Gluconeogenesis and the

chapter
7 Maintenance of Blood
Glucose Levels

I. OVERVIEW (FIGURE 7-1)

A. Gluconeogenesis, which occurs mainly in the liver and to a small degree in the kidney, is the syn-
thesis of glucose from compounds that are not carbohydrates.

B. The major precursors for gluconeogenesis are lactate, amino acids (which form pyruvate or tri-
carboxylic acid [TCA] cycle intermediates), and glycerol (which forms dihydroxyacetone phos-
phate [DHAP]). Even-chain fatty acids do not produce any net glucose.

C. Gluconeogenesis involves several enzymatic steps that do not occur in glycolysis; thus, glucose is
not generated by a simple reversal of glycolysis.

D. The synthesis of 1 mole of glucose from 2 moles of pyruvate requires the energy equivalent of
about 6 moles of adenosine triphosphate (ATP).

E. Blood glucose levels are maintained within a very narrow range, even though the nature of a per-
son’s diet may vary widely, and the normal person eats periodically during the day and fasts
between meals and at night. Even under circumstances when a person does not eat for extended
periods of time, blood glucose levels decrease only slowly.

F. The major hormones that regulate blood glucose are insulin and glucagon.

G. After a meal, blood glucose is supplied by dietary carbohydrate. However, during fasting, the liver
maintains blood glucose levels by the processes of glycogenolysis and gluconeogenesis.

H. All cells use glucose for energy; however, the production of glucose during fasting is particularly
important for tissues such as the brain and red blood cells.

I. During exercise, blood glucose is also maintained by liver glycogenolysis and gluconeogenesis.

II. REACTIONS OF GLUCONEOGENESIS

A. Conversion of pyruvate to phosphoenolpyruvate (Figure 7-2)
1. In the liver, pyruvate is converted to phosphoenolpyruvate (PEP) in two steps.
2. Pyruvate (produced from lactate, alanine, and other amino acids) (Step 1) is first converted to
oxaloacetate (OAA) (Step 2) by pyruvate carboxylase, a mitochondrial enzyme that requires bi-
otin and ATP.

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