Chapter 5
The Insulin-Glucose Connection
INTRO

The chief illness  being discussed in this chapter is  Diabetes.  

At present, nearly one in three Americans, including half of those age 60 and older, have a silent blood sugar problem, known as insulin resistance.  

The entire medical profession now agrees, after decades of research and observation that insulin resistance is the most significant etiology of Adult Onset Diabetes Mellitus.

Today we are facing a growing crisis because of the epidemic of Adult Onset Diabetes, triggered by insulin resistance.  The chief cause of this is the common Western Diet.  The science of nutrition is in chaos, flooded with misinformation and marketing, and we as the consumer and as the patient are not just confused, but we are being intentionally mislead and manipulated.

We lack the tools to either explain the cause or to help treat and prevent Adult Onset Diabetes, within the Western world.

Are we helpless. The answer is No.  We need a new perspective, and discipline.  We need to end the cycle of fad diets, on the heels of processed sugar consumption.

Most research has failed to address the congruence of the many external and environmental factors that play a role in the manifestation of insulin resistance. 

Instead we continue to seek answers from the metabolic pathways examined within the research and academic labs and fail to see the whole patient in the examining room.  Medical research, and certainly not single reports, constitutes medical advise or medical practice.  We all know that in medicine, one must take a whole patient approach in order to heal the whole patient.

In presenting the XOK Program Lifestyle, a  program resulting from 30 years of processional observations and the empirical study of case histories, we can reduce the problem to several simple facts that everyone in the health profession can agree on.

First, as of today, we do not yet have the double-blind clinical  data to support the XOK theory nor the conclusions.  This is our major weakness. There are many anecdotes and popular fads that suggest the XOK  theory, but lack the scientific data to support our clinical experience.

Our goal in this chapter  is to present  the growing body of  scientific data and to connect them in a  manner that breathes life into the observations that lead us to the development of the successful XOK Program, which at the end of this discussion, should be obvious to all of us, lay people and medical professions alike.

Parallel to this we note  the ever present and growing  option  of alternative fads, diets  and popular non FDA “medicines” -   as short-cuts- more callously often referred to with the label of “quackery”.  Among data scientist this is called the signal to noise ratio.  Marketers exploit our doubts, and lack of consensus in order to exploit the market created by crisis of insulin resistance and obesity.

At this point, let us review a few characteristics empirical studies as they relate to medicine. 

1   -   Science is not in whole a mathematical formula of statistics
	Math is essential to science, as it is a descriptive language which scientists use to explore logical reasoning.  However, it is not science in of itself.

2-    Individual human beings are more than a statistic.  
	In medicine, we treat the patient, not the lab results.

3-    Statistics are invalid tools for individual human life  <<== GEORGE, you really want to say this?  I don't even know what it means.

4-    Medicine is the practice of an art, based on scientific understanding.  
	Art and Science are equal aspects in the medical practice, each comprising a 50% role in the healing process.

5-    Observation is the best tool for discovery.
	 It is not pure science or pure art, but it is the only means for humans to gain experience.  We learn by doing and observing.

6-   Human nutrient and diets are not easy to study in the lab.
	The ingredients of a daily menu eaten by, say our Africans ancestors, living for generations in the savanna and brush, or aboriginals living in the Amazon Jungle, is totally unpredictable by the modern nutritional  research scientists, and yet they live, and largely live healthy with regard to their nutrition as long as their food supplies remain abundant and stable.

 7   Modern research, however, provides the basis of our nutritional understanding.
 	The ingredients of a daily menu of the patient in the ICU fed by enteral or IV means is totally capable of being analyzed by the lab scientist.
8  The clinical effects of these 2 menus  on the individual  cannot be compared . << Remove this.  It is either not what you meant or it is misstated.  In any event, it is obvious from the above

9 Not all observation are false. 
	Not all allegorical data is invalid, although it needs to be treated with caution.  Some may be misleading and some are not.

https://www.quackwatch.org/01QuackeryRelatedTopics/cancer.html

The Strengths and the Weaknesses of the Process of Observation

The Modern (post)Industrial revolution that began close to 200 years ago has in some instances  disadvantaged us in the process individual discovery and observation. We precondition our observational powers, and turst the experts.   We have the defined rules and the regulations from government agencies such as the FDA and of the Pharmaceutical industry to guide us.  This is not that different than what Galileo experienced from the Church, although perhaps less malicious.  But in both cases, there is a preconceived notion of what is acceptable facts, regardless of the data.

<<Galileo, Newton and fellow scientists made observations and discovered new phenomenon that were at first ignored or  discarded as invalid.>>  George, I was going to just remove this, but I leave it here to point out that this is factually wrong in both cases.  Galileo and Newton were both celebrities from a very young age.

Many Physicians and scientists and their research and clinical observations  were placed in the category of being “quacks” and drummed out of the center stage of medicine and science.  <<CORRECT which is probably what you meant above>>

What was their failure ?  They failed to observe the written and the unwritten rules of the institutions that paid for and supported research. Plus ça change, plus c’est la même chose



Insulin Resistance and Its History

Insulin resistance is no longer thought to be triggered solely  by genetic factors.  We all agree that it is more likely an acquired disease, precipitated by negative lifestyle patterns and external environmental conditions, principally the poor dietary choices in the marketplace, exasperated by a lack of exercise. A major result is the excess concentration of non-metabolized glucose over a “long “period of time.

<<George:  Non-Metabolized?

This in turn results in the storage of excess body fat and fat deposits in liver and pancreas.  This gives birth to “sick” Insulin and Insulin resistance. 

We all agree that an abundance of evidence points to insulin resistance as a significant contributing factor in the development of pre-Diabetes and type 2 Diabetes.  

From an integrated perspective we must acknowledge that Insulin resistance is associated with dyslipidemia, hypertension, and inflammation.  This opens the door to a host of other probably related clinically observed illnesses and conditions. 

Many  researchers, both scientists and pseudoscientists, seek a thread within the laboratory to connect cause with effects.  Billions of dollars are spent on this problem and drugs to the tune of thousands of dollars a month are being prescribed to combat insulin resistance. 

Why do we have a crisis with insulin resistance?
	Insulin resistance is probably caused by an immune based factor that decreases the competence of the insulin to serve effectively  in its role. 

There is some evidence that microbes living within the digestive system, that are now being uncovered as possessing major genetic factors,  play a role in this phenomenon. <<George, this makes no sense.  Human Genetic Factors or Microbial Genetics?

Furthermore, we can all agree that insulin resistance also negatively impacts exogenous insulin that is inserted into the patient.  
While this condition can be asymptomatic for a considerable period, it is a natural precursor for pre-diabetes, heart disease and other illnesses.  

We can all agree that insulin resistance is most often found in individuals who present with higher body-mass-index (BMI), hypertension, and increased weight circumference.   

Over time, due to prolonged exposure to elevated  concentrations of glucose, the pancreas will become overworked.  Additionally, glucose that is not metabolized to produce energy will be stored as glycogen in the liver and as fat deposits in the pancreas, puts osmotic strain on the kidneys, and creates a condition known as pancreatic steatosis.  Beta cells grow in size and become exhausted from overuse.  As a consequence the body becomes less efficient in metabolizing glucose.  This may be considered the production of “sick” insulin in that it will not function as well in controlling blood glucose levels.  We all understand that this triggers the cycle of disease where the pancreas releases a higher quantity of insulin in an attempt to compensate for blood glucose levels that are not suitable over long periods of time.    We all know that the human body is not designed to sustain blood sugar levels over 130mg/dl as a baseline, not to mention 250 or 300. 
At this point very often exogenous insulin is often introduced, but it is already at this point less effective in metabolizing the excessive levels of glucose.        

As we all know, and as it is in most disease conditions, inflammation plays a significant role in the disease state.  Pancreatitis, (note the 'itis' )is now believed to be a precursor to cancer of the pancreas, and this has been substantiated on the genetics level.

The result is that excess glucose will be stored as glycogen in the live. Excess glucose becomes stored  as fat in the body tissues.  In addition excess glucose becomes stored as fat deposits in the liver (causing non-alcoholic fatty liver disease (NAFLD).  More recently, medical research has learaned that fat deposits also build up in the pancreas causing the condition known as pancreatic steatosis or Non-Alcoholic Pancreatic Disease (NAFPD).  This condition impedes this endocrine organ's critical biological function.  The normal intake of glucose allows the beta cells in the pancreas to release insulin which then convert glucose into energy via the process of metabolism.  This is what converts ADP, amino acids already in the body, to ATP which furnishes the energy the body requires on a daily basis.  

The conversion of glucose into glycogen results in weight gain and a greater propensity for obesity and Diabetes.  These, then, are the wages of an unhealthy lifestyle.  Too great an intake of glucose and the failure to exercise inhibit the metabolism of glucose and instead of producing energy, produce excessive body fat, fatty liver disease.  But, as science is now learning, the even-more-serious issue concerns the inability of the pancreas to release healthy insulin in sufficient quantities to metabolize the excess glucose that is ingested.  Science is learning much more about the biology of insulin resistance.