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Shaun Rogers struggled for more than 20 years to manage his weight even as his diabetes kept getting worse.
肖恩·罗杰斯为了减肥抗争了20多年，即使他的糖尿病愈发严重。
By just dieting and continuing the cycle with the insulin, I was never gonna lose the amount of weight I needed to lose,
我就是节食，然后继续使用胰岛素，我永远不会减掉我需要减掉的重量，
to change the whole cycle and get the diabetes under really good control.
来改变整个循环，让糖尿病得到好的控制。
Insulin which stabilizes blood sugar can make people feel hungry, making it harder for them to lose weight.
胰岛素可以控制血糖，但却让人们感到饥饿，让他们更难减肥。
But bariatric surgery is expensive. In the US health insurance companies won't pay for the procedure,
但减肥手术很昂贵，美国医保公司不会为此支付，
unless the patient's body mass index or BMI is at least 35, even if the patient's diabetes is uncontrolled.
除非病人的身体质量指数至少为35，即使病人的血糖没有得到控制。
BMI is a measure of body fat based on a height and weight
BMI是根据身高和体重测量脂肪的指数，
and is not always an indication of how well a patient is responding to treatment for diabetes.
并不总是病人对糖尿病治疗反应好坏的指标。
BMI is not really a fair or accurate representation of who should be getting therapy.
BMI并不能公正，且准确代表谁应该接受治疗。
Dr. Stacy Brethauer at Ohio State University says the criteria for the surgery is outdated.
俄亥俄州立大学的斯泰西·布莱森豪尔医生促成这种手术标准过时了。
The patient who doesn't get the operation, we know very well that their disease will progress,
那些不接受手术的患者，我们清楚地知道他们的病情还会恶化，
their lifespan will be shortened if they don't get effective treatment.
如果不接受有效治疗，他们会减寿。
The American Medical Association classifies obesity as a complex, chronic disease that requires medical attention.
美国医学会将肥胖界定为复杂的长期性疾病，需要进行医疗处理。
Left untreated, obesity can also lead to heart disease, cancer and diabetes.
如果不治疗，肥胖可以导致心脏病、癌症和糖尿病。
No one asks somebody with cancer or heart disease to just do it themselves.
没有人会让癌症和心脏病患者自己处理。
They have to participate in their care and do the right things,
他们要接受照料，做正确的事情，
but there's you know also effective therapy being offered to those patients at the same time.
而且让患者在正确的时间接受有效的治疗。
Since his surgery, Rogers has lost a significant amount of weight and his diabetes is under control.
自从手术后，罗杰斯减重很多，糖尿病也得到了控制。
He no longer needs oral medication, and his insulin is down from nearly 500 units per day to about 10.
他不再需要内服药物，他的胰岛素水平从每天的近500下降到大约10。
It's changed my life so much. I would you know tell anyone do it.
这极大改变了我的生命，我会告诉其他人这么做。
Diabetes is a global health issue. More than 400 million adults, one in eleven have this disease.
糖尿病是全球性疾病，超4亿成年人患病，每十一人中就有一人是。
The World Health Organization estimates that number will rise significantly in the near future.
世卫组织预计这一数字将在未来大幅度提高。
If diabetics have bariatric surgery early on, they can be cured.
如果糖尿病患者及早接受手术，他们可以得到治愈。
For those who have had the disease for ten years or more, and need insulin shots,
对于那些患病10年以上，而且需要注射胰岛素的，
the surgery won't reverse their diabetes, but Brethauer says it can greatly improve their health.
手术不会逆转他们的糖尿病，但布莱森豪尔称这将极大改进他们的健康。
Carol Pearson VOA news
卡洛·皮尔森，VOA新闻
