HOI NGH! KHOA HOC CONU Nl=ni= o " - - " " v ^ •
»BT.as"Jssf?.%fKr;„'yrT"^^^
Huj^h V » , T n » n g ' . Quyln Dinh T r f . L j T u Hu^ng', Pimm Hung LUC ' rniiSngDsi/KKyDuiicCanTJw
V * . Cdng ngW sinh/wt W«n H41 (am Khoa/»c .a C&s n5h# W Ns-"
IJ IIS. X7 -. h^.. nhir rhi di V din x6t nghi?m Glucose mau liic doi va sau 5n 2 gift.
Trons . * bin, » i , bjnh dii fl». * * 8 . " ^ ^ J ' ' ™ ^ " , t ^ ° a S , * r i Glucose miu lie do *5p khong d6ng ngH. v*
Chi si niy cung cSp thSng tm « J w g 0 ) ' r " , ' " ° S S n g S o T . « ighijm HbA.c khong chl dinh g,i k a qui diiu hi m vi8c benh di d « ^ kien, » i . to. * i » « > " ^^J^^co to chm,gJ^ dO » g » ^ ^^^ ^ ^ _l_^ ^ _ ^ ^ ^^. ^ _,.^ ^ ^ b«nh nhin nong 3 thing qu. n» a » d » b,« "UC lo to, che v y » » e ^j_ ^^^ ^^^_ ^ chimg t6 b«nh nhin tB hoie sip c6 b , „ ' J ^ « " « ° ° ^ ™ ° S S m ^ c " * O l u c ^ miu lie doi kh6„gthi .61 len duoe Vi
:htt.r^;ArhSnih';e^^"^Crn^^*™.-»"''"™
dudng type 2 ".
n **«• X« nghiem HbA,e, Xet ngtaem Glucose. Bjnh dai thio duimg, Benh dii thio duimg type 2 Mifctiiu
BSnh g,a >*c Iheo d« du6r« t«*«l!«.« xa nghiem Hl)A,c vS..«ttghWm Glucose trong aSu W b«nh asi to dtrftno t«»
ISh'Sf«n"!fhl^bI!;^aS WO ,»Kmg typo 2 dang diiu tti A , kham b«nh ft B«nh »i#n vS Phong kham bfnh tt, nhan ^ S s l * S ^ n Z » t * S j Z S b E g xa nghifm HbA,c ^ M nghiem Glttcose mSu o o4o «,», diam xet ngh«m cOa nguwi t>$nh d ^ thdo du6ng Q ^ 2.
Kit qui nghiin cOu
Qua 4 l^n l§p l^i cua x6t nghigm Gkicose vS xet nghigm HbA,c tr§n 60 bgnh nhSn d bgnh vien (n=30) va phong kham {n=30^
mfii iSn cdch nhau 1 thing cho t h ^
Gii>a binh vign vd phe«g khSm khfing c6 svr khic t)igt trong di&u tn t)gnh DTO type 2 thi hign qua cdc gid trj nfing dO c^
xdtnqhidmGlucosevdl*AiCbi6nlh'i6nr*iirnhau. ,» ,» ^ ai • u:^ «.« *™
r46ng dOxdt nghigm Glucose vd xdt nghigm HbA,c qua cdc thdng theo doi dilu tn tir iSn 1 din ^n 4 diu co bien thi&n gi^m dSn. , Trong 60 ngirdi tham gia ngrten ci>u cua chiing toi c6 75% cao huyfit dp. , ^ , _^.. _.,, . „ ; _ - Khdng c6 mil tuong quai cua n6ng dp Glucose va HbAiC mau vdi dO tuoi, cdn ngng. chieu cao, BMl, v6ng eo, v6ng mdng vd huyet dp. Kh6ng c6 sv tuyin tinh gl&a n6ng d0 xdt nghiem Glucose vd xet nghigm HbAiC vdi d^ tu6i trong Klt"qS xdt Shigm l&i 4 th4y ning dO Glucose c6 ve diflj-c gid trj binh thirong {<120 mg/dl) Id 43 nguiin chilm ti Ig 71,7%
nhung nlog dO xdt ngligm HbA,c chira v l d u ^ gid tq binh thu^g (<6% ) qua 3 thdng dilu tri tir d6 bdc si dieu tn c6lh6 di/a ra phuong dn (siu trj khdc hay c6 thi ndi Id xdt nghigm HbA,c diing d i theo doi s^r kilm sodt duimq huyet cua bgnh nhdn ddi thdo difdng tit hon xdt ngNgm glucose.
Chung Kl kit ludn ilng xdt nghigm HbAiC din ftiilt cho vigc theo doi dieu tri bgrtfi nhdn ddi thdo duwng type 2 vd nen sau mfii 3 thdng xdt nghigm HfcAic 1 lln.
MdTElAu
Bgnh ddi thdo dudng hign nay Id mgt v^n d l sijc khde mang tinh chat toan cau dnh huidTig din nhilu nguwi nhit Id trong d9 tuli lao dgng trdn t o ^ Ihl gidi, TTieo th6ng bdo cua tfi chCrc y t l the gidi WHO (2003), toe dp phdt Win cua bgnh DTC tSng nhanh trong thiri gian qua. Nam 1985cathlgioichic630trigu ngu*i bj DTD, nam 2003 todn the gi6i c6 171,4 t r i ^ ngudi mac bgnh DTO, con so ndy dl/ dodn se tdng gip dfli vdo ndm 2030. Mfii ngdy trSi qua cd 8700 ngudi chet lien quan ddn DTD. Tl H nSc bgnh ddi thdo dudng cung Ididc nhau d cac chau lyc vd cac vung lanh thi. Ngodi ra DTD cdn la ganh nang doi vdi sy ph*
triin kinh t l vd xa hgi vi cdc hgu qud ngng n i cda bgnh do su- phat hign tri vd dilu tri mugn. Phdt hign vd qudn h^ sdm bgf*
DTD trong c^ng dfing xet nhilu goc dg ca v l kinh l l vd si>c khde cdng dfing la vo cung can thilt Trdn thi gidi da dii>ng mi*
ring bgnh 0TB hodn todn cd thi phdng vd qudn ly 6\ityc. nhung ngudi mang ylu t l nguy ca cao niu dirp^ can thigp k|p ttm bing thufic hodc t)lng chl dp dn uong, luygn tgp thay dfii loi SOTig co khd ndng hgn che mac bgnh. Mat khdc nhOng ngudi m^
bgnh DTD niu duvc qudn ly vd dilu trj kjp thoi se giam hogc Idm didm l^i si/ xuat hign cdc biln chdng do bgnh gdy nSn.
D l ddnh gid dirdng huylt cd dirgrc kilm sodt tfit hay khong trong mdt qud trinh vd tien luong ve biln didng, ngifdi bgnh cai Idm xet nghigm HbAic tiic do tJ tg huylt sac tfi Aic trang hing d u . HbAic Id huylt sac tfi hemoglobin gin kit vdi d i ^ Ghjccse trong mau. HbAic hay hernogkibin glycosyl Id sdn pham tao thdnh giija mgt ptidn tCr Glucose vdi goc Valin cOa dau N Ign cua chufii p phdn img tgo thanh Hbglycosyl khflng d n xuc tdc ciia enzym, n6 phg thugc vao nong dg ciia Glucose Irong mdu.
Cdng cd nt^lu dudng trong mdu thi HbAic hign dign cdng nhieu, do t l bao hfing cau cd tu& Itip Id 120 ngdy ndn xdt nghi&'i HbAic c6 gid trj thfing bdo muc dirdng mdu cua 3 thdng gan nhat, vigc djnh lu^ng Glucose mdu chi noi Idn tinh trang oB Gtucose mdu lie liy mdu ldm xdt nghigm thi vigc dinh luong Hbglycosyl phan dnh mdt cdch tfing qudt vd tfin tich trgng thSi c*
; CONG NGHE SINH HQC TOAN QUOC 2013
bing cua dudng huylt trong khodng thdi gian 100 ngay trudc ktii iSy mau d l xet nghigm. Do dd, xdt n^igm HbAic khfing di
<Idnh gid kit qud dilu trj cua bgnh nhdn trong 3 thdng qua md oon cho Ult mdc dg hgn c h l v l SI/xuit hien biin c h i ^ OTD, cW s6 nay cao dning te bgnh nhdn dd hogc sap cd biln chdng rit ngng. E)6i vdi ngi/fii lln diu ten phdt hign bgrti ddi thdo *Jdng. xdt nghigm HbAic rat cd idi trong vigc < ^ h gid bgnh dd d mdc dfi ndo, dilu md chi sfi dudng mdu liic ddi khfing t h i ndi lgn dupe
Kinh 1. Gtucose gin kit vdi hfiog d u
Ddnh gid vigc theo doi dudng huylt bing xet nghigm HbAic va xdt nghigm Glucose trong dilu tq bgnh ddi thdo dudng type 2 tgi thdnh ph6 Cin Tho.
Ddnh 9d tinh hlnh bgnh d ^ thdo dudng type 2 dang dilu bi den khdm bgnh d Bgnh vign vd Phong khdm bgnh tu nhdn cda bdc sT chuygn khoa ngi tilt vd tin mgch bdng xdt nghigm HbAic va xdt nghiem Glucose mdu d cdc thdi diim xdt nghigm cua ngudi bgnh ddi thao duang type 2.
OC» TUVNG vA PHUONG PHAP N G H ^ C O U D)adiem
€)6i tupng n^ien cuu cua chung tfii fien hdnh trdn ngudi dan bi bgnh DTD type 2 co hg khau thudng tni tai thdnh phfi Cdn Tho, eg thi Id d bgnh vign va phdng khdm l^gnh tu nhdn cCia bdc sT chuyen khoa ngi tilt vd tim mach.
Tbdi gian nghidn cdu: 04 thdng lidn tgc, td 15/10/2012 d ^ 22/02/2013.
Phuong phdp nghidn cdu Nghidn cihi d t ngang md td Thilt Iffi nghien cuu
Chpn b ^ h nhdn bj tignh DTB type 2 thugc dign dupe nghign ciru kham lam sang vd can Idm sang, bgnh nhdn DTD type 2 dup'c chpn theo tifiu chi cOa WH01908.
Qhnynirau
Chgn mSu: Theo phuong phdp chpn miu k l tilp lidn tgc.
S6 brgng miu: 60 miu (60 bgnh nhdn dupe chon) vd Idy mdu c6 sfi lan Igp 1^ la 04 lan (04 dpi) tren 01 bdnh nhan, mfii noi chpn liy 30 miu.
TT)di gtan thu tfi^p sd ^ u - M ^ tuin (07 ngdy lien tuc, tir ngay 15 - 22 cua thdng), theo 4 thdng lien ^ . Khdm c$n Idm sdng (xet nghigm mdu)
Gfim cac xdt nghigm djnh luyng Glucose trong huylt thanh vd djnh lupng HbAic trong mdu.
Cich liy b^r^f^im
Liy mdu cOa bgrtfi nhdn bj bgnh DTD type 2 thupc dign Argpc nghien cuu cho vao type diuyen diing cOa phong xet nghigm, lay mdu vao liic sdng tif 6h30 - 8h khi bgnh nhdn chua an sdng theo ngay gid da qui djnh d l thi/c hign xdt nghigm HbAic vd Glucose.
Thyc hign x6t nghigm HbAiC va Glucose tgi Khoa Xdt nghigm cua Tmng Tam Y Khoa sfi 10.
C6cx6t nghidm miu
Op* kipng nfing dg Glucose (Phuong phdp GOD-PAP)
Dmh kidng ning dg HWic b i i g mdy phdn tidi Hemoglobin D-10 vdi test HbAic (Bk) - rad) Gid trf doi chi&i doi vdi ngifdi binhttiudvig
HbAic: 4 - 6%, Glucose: 80 -120 mgM Xir ly vd phan tidi so Eeu
Su dyng phin mim SPSS 13.0 d l nhgp va xir ly sfi ligu.
KfrOUAvABANLAJAN
Miu nghign cuu gfim 60 ngudi tham gia va duvc qui dinh cy thi v l ngdy gid liy mSu vd sfi lln liy miu tren mgt bgnh nhdn Id 4 lln.
Gidl tinh tmrg miu nghifin cuu cd 24 nam, 36 nir, dg tufii tnjng binh la 55,0 ± 8.02 tufii.
Khao sdt gid trj cua xdt n^dgm Gtucose vd HbAic d Bgnh vifn vd Phdng Idiam
Chiing tra diing phdp kilm djnh t (kidawodent sample T-test) khflng ghdp cgp hai phia d l so sanh gid t i tmng binh nong dg xet nghigm Glucose vd gid trj tnjng binh nfing dg xet nghigm HbAic aia ha nhfim bgnh vign vd phdng khdm.
Xdt nghigm Glucose
Bdng 1. So s^h nfing d$ Glucose mau a miu Bfnh vi$n vd Ph6ng khim (n=30) D j a t S ^ t h u I h g p s f i i g u
Glucose l l n l
Glucose tin 2
Glucose l l n 3
Glucose Idn4
Phong khdm B ^ v i g n Phong khdm B ^ n h v i ^ Phbngkhdm 8^nhv)$n Phong khdm
Gid tn bung binh 167,60 134.90 148,43 142.17 132.80 132,07 119,40 120,37
Dfy l$ch chuan 73.33 49.09 60.69 42,77 42,80 26.03 23.61 21,39
Gid In khdc bigt 32,70
6.27
0,73
-0.97 t 2.03
0,46
0,OB
-0.17 P 0,051
0,646
0.936
0,869 ' Nfing d( Gucose tinh tidng don VI. mgU
Nh$n xit: Gid tr) trong binh ctia nfing dfi cdc lan xet nghigm Glucose d hai nhdm BV va PK khac bigt chua cd j^ nghTa thtong kS v) (p > 0.05) hay nfii cdch khdc gida bgnh vign vd phdng khdm khfing cd sy khdc bigt trong dilu tri bgnh ddi thdo dudng type2 the hign qua cdc lln xdt nghigm Glucose. G'ld tii tmng binh Glucose lan 1 d nhdm Bgnh vign cao lion d nhfim Phfing kham XS nghigm Qucose tin 4 d bgnh vign cfi gid tq nfing dfi Glucose thip hon d phdng kham, qua theo doi dilu Iq thi nfing dg Qucose tnmg mdu diu gidm din theo tdng thdng d Bgnh vign vd Phfing khdm.
Xdt nghigm HbAic
BSng 2. So ainh nong d ^ HbA^: mau 6 mau Bgnh vi^n va Phdng kham (n = 30) Dia d l l m thu th$p sfi li$u
HbA,cldn1
HbA,clln2
h1bA,clln3
HbA,clln4
B$nh vign Phdng khdm Bgnh vign Phoftgkhdm Bgnh vign Pftdngkhdm Bgnh vign
Gid trj binh 10.10 9,22 9.79 8.89 8,50 8.65 7.67
trung Dg Igch chuin 3.90 2,12 3.68 1.66 2,21 1,28 1,42
Gid tn bigt 0,88
0,91
-0,15 khdc t
1,09
1,23
-0,32 P
0.281
0,222
0,750
' Ndng dO HbA,c tinh bdng don vi %
A/ftSn xit: Gia tii Hung binh ciia ning do cac lin xSt nghiem HliAic * hai nh6m BVva PK l(h&; bISt chira c6 J nghia thong H hay noi each khSc giOa l*nh vien va phong l<ham khang co sv khic biet Irong diiu trj b«nh dai thao au<mg tvpe 2 GB tii Hun) binh HbA,c lin 1, 2. 3 ft B«nh vi«n cao hem Phdng kham, cdn lin 4 gia In tnjng binh HbA,o ft Phong kham cao hm ft B«i*
vi#n.
rem /ii/;B«nh vi j n va Phong Itfian, kh6ng c6 sv khac bi#t tong «eu t i benh DTD lyiie 2 IhS h«n qua cac tiang tieo doi d*i«
S a ^ J 2 ^ ^ l l ' * J ! [ " . ° ' " ? ^ ° ' * " " * " " * " " ' i ^ " * " * = " * " ^ m-tn b«nhdin khSm b$nh ft b«nh vi«n*
thi eft ti«u Chung benh nJng hon khi den khSm benh ft phdng kham tv cOa bac sT chuydn khoa, thi hidn qua cac xet nghpfi"
; CONG N G H £ SINH Hpc TOAN QUOC 2013
Glucose va l*AiC d nhdm Bgnh vign lan 1. 2,3 cd nong dg cao hon nhom Phong ktiam vd lln 4 d Phong khdm cao hon d Benh vien, a l u ndy cung phu hgp vdi tdm ly cua ngudi bgnh.
Oanh gid nfing d$ dudng huylt so vdi sd luong bdtih nhSn tnxig miu ngtuen cuu ta Can Ttw Glucose mdu so vdi so kivng bgnh nhdn mau ng^iien cuu (n = 60)
Thi hign tpja bilu dfi phdn tich cua 4 lan xi^ n^iigm fucose trdn miu nghien cuu cho thay 6 lg benh nhan cd nfing dp c^ucose
< 120 mg/dl tang Idn nhilu d lln 4 trong miu nghidn cuu.
Nfing dfi fucose mdu cua ngudi du^rc gpi la tHrdi ttnidng sau khi an 2 ^ d oo nfing dp fucose tatmg mdu td 80 - 120 m^d, tarig gkjcose mdu khi xdt nghigm ghicose mau nong do > 120 mgWI.
Nfing do Nfing d9 glucose > 12(glucose < 120
mg/dl mg/dl Bieu do 1. Norig dg Ghjcoee theo sfi hfqmg berrf) nhin trong miu nghiin cuu
Wi^n xdt Qua phdn tfch cho thiy lln 1 nong dfi Glucose mdu > 120 mg^dl Id 56,7 % vd nfing dd Glucose mdu < 120 mgfti la 43,3 %, sau 3 ttidng dilu tii chmg ^ thiy d lln 4 nfing dg Gtucose mau >120 mg/d la 28,3 % va Gkicose mdu < 1 2 0 m ^ la 71,7%.Tu dd cd t h i ndi ring dilu tq cd dien tien ^ nhung d l biit chic Id thgt su ^ can phai theo ddi bing xdt nghigm h ^ xdt n^«gm HbAic phdn dnh cd qud trinh cua 3 thdng.
Gia t i cac lan xet nghiem HbAic mau so vfii so lu^ng bgftf) i M n mau nghien cuu (n = 60)
Qua cac lln xdt nghigm HbAic cho thiy tat ca dfii tugng bgnh nh&i t>j tignh ddi thdo dudng tmng nghifin cuu qua 3 thdng d i u tq khdng dua v l dugv nfing dg HbAic < 6%.
T?ieo Higp tifii ddi thdo dudng cda htoa Ky (American Diabetes Association) dua ra phac dfi d i u trj ddi thdo dudng type 2 nan 2008 liy gid trj HbAiC = 7 % ^ so sdnh vd ddnh 9a k^ qud d i u tri I h l hign cpja bang
Bieu do 2. Hong dg HbAtC theo so hf^ng tignh nhan trong mau n^iiBn cdu
/W)^ xdt Sfi Rgu bilu d 6 l ^ cho thay filg bgnh r^idncd nfing dp h-ftiAiC> 7% cd giam l i t it theo so ngudi d lan 1 la 54 ngudi a ^ lan 4 xufing cdn 44 ngudi, nhung nong dp HbAic chua trd v l tq sfi nhu d ngudi binh thudng {HbAiC < 6%). Tu phdc dfi d i u trj ddi ttido dudng nam 2fX)8 va theo bieu dfi 2 thi bdc sT dilu trj phdi dua ra phucmg an deu trj khdc d l d i u bi cho co higu qud ^ hon.
Khdo sdt sv biln thidn fi* lln 4 cua x a nghigm Glucose vd HbAtC so vdi so Kmng benh nhan tmng mau nghien c ^ HhAiC chua trd v l nhu d ngudi binh thudng (HbAiC < 6 %) vi d i n tiln thay dfii dap dng theo dilu tri chgm hon Gkicose nin bgnh nhdn d n tilp tyc theo doi HbAiC ngay ca sau khi dua dupe Glucose mau ve binh thudng.
B i l u do 3. Bien thl§n nfing d$ Glucose va HbAiC d l l n 4 so v d i sfi luor>g BN
€)l biit 43 tmdng hpp cd Glucose s 120 mg/d thi cd bao nhidu In/dng hpp cd HbAic < 7% vd cd bao ntiieu tnrang tipp HftiAic
^ 7% se phdn tfch tilp sau
Phai tkii 43 tfudng h9>p c6 nong d9 glucose £ 120 mg/dl d lln 4 cd anh hudng den HhAfC
Qua phdn fch 43 tnrdng hpp cfi nfing dg glucose £ 120 mg/dl d lln 4 cho thay gid tq tiung binh hfljAic la 7.49 %, gia tri nhi nhit Id 6 %. ^ tn Idn nhit Id 10 % va Idiao sdt dip d bdng 3
Bdng 3. Phan (ich HbAic cua 43 mrtng hgp nfing d6 glucose £120 mg/dl d lan 4
HbAK:<7%
H b l \ , c a 7 % Tfing cgng
s f i hrpng bgnh nhdn CO Glucose < 120 mg/d 16
27 43
TTIgX 37,2 62.8 100,0
* Nfing d$ hbAtC tWi t i ^ dcTn v j : %
N h ^ xgt B ^ 3 td sfi ligu cho ttily qua thdi gan dilu frj 3 thdng d bgnh nhan dai thdo dudng cd nfing dg trd v l glucose
<120mg/d nhung trong dfi nfing dg HbA,c <7% cd 16 trudng hpp chilm 37.2 % vd nong do HbAic & 7% c6 27 trudna hon chilm 62.8%. " ^ Tdm Igi: Qua nghidn cuu cua 60 bgr* nhdn trong 3 thdng tfieo dot dilu tq
Cd 16 bgnh nhan cfi nfing do Glucose < 120 mg/dl vd HbAiC < 7 % do dfi bac sT theo ddi d i u trj ndn duy tri phucmq cdcii dHu tq cho 16 bgnh nhdn ndy.
Cdn M 44 bgnh nhdn trong dfi co 27 bgnh nhdn (cfi Glucose < 120 mg/dl vd HbAic >7%), vd cd 17 bgnh nhan (cd Glucose
> 120 mg/d vd HbAiC >7%) do dd bdc si theo ddi dilu tri phdi thay dfii ttiuoc va dua ra phuwng cdch dilu tij khdc.
^ K S . ? ^ . ^ ^ ? * ' ^ ^ " ^ *^ " ^ ^ ' ' " ^ ^ " ^ ' ^ ^ "^^ ^ l ' ^ *^ " ^ ^ * « ° d5i qud trinh dilu t^
nghigm HbAiC trong dilu tn tfit hon xdt nghigm glucose mdu vi khdng phM thugc vao chl dp an uing cda bgnh nhdn.
KfTLUAN
Td cdc kit qud nghign cdu chung tOi nit ra nhdng kit ludn sau ddy
t S l ^ S n ^ ' t i S S d ? ' * ^ "^"^ " ^ " * '"^^ ^^^" * ^ ^ *^""^ ifii fi' dg tufii 50 - 59 tufii o6 nfing dg tmng binh cao
fnS^X'SL'^^^lg'?^'^'^^'^'^"^'''^ ^ ' "''^^
sr^ss;s^^:?si:^n?^'"nh^u^tr^
^^5it:fq2^tSLifdaT"'^"^^
'^r^p'^^^ni^iss^^^^^^
nghigm HhA,c khdng chl ^ g i a k S ^ dJu W ( S ^ S j h n^dn ^ ™ ^ ^ ^ viec theo do, dilu frj bgnh nhdn DTD type 2, x«
hign biln Chung do bgnh ddi ^ d ^ T s T n ^ r ^ ^ ^ ^ ^ ^ ^ ^ '^.S^J!^^ dfi hgn chl v l s^rxuA, lln diu tign dupe phdt hign bj bgnh ddiSdo dS.™ x ^ n S H l ^ . i f S ^ r h ? ^ ^L'^J^ "^^ "^ "^"9 ^ ' "^ "^"^
Chi sfi Glucose mdu Ific d« khfi^ ttil n o X d ^ ' ^ ' ' ' ^ " ^ ^ ^ S ' n S ' x d ' f ^ i ' S ^ H t ^ c T r ^ " ' ^ ' ' ^ ^ " * " ^
TAlUeunUMKHAO
D6 Dinh Hd (2002), Si lay , « n s f t ^ „fe ,,„„ , j „ 3,„j ^ „ j ^ ^ j , ^.^ ^ ^ ^
N^Th^T^ch, NouvSn Th, Khtid ,2007,. « * - , « „ ^ d , , ™ . , Nh. xuit h.n y b,c =hi nhanh Th.nh ph6 H6Ch, M , „ h - 2 0 . 7 , «
_ P h , ^ , h i M . , „ 0 S 4 , , M ^ ^ . „ ^ ^ „ , , , „ , ^ , „ „ „ , , ^ ^ ^ . ^ , ^ ^ , ^ ^ ^ ^ ^ ^ ^ ^ _ _ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ _ ^ _ ^ ^ ^ ^
'^Si^ZlJSI^IiSa^^S-tSSt " " ' * ' * " * ' ° " " "*"" " " ' " " * " ^ * ^ " 9 IVPe 2 mSi ChSn doSn l« b**
: C 6 N G N G H $ SINH HOC TOAN QUOC 2013 Hansen KW, Wrtandsen E, Helieberg K. Danielsen H (1997), Uremia and HbAic. Diabetes Care ;20:1341-2.
Thoma J, Stim F, Kutter D (2000), Influence of Urea on Ht>A1c-determinations t>y Menarini l-IA 8140 and on the difference between immunoturbWmetric and HPLC HbAic results. Clin Lab;46:261-8.
Tarim O, Kucukerdogan A, Gunay U. Eralp O, Ercan I (1999). Effects of iron deficiency anemia on hemoglot»n A l e in type 1 diat>etes mellitus Pediatr Int 41:357-62.
In torn of diabetes control, almost Vietnamese people p ^ attentioi b> Chicose test in blood when ttiey are Iiungiy and 2 liouis after meaL lntUcatois siqiply information of Glucose of Ghicose in blood at mcment of test At that time, level of Glucose in blood is tow. It is not mean ttiat diabetes have beax really controlling and wittiout con^Kcaticm.
Tboefore, HbAic test is not only assessing the result of treatmmt in ttnee mondis but also showing the reducing level of coo^licalion
^pcarancg due to didjetes.Iflhis indicator is high it show that patient is ah^ady or witt have heavy conylicalion.
With person vAio is the first time discover diabetes, Ifl>A]C test is usefiil in assessing diabetes in v^4uch level, that indicalor of Glucose in blood when being hungiy can not express
Hence, we was canied out ttie research " Apply HbAfi lest lo monitor and control blood sugar of diabetes type 2 ".
0b}ec6ves
Assess the monitor of blood sugar by HbA Ic lest and Glucose test in cure of diabetes type 2 m Canlho city.
Assess situation of diabetes ^ p e 2 has l)een cured and exained in bi^iial and i^ivale cnisuhiiig room of doctor ^^ecialJzed on endocriDe cardiovascular by HbA|C test and Ghicose test in blood in moments of test of diabetic type 2.
The result of research
I h r o i ^ four limes of r^)eatiiig of HbA|C test and Glucose lest of over 60 patienis in hoqiital (n= 30) and consultmg room ( i ^ 30), eveiy lest was Gombicted once amonttL The results showed that:
Iheie were not different between ho^ital and consuhing room to cure diabetes of type 2 tinough concentrative valid of Glucose and HbA|C test because we received ifae same variation in both methods
Concentration of Glucose test and HbA|C lest lluough monttis of monitor and treatment flom the first tune to fourdi varied decreasingly.
In 60 participants of our research, arterial hypertension accounted for 75 pscenL
Concoitration of Glucose and HbAiC test v/ere not variation due to ags, ocaq>ati(ni, and education levels of patienis. There was not linear between concentration of Glucose test and HbAjC lest due to age in researdi san^iles.
TTie test at the fourtti time showed that Glucose concentration had normal valid (<120 mg/dl) in 43 people (71,7 %) but concentration of HbAiC test was not reach to nonnal valid (< 6 %) dirough 3 montlis of aire. From ttiat result, doctors could carry out other treatment methtMls or it also said that using HbA]C test to monitor blood sugar control of diabetics was better dtan Glucose test
We concluded tfiat HbAiC lest was necessary to monitor and cure diabrtic type 2 and the test should be done every 3 monttis.
Keywords: HbAjC test, Gtucose test, D i a b ^ s of type 2.