Any potential adverse effect of gluconeogenesis would be determined from the initial substrate; whether one is using amino acids to manufacture glucose or other precursors that are extremely benign such as from ketones, the glycerol backbone of fats, or from lactate and
pyruvate recycling.
Finally, because of the inactivation of
pyruvate dehydrogenase (by the low insulin concentration), the glucose that is used by tissues outside the brain is largely only partially broken down to
pyruvate and lactate, which can then be
recycled in the liver trough gluconeogensis [7].