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Gluconeogenesis occurs in everyone, in those eating the Standard American Diet and those on a ketogenic diet.  It occurs in diabetics and in those with completely normal blood sugars.  It is neither an explanation nor a justification for why those on ketogenic diets would exhibit abnormal serum glucose levels.  A patient presenting with consistent fasting serum glucose of 115 mg/dl (not just temporarily due to a systemic infection, for example) does not have normal blood sugars.  Those with completely and naturally normal non-diabetic blood sugars have them persistently, no matter what their diet.  Their pancreas does not "forget" how to produce insulin nor lose its stores thereof nor lose the ability to respond to rising sugar levels just because they adopt a very-low-carbohydrate diet.  Switch back to eating the Standard American Diet for a few days and see if your blood sugars normalize (fasting and post-prandial).  It is highly likely they will not.


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