Trn Th Mi Yn

VIP 3S
Cn v ca ch tch

THC PHM CHC NNG V
BNH I THO NG
Functional Food for Diabetes
Ni dung:
Phn I: Cn thy triu dch bnh mn tnh
khng ly v vaccine d phng.
Phn II: i cng bnh i tho ng
I. Khi qut tiu ha v chuyn ha Glucid
II. i cng bnh i tho ng.
Phn III: TPCN vi bnh i tho ng
Phn IV: Cc chin s tin phong v SKC.
Phn I:
Cn thy triu dch bnh mn tnh
khng ly v Vaccine d phng.

1 0 0 0 0 0 0 0 0 0 0 ...
V C T N X V HV TY HB DL
...
Sc
khe
Tiu ch cuc sng
Sc khe
l g?
Khng c bnh tt
Thoi mi y
Th cht
Tm thn
X hi
Quan im
chm sc
bo v SK.
Chm sc bo v khi cn
ang khe
Do chnh mnh thc hin
CNH + th ha
Thay i
phng thc
lm vic
Thay i
li sng
li sinh hot
Thay i cch
tiu dng
thc phm
Thay i
mi trng
Hu qu
1. t vn ng th lc (70-80%)
2. S dng TP ch bin sn
3. Tng cn, bo ph
4. Stress
5. nhim mi trng
6. Di truyn
1. Tng cc gc t do
2. Thiu ht vi cht, vitamin,
khong cht, hot cht sinh hc
1. Tn thng cu trc, chc nng
2. RL cn bng ni mi
3. Gim kh nng thch nghi
Cn thy triu
dch bnh mn tnh khng ly
gia tng
6 c im tiu dng thc phm
Tnh ton cu
Pht tn cc mi
nguy ATTP
n ung
ngoi gia nh
TP km cht
lng
TP nhim
TP gi
S dng TP
CN-CB-BQ
TP nhim
Cht bo qun
Thiu ht
vitamin,
cht khong,
HCSH, cht x
Thay i
trong SXTP
HCBVTV
Thuc th y
Phn bn
ha hc
Nc ti
Cng ngh
CBTP
Thit b my
mc
Ha cht,
ph gia
Chui cung cp
TP ko di
c im
s dng
TP n ngay
TP t ng vt
Giu bo, giu
nng lng
Khu phn n hng ngy
nhim Thiu ht
Tng





RL cu trc chc nng RL cn bng ni mi
Gim kh nng thch nghi
Cn thy triu dch bnh mn tnh khng ly
Vitamin
Cht khong
HCSH
Cht x
Ha cht
Sinh hc
L hc
Cn thy triu
dch bnh mn tnh
khng ly
Bnh tim mch:
17-20 triu ngi t vong/nm
Hoa K:
-2.000 TBMMN
-2.000 nhi mu c tim
1,5 t ngi HA cao
VN: 27% cao HA
Long xng:
1/3 n
1/5 nam
Hi chng X
30% dn s

Ung th:
10 triu mc mi/nm
6 triu t vong/nm
S lng v tr ha



i tho ng:
8.700 ngi cht/d
6 cht/pht
1 cht/10s
344 triu tin T
472 triu (2030)



X hi cng nghip
(Pht trin)


Thu nhp cao
No



Dch bnh mn tnh
khng ly

Bo ph
Tim mch
i tho ng
Long xng
Bnh rng


Phng c hiu


Vaccine TPCN
Phng c hiu


Vaccine


Dch bnh truyn nhim

Suy dinh dng
Lao
Nhim khun (t, l,thng hn)
Nhim KST


X hi nng nghip
(cha pht trin)


Thu nhp thp
i ngho

Cc dch bnh ca loi ngi
TPCN
Cung cp cc
cht AO
Cung cp
hot cht
sinh hc
B sung
Vitamin
B sung
vi cht
1. Phc hi, cu trc, chc nng
2. Lp li cn bng ni mi
3. Tng kh nng thch nghi
1. Chng lo ha, ko di tui th
2. To sc khe sung mn
3. Tng sc khng, gim
nguy c bnh tt
4. H tr lm p
5. H tr iu tr bnh tt
TPCN - Cng c d phng ca th k 21

80% s bng pht bnh tim mch, no, T
40% bng pht ung th

C th phng
trnh c
Phn II:
i cng bnh i tho ng
H tiu ha
ng tiu ha
Cc tuyn
Ming (Tin mn)
Thc qun
D dy
Rut non
Rut gi
Hu mn
Nc bt
Gan
Ty
Tuyn d dy Rut
I. Khi qut chuyn ha Glucide:
CHC NNG H TIU HA
Chc nng co bp
Nho trn
Nghin nt
y thc n t trn di
Tit dch
Tit men tiu ha
Chc nng bi tit
Chc nng tiu ha
Phn gii TP thnh phn t
n gin hp thu:
Glucide G
Protide
.
Acid amin
.
Dipeptide,
.
Tripeptide
Lipide
.
Acid bo
.
Monoglycerid
Chc nng hp thu
a thc n c tiu ha
qua nim mc rut vo mu
o thi - SPCH
Bi tit mt s Hormone
VAI TR CA GLUCID
1. Cung cp nng lng
- Cung cp 70% nng lng ca khu phn n.
- 1 phn t Glucose cho 38 ATP (Adeno Triphosphat) v 420 Kcal.
- Ngun nng lng ch yu cho mi hot ng, mi t bo, m v
c quan.
2. Cc dng tn ti:
2.1. Dng d tr: Glycogen: tp trung nhiu gan, c.
2.2. Dng vn chuyn: Glucose trong mu v dch ngoi bo.
2.3. Dng tham gia cu to rt nhiu thnh phn:
+ Pentose: TP axit AND v ARN.
+ Glucid phc tp (Glycoprotein, Glycolipid): cu to mng t bo,
mng bo quan.
+ Axit Hyaluronic: l mt disaccharid to nn dch ngoi bo,
dch khp, dch thy tinh th mt, cung rau, va c tc
dng dinh dng, va c tc dng bi trn, va c tc
dng ngn s xm nhp cht c hi.
+ Condroitin: l mt Mucopolysaccharide axit, l thnh phn
c bn ca m sn, thnh ng mch, m lin kt da, van
tim, gic mc, gn.
+ Heparin: l mt Mucopolysaccharide, chng ng mu.
+ Aminoglycolipid: to nn cht Stroma ca hng cu.
+ Cerebrosid, Aminoglycolipid: l thnh phn chnh to nn v
Myelin ca dy thn kinh, cht trng ca thn kinh.


3. Tham gia hot ng chc nng ca
c th:
Thng qua tham gia thnh phn cu
to ca c th, Glucid c vai tr
trong nhiu chc nng: bo v, min
dch, sinh sn, dinh dng, chuyn
ha, to hng cu, hot ng thn
kinh
4. Chuyn ha Glucid lin quan n
nhiu chuyn ha khc, l ngun to
Lipid v acid amin.
TIU HA V HP THU GLUCID
Insunlin
Glucid
Glucose
Men
TH
G
G
Nng bnh thng
G = 100mg %
RUT MU T BO
- TB hng cu
- TB gan
- TB no
T bo
G

G.6P vng Kreb
Nc tiu
Nng 170mg %
TB
+ Nng bnh thng Glucose mu = 1g/l.
+ Khi c th s dng mnh Glucid (lao ng
nng, hng phn TK, st): [G] c th tng
ti 1,2 1,5g/l.
Nu cho qu 1,6g/l: G b o thi qua thn.
+ Khi ngh ngi, ng: [G] gim ti 0,8g/l.
Khi gim ti: 0,6g/l: hn m do TB thiu nng
lng.
+ S iu ha cn bng Glucose thch hp:
[G] = 0,8 1,2 g/l

NGUN CUNG CP TIU TH
1. Glucid thc n
2. Glycogen gan: lng
Glycogen gan c th duy
tr [G] mu bnh thng
trong 5-6 gi.
3. Glycogen c: co c to
acid lactic, v gan to G.
4. Tn to G t protid v
lipid
1. Thoi ha trong t bo
cho nng lng, C0
2
,
H
2
0.
2. Tng hp acid amin lipid.
3. Thi qua thn nu
Glucose mu 1,6g/l
IU HA CN BNG GLUCOSE MU
Insulin
i khng Insulin:
- Adrenalin.
- Glucagon
- Glucocorticoid
- Thyroxin
- STH
1. iu ha ni tit:
2. iu ha thn kinh:
+ ng huyt tng: Hng phn v no v
h giao cm (Hi hp, xc ng, stress).
+ Vai tr vng di i th:
- Trung tm A: iu ha G v TB khng
cn Insulin (TB hng cu, TB no, TB
gan).
Khi [G] < 0,8g/l: Trung tm A b kt
Tng tit Glucagon, Adrenalin, ACTH
tng G t 1,0g/l.
- Trung tm B: iu ha G vo TB phi c
Insulin.
Khi thiu Insulin, Trung tm B huy ng
mi c ch ni tit lm tng G.
VAI TR CA INSULIN
Insulin do t bo ca Ty o tit ra.
Insulin c tc dng lm gim G mu nhanh v mnh:
lm cho G nhanh chng vo TB v nhanh chng
c s dng (thoi ha cho nng lng, tng
hp Glycogen, tng hp lipid v axit amin):
1. Hot ha Hexokinase lm G nhanh chng vo
TB.
2. Tng kh nng thm ion Kali v Phosphat v c
vo TB, to iu kin cho qu trnh phosphoryl
ha v s dng glucose.
3. Trc tip chuyn Glycogen syntherase t dng
khng hot ng sang dng hot ng tng
hp Glycogen t Glucose.
4. c ch mt s men xc tc tn
to ng nh Pyruvat
carboxylase.
5. Gn vi th th c hiu trn
mng t bo ch to nn cht
trung gian l oligoglycopeptid
c tc dng vn chuyn G vo
t bo.
6. Lm gim thoi ha cc cht
c kh nng to ra G nh:
Glycogen, lipid, protid.
II. I CNG BNH I THO NG:
1. Tnh hnh v nguy c:
Lch s:
Bnh i tho ng l mt trong nhng bnh u tin
c m t t 1500 trc CN Ai-Cp vi triu chng l
tho nc tiu qu ln nh mt Siphon.
Ti n : m t bnh c nc tiu ngt nh mt ong.
Ti Trung Quc: m t bnh c nc tiu thu ht kin.
Ngi Hy Lp (nm 230 TCN) gi l Bnh i qua.
Ngi Hy Lp (th k 1 SCN) gi l i tho ng
(Diabetes Mellitus DM) vi ngun gc ting Latin:

Diabetes Mellitus
i tho ng
c im dch t hc ca Diabetes Mellitus:
1. Th gii (Lin on DM quc t - 2013):
Nm 2012: 371.000.000 ngi b DM
Nm 2013: 382.000.000 ngi b DM
Nm 2030 c tnh: 552.000.000 ngi b DM. 1/10 ngi ln b DM
S lng ngi b mc DM tng 45% trong 20 nm qua.
2. T l DM chu U, Canada: 2-5%
3. T l DM M: 5-10%, c 15 nm tng gp i.
4. DM ng Nam v Vit Nam:
+ Tc tng t 2000 nhanh nht th gii.C 10 nm gp i.
+ L do: Tc DM t l thun tc th ha. Tc th ha t l
thun vi tc Ty ha ch n ung !
Vi c im M ha thc n nhanh:
Bnh m kp tht
Xc xch
Khoai ty chin
Pizza
Nc ngt ng lon
5. T l DM Typ 1: 10%, Typ 2: 90%

DM ti M: Quc gia ca i tho ng!
8,5% dn s M b DM (25.800.000 ngi)
Nm 2010: c 1.900.000 mc mi
26,9% ngi 65 tui b DM 10,9 triu ngi).
C 215.000 ngi < 20 tui b DM
C 1/400 tr em b DM.
11,8% nam (13 triu ngi) b DM
10,8% n (12,6 triu ngi) b DM.
C 79.000.000 ngi t 20 tui tr ln b Tin
DM.
c tnh:
- Nm 2025 c 53,1 triu ngi b DM
- Nm 2050: 1/3 ngi M b DM
DM l nguyn nhn chnh gy bnh tim v t
qu, nguyn nhn th 7 gy t vong Hoa K.
Tin i tho ng
(Pre Diabetes)
Tin i tho ng (Pre Diabetes): l mc
ng mu cao hn bnh thng nhng
thp hn gii hn i tho ng (ngng
thn).
+ M, nm 2013: c 79 triu ngi ln giai
on tin i tho ng.
+ Nu giai on tin i tho ng l c
nguy c b i tho ng Typ 2 v nguy c
bnh tim mch.
+ gim nguy c i tho ng v a mc
ng huyt v bnh thng cn c ch
gim cn, ch n ung thch hp v vn
ng hp l.

VIT NAM
* T l gia tng T: 8-20%/nm (nht th gii).
* Theo Vin Ni tit:
+ Nm 2007: 2.100.000 ca T.
+ Nm 2010: 4.200.000 ca T.
+ Nm 2011: gn 5.000.000 ca

* 65% trong s b T: khng bit mnh b mc bnh.
* T l mc bnh thnh th: 4%.
* T l mc bnh nng thn: 2 - 2,5%.

NGUY C I THO NG
Tng cn qu mc bo ph bo bng
Sng, lm vic tnh ti t vn ng th lc
Ch n: nhiu m ng vt, acid bo no, thiu vitamin,
cht khong, HCSH, cht x.
Ung nhiu ru stress TK. Tng gc t do Cao HA,
cholesterol
Di truyn Chm pht trin trong t cung
Cng tuyn i khng Insulin: Yn (ACTH, GH, TSH),
Gip (T3, T4), Thng thn (Cortisol, Adrenalin), Ty (Glucagon).
i tho ng
iu kin thun li gy T Tp 2
Cn thy triu dch bnh ton cu T!
X hi ang CNH, th ha dn ti:
1. Thay i phng thc lm vic:
- Lm vic trong phng kn.
- Cng c: my tnh.
2. Thay i li sng, sinh hot:
- Li sng tnh ti, t vn ng.
- Rp ht ti gia: TV, VTC, VTC-HD

3. Thay i tiu dng TP:
- Tnh ton cu.
- n ngoi gia nh tng.
- S dng TP ch bin sn n ngay tng.
- Phng thc trng trt, chn nui, ch bin
thay i.
- Khu phn:
+ Gia tng TP ng vt, tht, trng, b,
sat c, thy sn.
+ Gia tng acid bo no.
+ Gim cht x, TP thc vt.
+ Thiu ht Vitamin, vi khong, hot cht
sinh hc.
4. Thay i mi trng: gia tng nhim cc
tc nhn sinh hc, ha hc, l hc.

HU QU:
1. Tng cn qu mc v bo ph:
- Tng m: gy kt thi qu lm mt tnh
cm th ca cc c quan nhn
Insulin.
- Tng m: lm cng TB m, lm gim
mt th cm th vi Insulin.
2. t vn ng th lc: lm gim nhy
cm ca Insulin.
3. Ch n: tng m ng vt, t x,
thiu vi khong (Crom), Vitamin, hot
cht sinh hc: lm tng khng Insulin.
4. Stress thn kinh: Lm tng khng
Insulin.
5. Di truyn:
- M b T: con b T cao gp 3 ln tr khc.
- L thuyt: Gen tit kim ca James Neel: iu kin TP ch
duy tr Insulin tit nhanh p ng nhu cu tch ly nng
lng khi c hi n vo nhiu ch thnh thong xy ra (30 n
v). S p ng nhanh nh th trong k di do TP s dn n
tng Insulin (100 n v), gy bo ph, khng Insulin v kit qu
TB , gy T.
6. Cng tit cc tuyn i khng Insulin:
- Tuyn yn : GH, ACTH, TSH
- Tuyn gip : T3, T4.
- Tuyn v thng thn : Corticoid
- Tuyn li thng thn : Adrenalin
- Tuyn ty : Glucagon.
Con cng
Con s t
Con kh
Con ln
1. Ung va phi :
2. Ung qu liu :
3. Ung nhiu :
4. Ung qu nhiu :
UNG RU V SC KHE:
3n v ROH/d
1n v = 10g:
1 lon bia 5%
1 cc (125 ml) ru vang 11%
1 chn (40ml) ru mnh 40%
Hng phn
Khoan khoi
Da d hng ho
T tin
p nh con cng
Hng phn
Tinh thn phn
khch
T tin qu mc
n to ni ln
Cm thy mnh
nh con s t
RL thc
Khng kim sot
c hnh vi
Hnh ng theo
bn nng
Phn x bt trc
nh con kh
c ch mnh
Mt, mt ngu
Ni lm nhm
Ngy kh kh
nh con ln
Cc yu t n ung ng vai tr
nguyn nhn T Tp 2
Khu phn ngho cht x,
t rau qu v ng cc ton phn
Khu phn t c, thy sn.
Khu phn giu cht bo c bit l
cht bo bo ha
TP c ch s ng huyt (Glycemic
Index GI) v Glycemic Load GL) thp
c tc dng bo v chng li T Typ 2
Khu phn b sung Crom c tc dng
bo v chng T Typ 2.
Thiu thc phm xanh d b i tho ng
Thiu TP xanh: thiu Vit +
cht khong RLCN Ty T
T l T t l nghch vi
hm lng rau qu trong khu
phn n hng ngy
Mnh mm vi TP cng nghip -
D b T
6 loi TP dc tho lm gim T:
Tr xanh, mp ng, Rau sam,
B ng, Sn dc, Rau cn
CH N V NGUY C DM
SP ng vt
(Tht)
SP thc vt
(Rau qu)
Tnh acid
Tnh kim
i tho ng
DM
(+)
(+)
(+) (-)
(+)
(+) Thc phm
Are you at risk of developing Type 2 diabetes?
Bn ang nguy c pht trin
ca i tho ng Typ 2?

Li H
Ch DD
km
Qu cn
Tui
Di truyn
Are you at risk of developing Type 2 diabetes?
Bn ang nguy c pht trin ca T Typ 2 ?

2. nh ngha i tho ng:
Hi chng c c trng l tng Glucose
huyt v xut hin Glucoza trong nc
tiu do thiu Insulin hoc s khng li
khng bnh thng ca cc m i vi tc
dng ca Insulin.
i tho ng l g ?
C th khng sn xut Insulin
C th khng s dng c Insulin
Tng Glucose trong mu
i tho ng
Diabetes Millitus
Beta cell
T bo Beta
Blood glucose
ng mu
Insulin
Insulin
ng dn
Tuyn ty
Bng quang
Thn
D dy
Tim
Gan
Ty
Cn cnh
ca 1 tiu o
Langerhans
T bo Delta
T bo hng cu
T bo T bo
3. Phn loi:
C ch v cc th i tho ng
TY



I

R
TB -Langerhan
THN
RUT
MCH
MU
Glucid
G G
G
G
G - 6P
T BO
+
G
Tp I
Tp II
1,7 mg%
3.1. i tho ng Typ 1:
T ph thuc Insulin (Insulin Dependent Diabetes Millitus IDDM):
+ Tng ng huyt do thiu Insulin.
+ Thiu Insulin do t bo ca Tiu o Langerhans Tuyn Ty b tn thng (t min):
Yu t thun li
(C a, mi trng)
Phn ng t min
Khng th
TB c thm quyn min dch
(Lympho, i thc bo )
TB Tiu o
Langerhans
c im:
(1) Thng xuyn xy ra ngi tr
(< 30 tui)
(2) Lc u: dng Cyclosporin A ngn
cn hot ng Lympho bo v KT.
(3) V sau cn thit tim Insulin u n
(ch l iu tr ngn).
90% b ph hy
i tho ng Typ 1
Gene T nm trong NST s 6
3.2. i tho ng Typ 2:
i tho ng khng ph thuc vo Insulin
(Non Insulin Dependen Diabetes Millitus
NIDDM)
Tng ng huyt do Insulin vn c sn
xut bnh thng nhng SX chm tr v bt
lc trong vic chuyn Glucose vo t bo.
C ch:
SX Insulin:
Khng thch nghi (khng c nh sm)
Chm tr (nh 2 sau 60-90 pht)

S bt lc ca Insulin
(Khng Insulin)
Yu t gia nh
Yu t tng cn, bo ph
Bnh gan, ty
Li vn ng
RL ni tit
Thuc trnh thai
RL chuyn ha m
C thai
Mt s thuc
Glucose khng vo c TB
i tho ng Typ 2
c im:
1) Thng xy ra ngi ln tui (> 30 tui)
2) iu tr bng Insulin l khng cn thit.
3) Gan tip tc phn gii Glycogen d tr thnh
Glucose cng gy G mu.
TT Tiu ch phn loi IDDM NIDDM
1 T l ton b 0,5 1,0% 2,0 4,0%
2 Tui bt u Di 30 tui Trn 30 tui
3 Trng lng ban u BN khngbo ph BN bo ph
4 Cch bt u Thng hung tn m
5 i nhiu ung nhiu R rt t r rt
6 n nhiu Gy C Khng c
Bng: phn bit i tho ng tp 1 v tp 2
TT Tiu ch phn loi IDDM NIDDM
7 Tch ceton
Bin chng mch
Thng c nht l
bnh mao mch
Him c nht l
va x ng mch
8 S tit Insulin Rt gim Bnh thng hoc
hi gim

9 Ph thuc Insulin C Khng
10 Hm lng Insulin
huyt tng
Rt thp hoc khng
c
Thng bnh thng
TT
Tiu ch phn loi IDDM NIDDM
11 C quan nhn Insulin Him khi b bnh Hay b bnh
12 Hm lng Glucagon huyt
tng
Tng Bnh thng
13 Khng th chng c
Langerhans
Hay gp Khng c
14 Mi lin h vi khng
nguyn HLA
Hay gp Khng c
15 Yu t bn ngoi (nhim
VR, nhim c)
C th c Khng c
4. C ch sinh bnh ca DM:
ng cong l tng ca lng ng trong mu v nng Insulin theo 3 ba n trong ngy
S CHUYN HA GLUCID V NNG GLUCOSE MU
M M
RUT
Glucid
Glucose
MU
Glucose
GAN
Glycogen
Nc
tiu
0,8
1,0
1,2
1,4
1,6
1,7
Acid
Lactic
T BO
C
C CH BNH SINH I THO NG.
Glucid
Glucose
huyt
Glucose
T bo
(thiu)
-TB thiu
nng lng
- TB suy kit
i
n nhiu
1. Thiu Insulin
2. Khng Insulin
GAN
Tng Glucose huyt
ng
niu
Tng
p lc
thm thu
M m
1.Tng Lipid mu
2.Tng Cholesterol
Tng Acetyl - CoA
Toan mu VXM
Tng phn gii Protein
Cn bng N m
Tng th
Cetonic
Tng tng hp
Cholesterol
Gy
Nhim
trng
i nhiu
Kht
Ung nhiu
H
e
x
o
k
i
n
a
s
e

Huy ng
Gim tng hp Tng thoi ha
HI CHNG CHUYN HA
(Metabolic Syndrome)
Lch s:
+ M. Gerald Reave nu ra mt Hi chng chuyn ha gi l hi chng X ti Hi
ngh Hi Tiu ng nm 1988, vi cc du hiu:
(1) Tch m thn (tng s o vng bng)
(2) Cao HA.
(3) Ri lon Lipid huyt.
nhm ngi c theo di bnh Tiu ng t khi tin pht cho ti khi bnh
xut hin.
+ Cc nghin cu sau b sung thm nhiu d kin. Cc tn gi khc:
- HC ri lon chuyn ha X (Dysmeta_bolic Syndrome_X).
- HC khng Insulin.
- HC tin tiu ng.
- HC ri lon chuyn ha lin quan tim mch
( Cardiovascular Dysmetabolic Syndrome).
- HC Reaven.
NH NGHA: Hi chng chuyn ha l mt tp hp cc
biu hin bnh l v chuyn ha lm tng nguy c mc
bnh tim mch, tiu ng v x va M

+ Trong HC chuyn ha: ni bt l RLCH
Lipid v Glucid vn ph thuc trc tip v
Insulin.
+ Pht hin v phn nh c HC chuyn
ha l bc tin ln trong d phng v
khng ch nhng cn bnh gy t vong
cao nht trong th k 21.
+ HC X chim 20-30% dn s cc nc
cng nghip. c tnh n 2010, ring
nc M s c: 50-75triu ngi b HC X.
BIU HIN HC CHUYN HA:
1. Bo trung tm
- BMI > 25-30kg/m
2
- Vng bng: * 102cm (Nam)
* 88cm (N)
- T l vng bng/vng mng: * 0,9 (Nam)
* 0,85(N).
2. Huyt p: 140/90 mmHg.
3. Nng Glucose huyt:
- Nu o dung np Glucose: gim r rt.
- C th suy lun mc khng Insulin t t l:

Tryglycerid
HDL
Nu > 2 l bo ng
Nu t 4 l chc chn c khng Insulin

4. Nng bt thng cc loi Lipid huyt:
+ Tng Triglycerid: 1, 695 mmol/lit hoc 150mg/100ml.
+ Tng nng chung cholesterol
+ Gim HDL-C: 0,9mmol/lit hoc: 40mg/100ml (vi nam) v 50mg/100ml
(vi n).
+ Tng LDL-C. Do chi ph ln khi o nn nng LDL thc t c tnh b ng
cch ly nng cholesterol ton phn tr i HDL.
5. Biu hin khc:
+ Tng ng (Tng Fibrinogen & Plasminogen activator)
+ Tng Creatinin huyt v acid Uric huyt.
+ C Albumin niu vi th: 20mg/pht hoc t l Albumin/creatinin: 30mg/g.
+ Ri lon chc nng h ni mc (tng nng cc phn t kt dnh).
Chn on & khng nh
(d o, chi ph thp)
Nu c 03 yu t tr ln theo chiu hng xu
l coi nh c HC chuyn ha!
CHN ON
Vng bng
TG huyt
HDL-C
Glucose huyt khi i
Huyt p
YU T NGUY C GY HI CHNG X
1. t hoc khng vn ng
2. Ch n nhiu m ng vt (bo ha)
3. Ch n qu nhiu Glucid (nht l loi hp thu nhanh)
4. Ht thuc l
5. Di truyn
6. Gi, lo ha
7. Mi trng
8. Ph n sau mn kinh
9. Ung nhiu ru.
HC X chim t l 5% nhng ngi c cn nng bnh thng, 22%
nhng ngi tng cn v 60% nhng ngi bo ph. ngi ln
nu tng mi nm 5 pounds tr ln th nguy c b HC X l 45%.
Yu t nguy c gy HC X
D PHNG
1. Ch khi bc vo tui cao.
Khi c a di truyn (cha, m c hi
chng ny)
Cha m b tiu ng, VXM, bnh
mch vnh.
2. Theo di sm, nh k xt nghim
pht hin sm H.C X can
thip.
3. Thay i thi quen c hi trong
phong cch sng to thi quen
tt.
4. Thay i ch n ph hp:
Thnh phn TP & s Kcal va .
5. La chn Sp TPCN thch hp
d phng.
6. Duy tr mt ch tp luyn thn
th: trung bnh 30 pht mi ngy, t
nht 5 ngy trong tun.
KHI PHT HIN C H.C X
1. Thay i hn thi quen c hi trong phong cch sng.
2. Thay i ch n.
+ Gim calo t Glucid (cn 50% trong khu phn, nht l gim
ng, bt, thay bng ng cc dng ht).
+ Hn ch ti a m ng vt (lipid bo ha) thay bng m thc
vt.
+ Hn ch TP cha nhiu cholesterol: lng trng, gan, ph
tng.
+ Thay Protid t tht sang tht mu trng, c. Thay mt phn
Protid ng vt bng Protid thc vt.
3. Vn ng th lc thng xuyn, khng ch tng vng bng
4. Tng lng Vitamin oxy ha.
5. Theo di nh k Glucose, TG, HDL, HA, can thip kip thi
khi c du hiu H.C X.
6. Ngi bnh thng khi t 60 tui, cn a vo din qun l
H.C X.
7. Ngi c c a v di truyn, cn qun l HC X sm hn (40
50 tui).
8. La chn thch hp cc sn phm TPCN h tr gim triu
chng.
Triu chng DM
Tng ng huyt:
G khng vo c TB li G mu.
Gan tng SX G t Glycogen.
ng niu:
Khi G 10 milimole /l mu.
i nhiu:
ng niu ko theo nc lm nc tiu.
Kht nc: do mt nc nhiu qua nc tiu
Tch tr Cetonique trong mu gy nhim acid (Acidose)
(IDDM) (Gan tng s dng Lipid to nng lng)
Ceto niu (IDDM): do Cetose
Gy (TB khng c G, phi s dng Protein v lipide)
Triu chng i tho ng
Mt: th lc
Hi th: mi aceton
D dy:
Bun nn
Nn
au
Thn:
i nhiu
ng niu
H hp:
Th Kussmaul
(su nhanh)
C th: Gy
Trung ng:
Kht
i
L m
Ng lm
5. Cc bin chng ca t:
5.1. Bin chng cp tnh:
Nhim axit v cht Cetonic ( tp 1).
Nhim axit Lactic ( tp 2).
Hn m tng p lc thm thu (tp 2).
H ng huyt: do dng thuc h ng huyt hoc
nhn n thi qu.
Hn m h ng huyt.
5.2. Bin chng mn tnh:
(1) mch mu:
Vim ng mch cc chi di.
Va x ng mch.
Tng huyt p.

(2) Bin chng tim:
Nhi mu c tim.
Tn thng ng mch vnh.
Suy tim, au tht ngc.
(3) Bin chng mt:
Vim vng mc.
c thu tinh th.
Ri lon khc x, xut huyt
th knh, Lipid huyt vng mc...
(4) Bin chng h thn kinh:
Vim nhim dy thn kinh.
Tn thng TK TV, ri lon cm gic, gim
HA khi ng, tim p nhanh, ri lon tiu
tin, lit dng...
Huyt khi v xut huyt no.
(5) Bin chng thn:
Suy thn mn tnh.
X cng tiu cu thn.
Nhim khun ng tit niu.
(6) Bin chng da:
Nga: m h, quy u, c xu hng Lichen ho.
Mn nht, nm.
Nhim sc vng da gan tay chn.
U vng mi mt, phi hp tng cholesterol huyt.
Hoi t m: hay , khu tr cng chn (cc nt vng hi xanh l lan
ra ngoi vi, trong khi trung tm tr nn teo i).u
Bin chng ca DM:
Mt: Nhn p, c thy tinh th
bnh vng mc T, m mt
Rng: nu, vim
Hi th: aceton
Thn kinh:
t qu
Suy gim nhn thc
Tm thn: trm cm, lo u
Tai: nghe km
Tim mch:
Nhi mu c tim
Thiu mu cc b
VXM
Cholesterol
TG
HA: tng
Thn:
Lc km
Protein niu
D dy: Lit nh
Sinh dc: bt lc
Da:
Lon dng
Nhim trng
Lot
Hoi t
Bnh TK
Mch mu ngoi vi:
Nga
T
Thiu mu
au
C:
au c
Teo c
Nhc c
THUYT GLYCOSYL HA
Sn phm Glycate ha bn vng
Advanced Glycation End Products
AGEs
nh ngha: AGEs l cc phn t c to thnh do s kt hp ca cc phn t
ng d vi cc phn t Proteine, Lipide, acid Nucleic. l tnh trng sinh l t nhin
dn ti lm tng cc bin chng v nguy c bnh tt, tng tc lo ha trong c th.
O = C - H

H - C O - H


HO - C - H

H - C OH



HO - C H





H - C OH

H


+
H

H
N - R
D Glucose m vng
+
Hp cht nhm
Amino
Bn vng
Pht quang
AGE
C ch tc ng ca AGE
Glycosyl Proteine
+
Khng cn Enzyme
Tng theo tui th
Gn kt vi TB v
m lnh qua RAGE

Tn thng, suy chc nng
To cc Proteine km
hoc mt chc nng
(c 30.000 loi Protein)
Oxy ha


vim

Chc nng Prteine

1. Cu trc (cu trc c, da,
gn tt c t chc c th)
2. iu ha cn bng ni mi
3. Vn chuyn
4. Bo v
5. To nng lng

Bnh mn tnh
BNH C XNG KHP
A.G.E.s l nguyn nhn hoc tng nng nhiu bnh
SINH DC-TIT NIU
BNH NHN KHOA
Bnh vng mc tiu ng
Thoi ha im vng
Glaucoma
Chng vin th
ESRD/ gcui / Lc phc mc
Bnh thntiu ng
THN
Lo ha da
Bnh tiu ng au thn kinh
X cng b
Hn ch Vn ng chung
S tng trng khi u
CC BNH KHC
Ri lon cng dng
Tc nghn ng niu
BNH TMCH
Bnh suy tim
X va ng mch
Ni mng Ri lon
Cao huyt p tm thu
Bnh mch mu ngoi bin
Tng huyt png mch phi
Bnh mch vnh
Chng rung tm nh
BNH NG HHP
Vim khp dng thp
Vim khp mn tnh
a thot v
Xng vt gy
Cc bnh rng ming
Chng long xng
X ha phi
Bnh kh ph thng
H THN KINH TW
Stroke/ t qu/Tai bin mch mu no
Bnh Alzheimer
Amyotrophic/x cng ng vin
Phn III:
TPCN vi bnh i tho ng
Thc phm chc nng phng nga t:

1. Cc TPCN b sung cc axit bo khng no (n-3): cc
axit bo cha no c tc dng ci thin s dung np
Glucose v tng tnh nhy cm Insulin.
2. Cc TPCN b sung cht x (NSP) c tc dng gim
mc Glucose v Insulin trong mu, dn ti gim
nguy c T tp 2.
3. TPCN b sung Crom, Magie, Vitamin E:
- Lm cc m s dng Glucose d dng.
- Tng cc s dung np Glucose.
4. TPCN cung cp cc hot cht c ch men -
Glucosidase, nn c tc dng gim ng huyt.
Tinh bt TPCN
Saccaroza
(G + F)
Maltoza
(G + G)
Hot cht
(C trong u tng
ln men, l du)
-Glucosidase
Glucose huyt
+ +
-

5. TPCN cung cp cc cht chng oxy
ha (sn phm ca u tng,
ngh, gc, ch xanh, Noni). C TD:
Bo v v h tr cc t bo tiu o
Langerhan Tuyn Ty.
Bo v v KT cc th cm th ca cc TB,
cc m nhy cm vi Insulin.
Kch thch c th sn xut Nitric Oxyd (NO)
lm tng tun hon m, hi phc t chc,
tng nhy cm vi Insulin.
6. TPCN h tr gim cn, gim bo ph,
gim cholesterol v lipid mu, do
lm gim khng Insulin.

7. TPCN h tr ti to t bo,
t chc v chng vim
- Nhiu sn phm TPCN c tc
dng ti to t bo v t chc
(sn phm ca Noni, Ngh ).
- Nhiu sn phm TPCN tc
dng c ch cc yu t gy
vim: c ch cc Cytokin gy
vim (bt gi v lm bt hot
cc Cytokin gy vim, lm tng
nhy cm ca cc t bo i
vi Insulin).
Do s lm gim khng vi
Insulin ca cc m, nht l m
c, m m.
8. Cc khuyn co d phng T:
(1) D phng v iu tr tha cn bo ph,
c bit cc nhm c nguy c cao.
(2) Duy tr BMI tt nht (trong khong 21 23
kg/m
2
).
(3) Thc hnh hot ng th lc: trung bnh 20
30 pht mi ngy, duy tr t nht 5 ngy
trong tun. (Tng tiu hao nng lng, tng tnh
nhy cm ca Insulin v ci thin tnh trng
s dng Glucose cc c).

(4) Duy tr ch n v b sung TPCN: n rau qu,
u, ng cc ton phn hng ngy, n t ng ngt v t
cht bo bo ho (khng qu 10% tng nng lng vi nhm
c nguy c cao, nn mc < 7% tng nng lng), t
khu phn NSP 20g/ngy.
+ Nn s dng cc TP c hm lng cht x cao v ch s ng
huyt thp.
+ Ch n phi cung cp c 40-50% lng Calo di dng
Hydrat cacbon; 15-25% di dng Protein v 25-35% di dng Lipid.
Vi ph n v tr em cn tng Protein.
+ S dng thng xuyn cc TPCN phng nga T, tim mch,
huyt p.
(5) - Khng ht thuc l: ngi T c nguy c bnh
mch vnh v t qu. Ht thuc l lm tng nguy
c .
- Khng ung ru v ung c cn.
(6) Phng nga cc bnh km theo: v d VXM,
tng HA
(7) nh k xt nghim, kim tra ng mu

Thc phm, li sng v nguy c
bnh i ng type 2




NIDDM

Xu th gia
tng theo s
pht trin x hi
- kinh t.
Tng gp i
vo nm 2025
Tng ln c
tng lp tr
1. Tha cn, bo
ph
2. Bo bng
3. Khng hot ng
th lc
4. i tho ng b
m
5. Khu phn
nhiu cht bo no
6. Qu nhiu ru
7. Tng cht bo
khu phn
8. Chm pht trin
trong t cung
Tng
1. Gim cn t nguyn
ngi tha cn v bo
ph (duy tr BMI mc
tt nht)
2. Hot ng th lc
3. Thc phm giu
NSP
4. Thc phm giu
acid bo n - 3
5. Thc phm c ch
s ng huyt thp
(ht u)
6. m bo khu phn
cht bo no <7% tng
nng lng
7. Ng cc ton phn,
u, tri cy, rau.
Gim
Ghi ch:
NIDDM (Non - insulin - dependent
diabetes mellitus): i tho ng
type 2 - i tho ng khng ph
thuc
Type 2 Diabetes
i tho ng Tup 2
K+ channel
Knh K+
Ca2+channel
Knh Ca2+
Beta cell dysfunction.
Bt thng ca T bo Beta

Before meal: K+ channel
opened
Ca2+channel closed

Trc ba n:
Knh K+ m
Knh Ca2+ ng
Glucose send signal to beta cell
ng gi tn hiu ti t bo beta
Closed K+ channel
Opened Ca2+channel
Knh K+ ng
Knh Ca2+ m
Insulin produce & secrete
To v bi tit insulin
After meal
Sau ba n
G
SX - ATP
ng
(+)
ATP/ADP
Kh cc
Khi ng Gene Insulin
Bi xut
Beta cell could not detect
glucose signal
T bo Beta khng ch r
tn hiu glucose
Opened K+ channel
Closed Ca2+channel
Knh K+ m
Knh Ca 2+ ng
No insulin production
Khng sn sinh insulin
After meal
Sau ba n
Hyperglycemia
Qu tng ng huyt

B sung cht x
G mu

1

B sung -3 ci thin
dung np G v nhy
cm Insullin
2
B sung Cr, Mg, Vit E.
Tng dung np G
3
B sung cc AO:
- Bo v TB - Langerhan
- Kch thch th cm th c Insulin
- Kch thch SX NO nhy cm Insullin.
5
Gim cn bo ph gim khng Insullin.
Cha hot cht c ch men -Glucosidase
phn gii thnh G.
4
6
Chng vim tng ti to TB nhy cm Insullin.

7
B sung hot cht lm gim G mu: Iridoids, Flavonoids

8
T
P
C
N

p
h

n
g

c
h

n
g

i

t
h

n
g

Li khuyn gim nguy c ca bn
1. Nu bn ang tng cn.
Nn lm cc vic sau y:
(1) p dng v duy tr bin php gim cn hp l.
(2) La chn n ung nhng thc phm thch hp.
(3) Tp luyn thn th hng ngy.
2. Nu bn khng h c vn ng.
Nn lm cc vic sau y:
Tp luyn thn th hng ngy.
3. Nu Huyt p ca bn qu cao.
Nn lm cc vic sau y:
(1) p dng v duy tr bin php gim cn hp l.
(2) La chn n ung nhng thc phm thch hp.
(3) Khu phn gim mui v cn.
(4) Tp luyn thn th hng ngy.
(5) Tham kho kin bc s c nn dng thuc gim p cha
v nn dng TPCN loi no tt nht.

4. Nu bn c cholesterol v
Triglyceride mc qu cao.
Nn lm cc vic sau y:
(1) La chn n ung nhng thc
phm thch hp.
(2) Tp luyn thn th hng ngy.
(3) Tham kho kin BS c cn dng
thuc cha v dng TPCN loi
no tt nht.
Phn IV:
Nhng chin s tin phong v
Sc khe cng ng
1. Cho
2. Hi thm i tng
(tm hiu SK)
3. K v cc bin php
nng cao sc khe
4. Gip i tng la chn
bin php, SP.
5. Gii thch s la chn.
6. Hn tr li.



1. T vn v sc khe
2. T vn v sn phm
T do Dn ch - Minh bch Khoa hc



Nh phn phi

1) C lng tm o c ngh nghip
2) C kin thc SKC
- Ti sao dch bnh mn tnh xut hin
- Ti sao TPCN l vaccine d phng
- Nguy c v tc hi cc bnh mn tnh
3) C kin thc v thc hnh ng v Hiu ng lm ng
dng ng TPCN
4) Thc hin ng quy nh php lut v kinh doanh v sn
phm.
5) Thy r nt vn ha u vit ca ngnh ngh.
Mi nh phn phi = TTV + Chin s chm sc SKC
Nhng nt u vit ca bn hng a cp:

1) T vn trc tip cho khch hng v sc khe, v sn phm, trao i dn
ch v minh bch.
2)Hng ha nhanh chng n ngi tiu dng, gim c chi ph trung gian.
3) Hn ch ti a hng gi, hng lu trong h thng.
4) Hot ng mang tnh cng ng rng ri, h thng c tnh tng h v
trch nhim ln nhau, em nim vui, sc khe v s kh gi khng ch
cho mnh v cho c mi ngi.
5) Gi sn phm khng i t u n cui, t trn xung di.
6) Giao lu rng ri trong phm vi ton quc v quc t vi nhng ngy hi
honh trng cc khu du lch ni ting.
7) Mi ngi tham gia vo bn hng a cp u tm thy gi tr ring nh
nim vui, c hi, sc khe, giu sang v pht huy ht kh nng, tnh sng
to v s say m ngh nghip.
8) Bn hng a cp l mt trng i hc cng ng, o to cc nh phn
phi tr thnh nhng ngi nng ng, c kin thc SKC, k nng giao
tip, ch ng, t tin v ci m.
9) Ai cng c c hi thnh t, khng phn bit ng cp, tui tc, gii tnh,
ngh nghip .
10) Tn vinh tinh thn i km tn vinh vt cht, thc y pht trin kinh t -
x hi.
Hiu ng Lm ng Dng ng

























2 1 Sn xut - Manufacturing
2 Kinh doanh - Dealing
3
Cng b & Qung co
Claim &Advertisement
4 Qun l - Management
1
2 Phn loi - Classification
3 Phn bit - Differentiation
4 Tc dng - Efficacy
3 Dng ng Correct Usage 1 i tng Target Object
2 Liu lng - Dosage
3 Thi gian Duration
4 Cch dng Instruction of Usage
1 nh ngha - Definition Hiu ng Correct Understanding
Lm ng Correct Implementation
Trn trng cm n !