Glucose can be formed in the liver and kidney from two other groups of compounds that undergo gluconeogenesis. Those in the first group, such as some amino acids (especially alanine during starvation) and propionate, are converted into glucose without being recycled; those in the second group are formed from glucose during its partial metabolism in various tissues. Both muscle and red blood cells oxidize glucose to form lactate, which on entering the liver is resynthesized into glucose. This newly formed glucose is then available for recirculation back to the tissue, a process known as the Cori, or lactic acid, cycle. The Cori cycle may account for approximately 40% of the normal plasma glucose turnover.
In the case of adipose tissue, the cells hydrolyze fats (acylglycerols) and form glycerol that cannot be metabolized by the adipocytes. The glycerol diffuses from the cells, enters the blood, and is transported to the liver and kidneys where it is converted back into glucose. Finally, glucose is also released into the blood by glycogenolysis of the large store of glycogen in the liver.
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