Glycogen many respects serves as a countersignal to insulin. In response to insulin levels being below normal (when blood levels of glucose begin to fall below the normal range), glucagon is secreted in increasing amounts and stimulates both glycogenolysis (the breakdown of glycogen) and gluconeogenesis (the production of glucose from other sources). Muscle cell glycogen appears to function as an immediate reserve source of available glucose for muscle cells. Other cells that contain small amounts use it locally, as well. As muscle cells lack glucose-6-phosphatase, which is required to pass glucose into the blood, the glycogen they store is available solely
Glucose glucose themselves from certain precursors as the need arises. Nerve cells, cells of the renal medulla and erythrocytes depend on glucose for their energy production.<ref name="Löffler/Petrides 195">Peter C. Heinrich: "Löffler/Petrides Biochemie und Pathobiochemie." Springer-Verlag, 2014, , p. 195. (german)</ref> In adult humans, there are about 18 g of glucose, of which about 4 g are present in the blood. Approximately 180 to 220 g of glucose are produced in the liver of an adult in 24 hours. Many of the long-term complications of diabetes (e.g., blindness, kidney failure, and peripheral neuropathy) are probably due to the glycation of proteins or