Geometric Attractor Steering in Non-Equilibrium Metabolic-Immune Networks: A Unified Dissipative Systems Framework for Type 1 and Type 2 Diabetes Remission and Stabilization

Chronic metabolic and autoimmune disorders have conventionally been treated as irreversible, progressive pathologies managed through lifelong pharmacotherapy or perpetual hormonal replacement. Challenging this palliative paradigm, this paper establishes a unified dissipative systems framework that formulates Type 1 and Type 2 diabetes as topological phase transitions within a coupled, multi-scale 8-dimensional metabolic-immune manifold. Key Theoretical & Numerical Contributions: Type 2 Diabetes Remission via Least Action Pulse Steering: We model the bistable potential landscape governing plasma glucose, insulin, and functional versus dedifferentiated beta-cell pools under ectopic lipid accumulation. Applying Willems dissipative inequalities and Pontryagin optimal control, we derive a finite-duration least action pulse steering protocol capable of driving the physiological state across the separatrix saddle barrier into the healthy homeostatic basin of attraction. Numerical simulation demonstrates that an 8-week targeted intervention achieves complete, drug-free remission: following total cessation of external therapy, the system autonomously converges to and stabilizes at normal fasting glucose (97.26 mg/dL at Day 180), whereas insufficient interventions relapse to severe hyperglycemia (589.01 mg/dL). Type 1 Diabetes Pre-Symptomatic Screening: By tracking the Sturm-Liouville spectral turbulence gap (Omega_1,immune) of the local Koopman generator governing autoimmune repertoire fluctuations (effector T-cells, regulatory T-cells, and pro-inflammatory cytokines), the diagnostic framework identifies the loss of self-tolerance restoring forces 149.4 days (~5 months) prior to macroscopic clinical hyperglycemia. Raychaudhuri-Informed Autonomous Insulin Delivery (AID): For patients with established endocrine failure, we formulate a geometry-informed closed-loop artificial pancreas algorithm based on discrete Raychaudhuri bundle expansion (theta_k = Tr(L_meta,k)). In an acute 75 g carbohydrate challenge, the controller detects postprandial divergence early, blunting hyperglycemic peaks (168.93 mg/dL) and eliminating reactive hypoglycemic undershoots (safe nadir of 105.23 mg/dL vs. 95.32 mg/dL under standard PID control). Analytical Fold Bifurcation Triage: We prove a codimension-1 saddle-node (fold) bifurcation theorem establishing a critical irreversible beta-cell loss threshold (rho_crit), providing an exact clinical triage rule separating reversible dedifferentiation eligible for curative steering from irreversible apoptotic loss requiring autonomous closed-loop substitution. Open Science & Reproducibility: The complete open-source Python simulation models, differential equation solvers, and numerical trajectory datasets are publicly accessible under the MIT License at: https://github.com/sukuyoshi/metabolic_immune_dynamics. (This work extends the universal dissipative operator framework established in Yoshikai, 2026; DOI: 10.5281/zenodo.24156018 and DOI: 10.5281/zenodo.24156142).