{"id":63820,"date":"2022-11-14T15:56:14","date_gmt":"2022-11-14T08:56:14","guid":{"rendered":"https:\/\/asprou.com\/?p=63820"},"modified":"2023-04-06T15:46:42","modified_gmt":"2023-04-06T08:46:42","slug":"metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2","status":"publish","type":"post","link":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/","title":{"rendered":"METFORMIN<\/strong> \u2013 V\u00c0I \u0110I\u1ec2M C\u1eacP NH\u1eacT TRONG \u0110I\u1ec0U TR\u1eca<\/strong>\u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00ddP 2<\/strong>"},"content":{"rendered":"\n

\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng hi\u1ec7n \u0111ang l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd b\u00e1o \u0111\u1ed9ng to\u00e0n c\u1ea7u v\u1edbi h\u01a1n 463 tri\u1ec7u ng\u01b0\u1eddi m\u1eafc v\u00e0o n\u0103m 2019 v\u00e0 d\u1ef1 ki\u1ebfn t\u0103ng l\u00ean g\u1ea7n 700 tri\u1ec7u ng\u01b0\u1eddi v\u00e0o n\u0103m 2045. Ph\u1ea7n l\u1edbn nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng (> 95%) \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n l\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng t\u00fdp 2. B\u1ea5t k\u1ec3 nh\u1eefng can thi\u1ec7p v\u1ec1 thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng hay s\u1eed d\u1ee5ng thu\u1ed1c, s\u1ed1 l\u01b0\u1ee3ng ng\u01b0\u1eddi m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng s\u1ebd t\u0103ng l\u00ean \u0111\u00e1ng k\u1ec3 trong t\u01b0\u01a1ng lai g\u1ea7n. Do \u0111\u00f3, s\u1ed1 b\u1ec7nh nh\u00e2n b\u1ecb bi\u1ebfn ch\u1ee9ng \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u0169ng s\u1ebd t\u0103ng l\u00ean [3].<\/p>\n\n\n\n

K\u1ec3 t\u1eeb khi metformin \u0111\u01b0\u1ee3c FDA ch\u1ea5p thu\u1eadn v\u00e0o n\u0103m 1994, metformin \u0111\u00e3 nhanh ch\u00f3ng tr\u1edf th\u00e0nh li\u1ec7u ph\u00e1p \u0111\u1ea7u tay trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng t\u00fdp 2. Metformin cho th\u1ea5y hi\u1ec7u qu\u1ea3 cao trong vi\u1ec7c gi\u1ea3m HbA1c, nguy c\u01a1 h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft th\u1ea5p, kh\u1ea3 n\u0103ng gi\u1ea3m c\u00e2n nh\u1eb9, t\u00ednh an to\u00e0n cao v\u00e0 chi ph\u00ed th\u1ea5p. Tuy nhi\u00ean, s\u1ed1 li\u1ec7u v\u1ec1 c\u00e1c l\u1ee3i \u00edch tr\u00ean tim m\u1ea1ch \u0111\u1ed1i v\u1edbi metformin v\u1eabn c\u00f2n h\u1ea1n ch\u1ebf [1].<\/p>\n\n\n\n

1. C\u00f3 n\u00ean duy tr\u00ec metformin l\u00e0 thu\u1ed1c \u0111\u1ea7u tay trong \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng t\u00fdp 2?<\/strong><\/p>\n\n\n\n

G\u1ea7n \u0111\u00e2y, vi\u1ec7c qu\u1ea3n l\u00fd \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u00e3 chuy\u1ec3n t\u1eeb t\u1eadp trung ho\u00e0n to\u00e0n v\u00e0o vi\u1ec7c ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft sang xem x\u00e9t t\u00e1c \u0111\u1ed9ng c\u1ee7a c\u00e1c lo\u1ea1i thu\u1ed1c \u0111\u1ed1i v\u1edbi c\u00e1c bi\u1ebfn ch\u1ee9ng do b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng. L\u1ee3i \u00edch c\u1ee7a GLP-1 RA (nh\u00f3m \u0111\u1ed3ng v\u1eadn GLP-1) v\u00e0 SGLT2i (nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf k\u00eanh \u0111\u1ed3ng v\u1eadn chuy\u1ec3n natri \u2013 glucose 2) tr\u00ean tim m\u1ea1ch v\u00e0 th\u1eadn \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o vi\u1ec7c s\u1eed d\u1ee5ng metformin. Vi\u1ec7c kh\u1edfi tr\u1ecb v\u1edbi GLP-1 RA v\u00e0 SGLT2i cho th\u1ea5y t\u1ef7 l\u1ec7 suy tim sung huy\u1ebft, thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9, nh\u1ed3i m\u00e1u c\u01a1 tim v\u00e0 \u0111\u1ed9t qu\u1ef5 th\u1ea5p h\u01a1n so v\u1edbi metformin [4]. Do \u0111\u00f3, c\u00e1c nh\u00f3m thu\u1ed1c n\u00e0y n\u00ean \u0111\u01b0\u1ee3c xem x\u00e9t \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 b\u1ec7nh l\u00fd tim m\u1ea1ch ho\u1eb7c nguy c\u01a1 cao m\u1eafc c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch, suy tim ho\u1eb7c th\u1eadn m\u1ea1n t\u00ednh d\u00f9 c\u00f3 \u0111i\u1ec1u tr\u1ecb v\u1edbi metformin hay kh\u00f4ng [1, 2, 7].<\/p>\n\n\n\n

M\u1eb7c d\u00f9 s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng m\u1edbi c\u00f3 th\u1ec3 k\u00e9o d\u00e0i th\u1eddi gian th\u1ea5t b\u1ea1i \u0111i\u1ec1u tr\u1ecb, nh\u01b0ng chi ph\u00ed \u0111i\u1ec1u tr\u1ecb l\u00e0 kh\u00e1 t\u1ed1n k\u00e9m. Theo m\u1ed9t nghi\u00ean c\u1ee9u \u0111\u00e1nh gi\u00e1 v\u1ec1 t\u1ef7 l\u1ec7 chi ph\u00ed-hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb, so v\u1edbi metformin, kh\u1edfi tr\u1ecb v\u1edbi SGLT2i c\u00f3 t\u1ef7 l\u1ec7 chi ph\u00ed-hi\u1ec7u qu\u1ea3 t\u0103ng  478 000 \u0111\u00f4 la m\u1ed7i QALY (QALY: quality adjusted life years, t\u1ea1m d\u1ecbch l\u00e0 s\u1ed1 n\u0103m ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng) v\u00e0 t\u0103ng 823 000 \u0111\u00f4 la khi kh\u1edfi tr\u1ecb v\u1edbi GLP-1 RA \u0111\u01b0\u1eddng u\u1ed1ng. V\u00ec v\u1eady, chi ph\u00ed v\u1eabn l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p [1, 4].<\/p>\n\n\n\n

2. Metformin c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 vitamin B12 trong huy\u1ebft thanh<\/strong><\/p>\n\n\n\n

Gi\u1ea3m n\u1ed3ng \u0111\u1ed9 vitamin B12, ho\u1eb7c thi\u1ebfu h\u1ee5t vitamin B12, hi\u1ec7n \u0111\u01b0\u1ee3c coi l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang \u0111i\u1ec1u tr\u1ecb b\u1eb1ng metformin. Nguy c\u01a1 thi\u1ebfu vitamin B12 t\u0103ng \u1edf nh\u1eefng ng\u01b0\u1eddi d\u00f9ng li\u1ec1u cao ho\u1eb7c th\u1eddi gian \u0111i\u1ec1u tr\u1ecb d\u00e0i (> 4 n\u0103m) ho\u1eb7c c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 thi\u1ebfu vitamin B12 (nhi\u1ec5m tr\u00f9ng, k\u00e9m h\u1ea5p thu, thi\u1ebfu m\u00e1u \u00e1c t\u00ednh, b\u1ec7nh nh\u00e2n c\u1eaft b\u1ecf d\u1ea1 d\u00e0y, ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng kh\u00f4ng \u0111\u1ee7 ch\u1ea5t). Do \u0111\u00f3, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i v\u00e0 b\u1ed5 sung \u0111\u1ecbnh k\u1ef3 vitamin B12, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb thi\u1ebfu m\u00e1u ho\u1eb7c b\u1ec7nh th\u1ea7n kinh [2, 5, 6].<\/p>\n\n\n\n

3. \u0110i\u1ec1u tr\u1ecb metformin \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng t\u00fdp 2 v\u00e0 b\u1ec7nh th\u1eadn m\u1ea1n [5].<\/strong><\/p>\n\n\n\n

Metformin \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft qua th\u1eadn v\u00e0 c\u00f3 nguy c\u01a1 t\u00edch t\u1ee5 axit lactic khi ch\u1ee9c n\u0103ng th\u1eadn suy gi\u1ea3m. V\u00ec v\u1eady, vi\u1ec7c theo d\u00f5i eGFR (\u0111\u1ed9 l\u1ecdc c\u1ea7u th\u1eadn \u01b0\u1edbc t\u00ednh) \u1edf b\u1ec7nh nh\u00e2n \u0111ang \u0111i\u1ec1u tr\u1ecb b\u1eb1ng metformin, \u00edt nh\u1ea5t l\u00e0 h\u1eb1ng n\u0103m. T\u1ea7n su\u1ea5t theo d\u00f5i n\u00ean \u0111\u01b0\u1ee3c t\u0103ng l\u00ean 3\u20136 th\u00e1ng m\u1ed9t l\u1ea7n khi eGFR gi\u1ea3m xu\u1ed1ng d\u01b0\u1edbi 60 ml\/ph\u00fat\/1,73 m2<\/sup>.<\/p>\n\n\n\n

Metformin c\u1ea7n \u0111\u01b0\u1ee3c hi\u1ec7u ch\u1ec9nh li\u1ec1u ph\u00f9 h\u1ee3p v\u1edbi s\u1ef1 suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn:<\/p>\n\n\n\n

\u2022 eGFR t\u1eeb 45\u201359 ml\/ph\u00fat\/1,73 m2<\/sup>, xem x\u00e9t gi\u1ea3m li\u1ec1u khi c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng gi\u1ea3m t\u01b0\u1edbi m\u00e1u v\u00e0 gi\u1ea3m oxy m\u00e1u.<\/p>\n\n\n\n

\u2022 eGFR t\u1eeb 30\u201345 ml\/ph\u00fat\/1,73 m2<\/sup>, n\u00ean gi\u1ea3m m\u1ed9t n\u1eeda li\u1ec1u t\u1ed1i \u0111a \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/p>\n\n\n\n

\u2022 eGFR < 30 ml\/ph\u00fat\/1,73 m2<\/sup>, n\u00ean ng\u1eebng \u0111i\u1ec1u tr\u1ecb ho\u1eb7c khi b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u l\u1ecdc m\u00e1u, t\u00f9y theo \u0111i\u1ec1u ki\u1ec7n n\u00e0o s\u1edbm h\u01a1n.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

H\u00ecnh 1.<\/strong> Khuy\u1ebfn c\u00e1o hi\u1ec7u ch\u1ec9nh li\u1ec1u metformin d\u1ef1a tr\u00ean<\/p>\n\n\n\n

m\u1ee9c \u0111\u1ed9 suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn [5].<\/p>\n\n\n\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n\n\n\n

1. Chelsea Baker, Cimmaron Retzik-Stahr, Vatsala Singh, Renee Plomondon, Victoria Anderson, Neda Rasouli (2021), Should metformin remain the first-line therapy for treatment of type 2 diabetes?, Ther Adv Endocrinol Metab.<\/em> ; 12: 2042018820980225.<\/td><\/tr>
2. Davies, Melanie J., Aroda, Vanita R., Collins, Billy S., Robert A. Gabbay, et al. (2022), Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), Diabetes Care 2022<\/em>; 45(11):2753\u20132786<\/td> <\/td><\/tr>
3. David Z. Cherney and Katherine R. Tuttle (2020), Liraglutide for the Treatment of Type 2 Diabetes and Safety in Diabetic Kidney Disease, CJASN<\/em> 15 (4) 444-446; DOI:https:\/\/doi.org\/10.2215\/CJN.01260120.<\/td><\/tr>
4. Jin G Choi, Aaron N Winn, M Reza Skandari, Melissa I Franco, Erin M Staab, Jason Alexander, Wen Wan, Mengqi Zhu, Elbert S Huang, Louis Philipson, Neda Laiteerapong (2022), First-Line Therapy for Type 2 Diabetes With Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists : A Cost-Effectiveness Study, Ann Intern Med<\/em>., 175(10):1392-1400.<\/td><\/tr>
5. KDIGO 2022 clinical practice guideline for diabetes mangement in chronic kidney disease (2022), p. 58 – 63.<\/td><\/tr>
6. Medicines & Healthcare products Regulatory Agency (2022), Metformin and reduced vitamin B12 levels: new advice for monitoring patients at risk, https:\/\/www.gov.uk\/drug-safety-update\/metformin-and-reduced-vitamin-b12-levels-new-advice-for-monitoring-patients-at-risk, truy c\u1eadp 12\/11\/2022.<\/td><\/tr>
7. Scott D. Solomon, M.D., John J.V. McMurray, et al. (2022), Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction, N Engl J<\/em>; 387:1089-1098<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

ThS.DS. Nguy\u1ec5n Hu\u1ef3nh M\u1ef9 Trinh \u2013 BM DL DLS<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng hi\u1ec7n \u0111ang l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd b\u00e1o \u0111\u1ed9ng to\u00e0n c\u1ea7u v\u1edbi h\u01a1n 463 tri\u1ec7u ng\u01b0\u1eddi m\u1eafc v\u00e0o n\u0103m 2019 v\u00e0 d\u1ef1 ki\u1ebfn t\u0103ng l\u00ean g\u1ea7n […]<\/p>\n","protected":false},"author":82,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":""},"categories":[1796,2267],"tags":[],"yoast_head":"\nMETFORMIN \u2013 V\u00c0I \u0110I\u1ec2M C\u1eacP NH\u1eacT TRONG \u0110I\u1ec0U TR\u1eca\u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00ddP 2 - Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"METFORMIN \u2013 V\u00c0I \u0110I\u1ec2M C\u1eacP NH\u1eacT TRONG \u0110I\u1ec0U TR\u1eca\u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00ddP 2 - Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng\" \/>\n<meta property=\"og:description\" content=\"\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng hi\u1ec7n \u0111ang l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd b\u00e1o \u0111\u1ed9ng to\u00e0n c\u1ea7u v\u1edbi h\u01a1n 463 tri\u1ec7u ng\u01b0\u1eddi m\u1eafc v\u00e0o n\u0103m 2019 v\u00e0 d\u1ef1 ki\u1ebfn t\u0103ng l\u00ean g\u1ea7n […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/\" \/>\n<meta property=\"og:site_name\" content=\"Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/asprou.com\/\" \/>\n<meta property=\"article:published_time\" content=\"2022-11-14T08:56:14+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-06T08:46:42+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/asprou.com\/wp-content\/uploads\/2022\/11\/Picture1.png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Organization\",\"@id\":\"https:\/\/asprou.com\/#organization\",\"name\":\"Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng\",\"url\":\"https:\/\/asprou.com\/\",\"sameAs\":[\"https:\/\/www.facebook.com\/asprou.com\/\",\"https:\/\/www.youtube.com\/channel\/UC7JnqM5xyC69FGfE3cdVzFw\"],\"logo\":{\"@type\":\"ImageObject\",\"@id\":\"https:\/\/asprou.com\/#logo\",\"inLanguage\":\"vi\",\"url\":\"https:\/\/asprou.com\/wp-content\/uploads\/2020\/02\/Logo-HBU-Final.png\",\"contentUrl\":\"https:\/\/asprou.com\/wp-content\/uploads\/2020\/02\/Logo-HBU-Final.png\",\"width\":3697,\"height\":932,\"caption\":\"Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng\"},\"image\":{\"@id\":\"https:\/\/asprou.com\/#logo\"}},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/asprou.com\/#website\",\"url\":\"https:\/\/asprou.com\/\",\"name\":\"Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng\",\"description\":\"S\u00e1ng t\u1ea1o - H\u1ed9i nh\u1eadp Qu\u00f4\u0301c t\u00ea\u0301 - Ph\u00e1t tri\u1ec3n \u2013 Nh\u00e2n v\u0103n\",\"publisher\":{\"@id\":\"https:\/\/asprou.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/asprou.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"vi\"},{\"@type\":\"ImageObject\",\"@id\":\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#primaryimage\",\"inLanguage\":\"vi\",\"url\":\"https:\/\/asprou.com\/wp-content\/uploads\/2022\/11\/Picture1.png\",\"contentUrl\":\"https:\/\/asprou.com\/wp-content\/uploads\/2022\/11\/Picture1.png\",\"width\":816,\"height\":722},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#webpage\",\"url\":\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/\",\"name\":\"METFORMIN \u2013 V\u00c0I \u0110I\u1ec2M C\u1eacP NH\u1eacT TRONG \u0110I\u1ec0U TR\u1eca\u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00ddP 2 - Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng\",\"isPartOf\":{\"@id\":\"https:\/\/asprou.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#primaryimage\"},\"datePublished\":\"2022-11-14T08:56:14+00:00\",\"dateModified\":\"2023-04-06T08:46:42+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#breadcrumb\"},\"inLanguage\":\"vi\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Trang ch\u1ee7\",\"item\":\"https:\/\/asprou.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"METFORMIN \u2013 V\u00c0I \u0110I\u1ec2M C\u1eacP NH\u1eacT TRONG \u0110I\u1ec0U TR\u1eca\u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00ddP 2\"}]},{\"@type\":\"Article\",\"@id\":\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#webpage\"},\"author\":{\"@id\":\"https:\/\/asprou.com\/#\/schema\/person\/3d3ddad9f635622413e29236c0b2c45e\"},\"headline\":\"METFORMIN \u2013 V\u00c0I \u0110I\u1ec2M C\u1eacP NH\u1eacT TRONG \u0110I\u1ec0U TR\u1eca\u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00ddP 2\",\"datePublished\":\"2022-11-14T08:56:14+00:00\",\"dateModified\":\"2023-04-06T08:46:42+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#webpage\"},\"wordCount\":1373,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/asprou.com\/#organization\"},\"image\":{\"@id\":\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/asprou.com\/wp-content\/uploads\/2022\/11\/Picture1.png\",\"articleSection\":[\"Khoa D\u01b0\u1ee3c\",\"Tin t\u1ee9c khoa D\u01b0\u1ee3c\"],\"inLanguage\":\"vi\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#respond\"]}]},{\"@type\":\"Person\",\"@id\":\"https:\/\/asprou.com\/#\/schema\/person\/3d3ddad9f635622413e29236c0b2c45e\",\"name\":\"kduoc\",\"image\":{\"@type\":\"ImageObject\",\"@id\":\"https:\/\/asprou.com\/#personlogo\",\"inLanguage\":\"vi\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/cc76421529a060123b43983a03f98c12?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/cc76421529a060123b43983a03f98c12?s=96&d=mm&r=g\",\"caption\":\"kduoc\"}}]}<\/script>\n","yoast_head_json":{"title":"METFORMIN \u2013 V\u00c0I \u0110I\u1ec2M C\u1eacP NH\u1eacT TRONG \u0110I\u1ec0U TR\u1eca\u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00ddP 2 - Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/","og_locale":"vi_VN","og_type":"article","og_title":"METFORMIN \u2013 V\u00c0I \u0110I\u1ec2M C\u1eacP NH\u1eacT TRONG \u0110I\u1ec0U TR\u1eca\u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00ddP 2 - Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng","og_description":"\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng hi\u1ec7n \u0111ang l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd b\u00e1o \u0111\u1ed9ng to\u00e0n c\u1ea7u v\u1edbi h\u01a1n 463 tri\u1ec7u ng\u01b0\u1eddi m\u1eafc v\u00e0o n\u0103m 2019 v\u00e0 d\u1ef1 ki\u1ebfn t\u0103ng l\u00ean g\u1ea7n […]","og_url":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/","og_site_name":"Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng","article_publisher":"https:\/\/www.facebook.com\/asprou.com\/","article_published_time":"2022-11-14T08:56:14+00:00","article_modified_time":"2023-04-06T08:46:42+00:00","og_image":[{"url":"https:\/\/asprou.com\/wp-content\/uploads\/2022\/11\/Picture1.png"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Organization","@id":"https:\/\/asprou.com\/#organization","name":"Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng","url":"https:\/\/asprou.com\/","sameAs":["https:\/\/www.facebook.com\/asprou.com\/","https:\/\/www.youtube.com\/channel\/UC7JnqM5xyC69FGfE3cdVzFw"],"logo":{"@type":"ImageObject","@id":"https:\/\/asprou.com\/#logo","inLanguage":"vi","url":"https:\/\/asprou.com\/wp-content\/uploads\/2020\/02\/Logo-HBU-Final.png","contentUrl":"https:\/\/asprou.com\/wp-content\/uploads\/2020\/02\/Logo-HBU-Final.png","width":3697,"height":932,"caption":"Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng"},"image":{"@id":"https:\/\/asprou.com\/#logo"}},{"@type":"WebSite","@id":"https:\/\/asprou.com\/#website","url":"https:\/\/asprou.com\/","name":"Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng","description":"S\u00e1ng t\u1ea1o - H\u1ed9i nh\u1eadp Qu\u00f4\u0301c t\u00ea\u0301 - Ph\u00e1t tri\u1ec3n \u2013 Nh\u00e2n v\u0103n","publisher":{"@id":"https:\/\/asprou.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/asprou.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"vi"},{"@type":"ImageObject","@id":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#primaryimage","inLanguage":"vi","url":"https:\/\/asprou.com\/wp-content\/uploads\/2022\/11\/Picture1.png","contentUrl":"https:\/\/asprou.com\/wp-content\/uploads\/2022\/11\/Picture1.png","width":816,"height":722},{"@type":"WebPage","@id":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#webpage","url":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/","name":"METFORMIN \u2013 V\u00c0I \u0110I\u1ec2M C\u1eacP NH\u1eacT TRONG \u0110I\u1ec0U TR\u1eca\u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00ddP 2 - Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Qu\u1ed1c t\u1ebf H\u1ed3ng B\u00e0ng","isPartOf":{"@id":"https:\/\/asprou.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#primaryimage"},"datePublished":"2022-11-14T08:56:14+00:00","dateModified":"2023-04-06T08:46:42+00:00","breadcrumb":{"@id":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#breadcrumb"},"inLanguage":"vi","potentialAction":[{"@type":"ReadAction","target":["https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Trang ch\u1ee7","item":"https:\/\/asprou.com\/"},{"@type":"ListItem","position":2,"name":"METFORMIN \u2013 V\u00c0I \u0110I\u1ec2M C\u1eacP NH\u1eacT TRONG \u0110I\u1ec0U TR\u1eca\u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00ddP 2"}]},{"@type":"Article","@id":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#article","isPartOf":{"@id":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#webpage"},"author":{"@id":"https:\/\/asprou.com\/#\/schema\/person\/3d3ddad9f635622413e29236c0b2c45e"},"headline":"METFORMIN \u2013 V\u00c0I \u0110I\u1ec2M C\u1eacP NH\u1eacT TRONG \u0110I\u1ec0U TR\u1eca\u0110\u00c1I TH\u00c1O \u0110\u01af\u1edcNG T\u00ddP 2","datePublished":"2022-11-14T08:56:14+00:00","dateModified":"2023-04-06T08:46:42+00:00","mainEntityOfPage":{"@id":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#webpage"},"wordCount":1373,"commentCount":0,"publisher":{"@id":"https:\/\/asprou.com\/#organization"},"image":{"@id":"https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#primaryimage"},"thumbnailUrl":"https:\/\/asprou.com\/wp-content\/uploads\/2022\/11\/Picture1.png","articleSection":["Khoa D\u01b0\u1ee3c","Tin t\u1ee9c khoa D\u01b0\u1ee3c"],"inLanguage":"vi","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/asprou.com\/khoa-duoc\/metformin-vai-diem-cap-nhat-trong-dieu-tridai-thao-duong-typ-2\/#respond"]}]},{"@type":"Person","@id":"https:\/\/asprou.com\/#\/schema\/person\/3d3ddad9f635622413e29236c0b2c45e","name":"kduoc","image":{"@type":"ImageObject","@id":"https:\/\/asprou.com\/#personlogo","inLanguage":"vi","url":"https:\/\/secure.gravatar.com\/avatar\/cc76421529a060123b43983a03f98c12?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/cc76421529a060123b43983a03f98c12?s=96&d=mm&r=g","caption":"kduoc"}}]}},"modified_by":"khoandd","_links":{"self":[{"href":"https:\/\/asprou.com\/wp-json\/wp\/v2\/posts\/63820"}],"collection":[{"href":"https:\/\/asprou.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/asprou.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/asprou.com\/wp-json\/wp\/v2\/users\/82"}],"replies":[{"embeddable":true,"href":"https:\/\/asprou.com\/wp-json\/wp\/v2\/comments?post=63820"}],"version-history":[{"count":2,"href":"https:\/\/asprou.com\/wp-json\/wp\/v2\/posts\/63820\/revisions"}],"predecessor-version":[{"id":63823,"href":"https:\/\/asprou.com\/wp-json\/wp\/v2\/posts\/63820\/revisions\/63823"}],"wp:attachment":[{"href":"https:\/\/asprou.com\/wp-json\/wp\/v2\/media?parent=63820"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/asprou.com\/wp-json\/wp\/v2\/categories?post=63820"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/asprou.com\/wp-json\/wp\/v2\/tags?post=63820"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}