事件记录
面试官: There's a pretty good chance that either you or one of your family members is affected by diabetes, 肥胖和其他代谢问题. 大发娱乐要谈谈一家可以大发娱乐你的全新诊所. 接下来是《大发娱乐》.
播音员: Medical news and research from University of Utah physicians and specialists you can use for happier and healthier life. 您正在收听的是范围.
面试官: Dr. 蒂姆·格雷厄姆（Tim Graham）是美国糖尿病协会的医学主任, 犹他大学医疗保健肥胖和新陈代谢项目. 大发娱乐来谈谈专门治疗糖尿病，肥胖和新陈代谢的新诊所. 这是一件大事，它现在已经成为一种独立的东西.
Dr. 格雷姆: 是的. We basically have what we call a service line that covers multiple clinics throughout 犹他大学医疗保健 and we've got a couple of very exciting areas that we've brought new services to the people of Salt Lake and Utah. 首先, 大发娱乐有犹他州糖尿病和内分泌学诊所, 现在哪家公司大发娱乐提供团队糖尿病护理.
I often joke it really takes a village to take care of a patient with diabetes because individuals with diabetes have problems with eyes, 他们的脚有问题, 他们需要特殊的营养考虑. We like to have them work with exercise physiologists to improve their activity and to do it in a sustainable way where they don't develop sport-related injuries. 他们通常需要物理治疗等等. 有时是行为健康需求. So we like to bring all those services in a team-based fashion to our patients who come into the diabetes center here at University of Utah.
面试官: 这是一种新的思考糖尿病的方式. 我说的对吗?
Dr. 格雷姆: 它是. 在过去, it used to be a very much a sub special physician-driven care plan where you would go see a doctor that would make some recommendations, 把你送回你的初级保健大发娱乐提供者那里. 大发娱乐所做的就是当病人来找大发娱乐的时候, 大发娱乐大发娱乐提供所有这些服务，大发娱乐大发娱乐提供一个很好的, 统一的方式，使您不会觉得您一直在供应商之间的杂耍. And then we send the patient back eventually to their primary care provider with a much more comprehensive care plan that sort of details all these things and doesn't just pay attention to the insulin dosing or other types of diabetes medication dosing.
面试官: 诊所还做什么？它是如何大发娱乐人们的?
Dr. 格雷姆: So we've also established a really exciting program in conjunction with bariatric surgery. 大发娱乐现在有一个非常好的方法来逆转糖尿病通过减肥手术. 所以可能比大发娱乐给人们的任何药物都好, 如果大发娱乐能让他们做胃旁路手术或胃袖手术, it largely reverses diabetes for a lifetime and longer-term studies are just coming now to bear that shows, this is a very sustainable effect and people do extremely well even a decade out past surgery.
And every decade you don't live diabetes is a decade that will save your body from a lot of damage. So we have partnered with bariatric surgery program to develop a unified approach to obesity. BMI大于等于35的人, BMI的定义是千克每平方米, 我用这个词是因为我认为更多的人会知道它是什么. 如果你不知道, just Google BMI and you'll find any number of BMI calculators where you pop in your weight and your height and it will tell you what your BMI is.
但是如果你的身体质量指数大于等于35并且你有任何与肥胖相关的疾病, 可能是糖尿病，也可能是高胆固醇或者高血压, 如果你有这些情况, 那你就要接受减肥手术了. So we've recognized this is a really important sort of additional therapy we bring patients. And so we've got a medical bariatric program that's now partnered with the surgical bariatric program to provide what we call a comprehensive weight management program. 这也不仅仅适用于身体质量指数很高或患有糖尿病的人. It's for people who just want to lose weight and would like get some medically-supervised nutritional attention and exercise physiology attention to help them.
面试官: 从你告诉我的情况来看, 这种基于团队的方法, 好像有人在听，在思考, “我应该保持一点健康, 我应该能吃得更好，为什么我不能自己做这件事?“但在当今世界，这真的比这困难得多. 这就是为什么你们要把所有这些人，所有这些专家聚集在一起?
Dr. 格雷姆: 是的，我认为这是大发娱乐的社会建立起来的一个神话. 就好像，如果你不能减肥，你就有问题. 每个人都应该有毅力去做这件事. 大发娱乐看《大发娱乐》之类的节目." And while I love that sort of program for bringing to attention the problem with obesity, 这些人接受了一整天的培训. 他们请人为他们准备饭菜. Who has the time, the money and the willpower to basically do that on a day-to-day basis?
The idea that it's just something we can easily do on our own without having help is really wrong-headed. 而且, I think it's even than the attitude of physicians for many years that the patient should just be able to do it on their own. 但每次我送病人去医院的时候都会给他们一些笼统的建议，比如, “去减肥吧，变得更健康,“他们似乎并没有减肥回来，吃得更健康. So I think that we really have to come up with personalized strategies to help patients, 支持他们, 甚至能让他们实现目标. 一般来说，当人们在这样的团队中工作时，他们会做得更好.
面试官: 是的. And I would imagine too that over the past many years we've learned a lot more about these things. 你真的需要这些专家来更好地理解它?
Dr. 格雷姆: 绝对. The other side of this is that we now know that obesity is at least 50% genetic in origin. And so the idea that it's just because you're lazy and you don't exercise is completely incorrect. And anything that's genetic in origin has a biological basis so we now understand and very cutting edge research done here, 无论是在犹他州还是其他地方, that the brain is wired differently when you become obese and it's very hard to undo that wiring. 所以事实是人们, 当他们减肥的时候, 往往会有大发娱乐所说的累犯，他们的体重很快就会反弹.
面试官: 大发娱乐都听说过，对吧?
Dr. 格雷姆: 是的. 溜溜球的重量绝对是大脑固有的. 这是生物. 不是因为缺乏意志.
面试官: 所以这样的诊所真的可以大发娱乐那些 . . . 这不是一颗神奇的药丸, 这可能需要一些工作和时间, but it sounds like it would offer hope to somebody that has not had hope before or has failed in the past?
Dr. 格雷姆: 这是正确的. 我想说，这也包括那些严重肥胖的人. 大发娱乐用这个词, 我不喜欢它，因为它听起来太消极了, 但是病态肥胖, 即BMI大于等于40. People who get up that high have a very hard time losing weight and they need additional support, 尤其是物理治疗. Think about many people are starting to get joint problems when you start getting heavier with a BMI of 40-45 range.
所以大发娱乐需要带更多的东西来大发娱乐这些人, 他们中的许多人将成为减肥手术的候选人, 有些人不会. 但仅仅因为他们不是，并不意味着他们不需要特殊的医疗保健. And so we really are trying to bring medical bariatrics up to get up to speed with the great advances that have been happening in surgical bariatric. And to give a home for everyone with all these problems so that they don't have to just see the primary care provider who might tell them every time, “你知道你需要减肥. 你知道你需要 . . . "
面试官: 每年你都会听到这种说法，对吧? 然后一年过去了，当你回来的时候，你还是在同一条船上.
Dr. 格雷姆: 实际上要达到效果需要更多的东西.
面试官: Where can I find more information about the Diabetes, Obesity, and 新陈代谢 Program?
Dr. 格雷姆: 大发娱乐在犹他大学的网站上，有关于 . . . 如果你去犹他糖尿病中心, we've got a web page that will actually branch out all these different programs we've been developing.
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