Development and potential reversal of type 2 diabetes: How critical is vitamin A in the regulation of insulin responsiveness and lipid homeostasis?

受2型糖尿病影响的人数迅速增加，这一点令人严重关切。糖尿病是一个世界性的问题，从1980年的1.08亿上升到2014年的4.22亿。在菲律宾，每六个菲律宾人中就有一个患有糖尿病前期或糖尿病。最近的研究表明，2型糖尿病是通过肝脏和胰腺中过多但可逆的脂肪堆积而发展起来的。也有一些证据表明，维生素A可能导致了这种情况，但潜在的机制尚未完全了解。此外，目前还不清楚为什么一些人比其他人更快地患上2型糖尿病，即使他们的肝脏脂肪含量相似。因此，这项拟议的研究旨在了解维生素A是否会增加脂肪肝引起的代谢压力，以及维生素A代谢的变化是否会导致肝脏脂肪增加，从而导致肝脏脂肪积累的恶性循环，加速糖尿病的发展。这项研究最终将评估菲律宾糖尿病患者的饮食减肥是否可以改善糖尿病控制的方方面面，以及低能量流质饮食在文化上是否可以接受。最后，该项目可能有助于制定新的预防战略，使卫生部能够减轻菲律宾糖尿病及其并发症的负担。

The rapid increase in number of people affected by type 2 diabetes is matter of grave concern. Diabetes is a world-wide problem and has risen from 108 million in 1980 to 422 million in 2014. In the Philippines, one out of every six Filipino has either pre-diabetes or diabetes. Recent studies have shown that type 2 diabetes develops by excess, yet reversible, fat accumulation in liver and pancreas. There is also some evidence suggesting that vitamin A may contribute to this condition, but the underlying mechanisms are not yet fully understood. Furthermore, it is not yet clear why some people develop type 2 diabetes faster than others, even with a similar liver fat content. The proposed study therefore aims to understand if vitamin A increases the metabolic stress that is caused by a fatty liver, and if changes in vitamin A metabolism could contribute to an increase in liver fat, therefore inducing a vicious cycle of liver fat accumulation and acceleration of the development of diabetes. The study will finally evaluate if diet-induced weight loss among diabetics in the Philippines could improve all aspects of diabetes control, and if a low energy liquid diet is culturally acceptable. Finally, the project may help to develop new prevention strategies to enable the Ministry of Health to reduce the burden of diabetes and its complications in the Philippines.