Liver gluconeogenesis

Figure 21.20 Diagram of a tori q/de in a patient with a tumour. Lactate produced from glucose by tumour cells is converted back to glucose in the liver (gluconeogenesis) and released into the blood for re-uptake by tumour cell, an ATP-reguiring process. Note that muscle, immune cells and red blood cells will also contribute to the cycle (see. Chapter 6 Figure 6.10).

Increases (1) protein catabolism (excepting liver) gluconeogenesis (2) carbohydrate anabolism (liver) (3) blood sugar ... 

Metformin enhances tissue sensitivity to insulin and inhibits liver gluconeogenesis. The potential adverse effect is lactic acidosis. 

Fig. 43.6. Effects of epinephrine on fuel metabolism and pancreatic endocrine function. Epinephrine (Epi) stimulates glycogen breakdown in muscle and liver, gluconeogenesis in liver, and lipolysis in adipose tissue. Epinephrine further reinforces these effects because it increases the secretion of glucagon, a hormone that shares many of the same effects as epinephrine. Epi also inhibits insulin release but stimulates glucagon release from the pancreas.

Generally anabolic in liver (gluconeogenesis) and catabolic in muscle, skin, lymph, adipose, and connective tissue) ... 

This insulin effect of growth hormone observed in vivo may also explain some of the discrepancies observed between in vivo and in vitro effects of growth hormones on glucose uptake by muscle. Whereas growth hormone inhibits glucose uptake in vitro, in vivo its inhibitory effect is compensated for by the insulin secreted as a result of liver gluconeogenesis. 

Stumvoll, M., C. Meyer, G. Perriello, M. Kreider, S. Welle and J. Gerich, 1998 Human kidney and liver gluconeogenesis evidence foroigan substrate selectivity. Am J Physiol. 274(5 Pt 1), E817-826. 

Humans take folic acid from dietary sources, while the majority of microbes synthesise it de novo. Sulphonamides block the pathway of folic acid synthesis and, consequently, the microbial proliferation. Other sulphonamides are used as hypoglycaemic agents. They increase the insulin secretion and inhibit the liver gluconeogenesis. 

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