Insulin signal transduction pathway is secreted after glucose enters the beta cell and that triggers several other processes in a chain reaction. While insulin is secreted by the pancreas to lower blood glucose levels, glucagon is secreted to raise blood glucose levels. This is why glucagon has been known for decades as a counter-regulatory hormone. When blood glucose levels are low, the pancreas secretes glucagon, which in turn causes the liver to convert stored glycogen polymers into glucose monomers, which is then released into the blood. This process is called glycogenolysis. Liver cells, or hepatocytes, have glucagon receptors which allow for glucagon to attach
Glycogen storage disease type 0 liver provides a steady source of glucose from glycogen breakdown (or glycogenolysis). With prolonged fasting, glucose is generated in the liver from noncarbohydrate precursors through gluconeogenesis. Such precursors include alanine (derived from the breakdown of proteins in skeletal muscle) and glycerol (derived from the breakdown of triacylglycerols in fat cells). In patients with glycogen-storage disease type 0, fasting hypoglycemia occurs within a few hours after a meal because of the limited stores of hepatic glycogen and inadequate gluconeogenesis to maintain normoglycemia. Feeding characteristically results in postprandial hyperglycemia and glucosuria, in addition to increased blood lactate levels, because glycogen synthesis is