The liver begins gluconeogenesis, a process that produces glucose from amino acids, lactate, and glycerol, when glycogen stores are low and the body needs glucose.
To keep the blood glucose level steady throughout the fasting state, a number of metabolic processes occur in the cytosol and mitochondria. Locally and globally (through insulin, glucagon, and cortisol) controlled reactions in the gluconeogenesis pathway include several that are highly exergonic and irreversible. The ratio of stimulatory to inhibitory hormones controls how quickly gluconeogenesis occurs. The organs that provide circulating blood glucose to diverse tissues include the liver and, secondarily, the kidney. While fasting, different tissues create glucose using a variety of ways to keep their energy levels sufficient for proper operation.
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