Molecular mechanisms of protein induced hyperinsulinaemic hypoglycaemia

Figure 2 Glutamate metabolism. Oxidation of glutamate by glutamate dehydrogenase liberates free ammonia (NH₃) and alpha ketoglutarate, which enters tricarboxylic acid cycle cycle and generates ATP. In the liver glutamate also generates N-acetylglutamate (NAG), which in turn allosterically activates carbomyl phosphate synthetase (CPS) to regulate ammonia detoxification into urea. Glutamine provides a substrate for ammonia buffering, by adding ammonia to glutamate to form glutamine. TCA: Tricarboxylic acid cycle; GDH: Glutamate dehydrogenase.