481\/Q\u0110-BYT\u00a0&#8216;<em>V\u1ec0 VI\u1ec6C BAN H\u00c0NH T\u00c0I LI\u1ec6U CHUY\u00caN M\u00d4N \u201cH\u01af\u1edaNG D\u1eaaN CH\u1ea8N \u0110O\u00c1N V\u00c0 \u0110I\u1ec0U TR\u1eca \u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00cdP 2\u201d, 30\/12\/2020<\/em><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 b\u1ec7nh t\u0103ng glucose m\u00e1u suy gi\u1ea3m b\u00e0i ti\u1ebft insulin v\u00e0 n\u1ed3ng \u0111\u1ed9 s\u1ef1 \u0111\u1ec1 kh\u00e1ng insulin ngo\u1ea1i vi thay \u0111\u1ed5i d\u1eabn \u0111\u1ebfn t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft. Tri\u1ec7u ch\u1ee9ng s\u1edbm li\u00ean quan t\u1edbi t\u0103ng glucose m\u00e1u v\u00e0 bao g\u1ed3m u\u1ed1ng nhi\u1ec1u, kh\u00e1t nhi\u1ec1u, ti\u1ec3u nhi\u1ec1u v\u00e0 nh\u00ecn m\u1edd. Bi\u1ebfn ch\u1ee9ng mu\u1ed9n g\u1ed3m b\u1ec7nh [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[80,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Qu\u1ea3n l\u00fd t\u0103ng glucose m\u00e1u \u1edf b\u1ec7nh nh\u00e2n n\u1ed9i tr\u00fa \u2013 B\u1ed9 Y t\u1ebf - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 b\u1ec7nh t\u0103ng glucose m\u00e1u suy gi\u1ea3m b\u00e0i ti\u1ebft insulin v\u00e0 n\u1ed3ng \u0111\u1ed9 s\u1ef1 \u0111\u1ec1 kh\u00e1ng insulin ngo\u1ea1i vi thay \u0111\u1ed5i d\u1eabn \u0111\u1ebfn t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft.\" \/>\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=\"Qu\u1ea3n l\u00fd t\u0103ng glucose m\u00e1u \u1edf b\u1ec7nh nh\u00e2n n\u1ed9i tr\u00fa \u2013 B\u1ed9 Y t\u1ebf - 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