March 1969

Blood Glucose and Gluconeogenesis in Fasting Man

Author Affiliations


From the Joslin Diabetes Foundation, Inc., Department of Medicine, Harvard Medical School and Peter Bent Brigham Hospital, Boston. Dr. Felig is a special research fellow of the Public Health Service. Dr. Marliss is a fellow of the Medical Research Council of Canada.

Arch Intern Med. 1969;123(3):293-298. doi:10.1001/archinte.1969.00300130075011

Maintenance of blood glucose homeostasis in fasting man requires establishment of a fine balance between glucose production and utilization. Early in starvation, a decrease in serum insulin provides the alterations in substrate concentration and enzymatic activity conducive to augmented gluconeogenesis. As fasting progresses, glucose utilization is reduced as the brain consumes ketone bodies. A concomitant reduction in total gluconeogenesis is brought about by a reduction in plasma amino acid levels, particularly alanine.