Before reading this chapter please start with chapters:
First Concepts.
WOB is Optimal

Insulin controls carbohydrate metabolism. It drives glucose into cells, promotes DNA replication and protein synthesis. With other hormones  it controls also blood glucose level.  In healthy individuals blood glucose level varies between 80 -110 mg/ dl.  Any decline below 80 mg/dl may be dangerous (hypoglycemia), while  a five fold rise does not pose any immediate threat. Three hormones prevent a blood glucose decline, glucagon, growth hormone and epinephrine. Insulin removes excess blood glucose by converting it into glycogen, and fatty acids. It promotes also the formation of fat cells and obesity.

Islet cell adenoma

Our brain requires glucose and is therefore  extremely sensitive to a low blood glucose level as will be illustrated  with  the evolution of an islet cell adenoma. It is  a benign tumor producing insulin in excess of what the body needs. The growing tumor produces more and more insulin and blood glucose declines until the patient sinks in coma. The disease  proceeds through two phases:
1. Compensation:  When  tumor is small and insulin production  meager.  Nevertheless insulin stimulates an  increased secretion of  glucagon, and growth hormone, which  mobilize glucose and drive its blood level up to its normal value. Glucagon converts glycogen to glucose (glycogenolysis), and mobilizes glucose from protein (gluconeogenesis).  Insulin stimulates also epinephrine which raises blood pressure (vasoconstriction)  and  heart rate, raising  cerebral  blood flow.

Decompensation:  As tumor grows and more insulin is produced, glucagon and growth hormone  fail to mobilize enough glucose, and its blood level declines. Neurons are the first to be affected since requiring glucose. Consciousness is impaired and accompanied by tremor. WOB sends the mind a signal of intense hunger as if saying :"Get sugar!" It mobilizes glucose from the periphery by cutting down its utilization. It signals the mind fatigue and muscle pain. The patient lies down stops moving, which makes more glucose available to the brain. More epinephrine is secreted, cerebral blood flow rises and so does sugar throughput.

When blood glucose becomes even lower, WOB shuts down consciousness (eliminates the mind), patient faints, glucose uptake by non vital process is cut off and  diverted to  vital processes in  the brain stem. Increased efforts to mobilize glucose by  WOB deepen unconsciousness and the patient sinks in coma.

Islet cell tumor drives hypoglycemia

The patient condition is  driven by a growing islet cell tumor. As insulin production rises, and blood glucose level declines,  WOB reshuffles processes  to mobilize  enough glucose to sustain vital processes. Each reshuffle is the most optimal WOB solution in the particular circumstances.  In order to keep the patient alive, WOB sacrifices less vital processes. Fainting and coma are such solutions. They are not breakdowns, but necessary steps to keep the patient alive.

This narrative illustrates also the role of medicine in therapy. To support  WOB and assist it where it fails. Most patients with islet cell tumors arrive to the hospital during decompensation (hypoglycemia), which is corrected with a glucose infusion. When patient’s condition is stabilized, the tumor is removed surgically.

Diabetes mellitus

Also the evolution of diabetes mellitus proceeds through  WOB solutions designed to maintain life at any cost .  Unfortunately medicine fails to adhere to its role as a WOB assistant. Hyperglycemia is regarded as a failure which has to be corrected even if it contradicts WOB.  Medicine ignores WOB messages that its treatment is false. As the disease evolves, treatment becomes hampered by grave side effects, 1. Bouts of hypoglycemia, 2. Obesity and hypertension, and 3. Insulin resistance.  All three are WOB messages that it opposes medical treatment. Particularly insulin resistance, which  is WOB solution to maintain hyperglycemia.  WOB makes external insulin and other drugs  ineffective. Insulin resistance is a WOB solution to maintain life despite a false medical treatment. From the WOB perspective diabetes mellitus is driven by an rising demand for glucose by the brain. A rising normoglycemia, and not a rising hyperglycemia as medicine postulates


Since diabetes mellitus is about glucose craving by the brain, why not train the body to function adequately with less sugar?  This may seem bizarre, yet
WOB can be trained to master many  unusual feats. You decide to become an athlete and start training which is a message from mind to WOB that it has to support your will. WOB will object and send messages like fatigue, or muscle pain as if saying: "Skip it!" Yet mind continues insisting. The outcome has been described elsewhere    Such a feat is indicated here by the Yogi  suffix.  Following the example of the Hindu  Yogi, who masters many involuntary processes, like breathing and heart rate, one may train to master other involuntary feats, like rope walking,  or athletics, which are called respectively Circus-Yogi, and Muscle-Yogi. Insulin-Yogi can do with less insulin.

The notion of an
Alcohol-Yogi, illustrates how  to train WOB  to handle a poison. A Cancer-Yogi trains his WOB to prolong remission..  How then to train WOB to require less glucose, and become an Insulin-Yogi? We may apply the training program of an Alcohol-Yogi. 

Training to live with hypoglycemia

Imagine a healthy individual  who decides to get used to rising doses of insulin. He injects himself with a small dose of insulin and  immediately feels dizzy.  During the following days he repeats the same treatment (training) until he does not feel dizzy anymore, whereupon he raises the insulin dose, feels dizzy again, and continues his training. Throughout his training he keeps closely  a glass of sweet water in case he feels like fainting. Dizziness is a WOB message to the mind as if saying: "I fail to maintain an adequate blood glucose  level, go and lie down!"  You may regard it as an analog to muscle pain experienced by an athlete which is a WOB message to the mind as if saying: "I fail to grow  enough muscle fibers to support your training, take a rest!"

Hypoglycemia  training mimics the growth of an  islet cell adenoma. As long as WOB maintains compensation, training is effective and may continue. However when decompensation ensues, training ought to be stopped. Above all training has to be gradual, which applies also to the athlete. If exaggerating he might tear a muscle or a ligament.

You may regard such an exercise as unethical. However
every diabetic patient is forced to undergo a similar training. Since treatment aims to restore normoglycemia which from the WOB perspective is a hypoglycemia, medicine trains diabetic patients to become Insulin-Yogis. Every patient gets used to dizziness and sweating when he fails to adequately dose up his insulin.  Many patients carry a lump of sugar to protect themselves from fainting. With time they become used to dizziness, and it stops  bothering them.

Insulin damage

Yet even an Insulin-Yogi cannot repair insulin damage. Medicine induced hypoglycemia stimulates epinephrine secretion, which promotes hypertension. Insulin itself promotes fat formation and obesity. The growing adipose tissue competes with the brain for glucose and aggravates the disease (diabesity)." In epidemiological studies of non diabetic human beings, hyperinsulinemia has been associated with poorer cognitive performance and an increased risk of Alzheimer's dementia" (The Lancet, 363:1253, 2003). Yet another reason why WOB resists insulin.

Above all looms a glucose toxicity and its sequels. The main therapeutic objective is to slow down disease progression. The physician has to find a compromise between the rising demand of the brain for  glucose, and glucose toxicity.

Clinical trials

Medicine justifies  its treatment by the outcome of clinical trials. Several studies have  shown that diabetic complications decrease markedly and consistently as blood glucose levels approach 'normal' patterns over long periods. Which suggests that if a diabetic closely controls blood glucose levels the rate of diabetic complications goes down.

Clinical trials ought to be mistrusted. Their reasoning depends on machine statistics which fail when applied to humans. In such a trial the human organism is reduced to an insignificant point while in reality he is a complex  and irreducible entity.

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