Carnitine is needed to transport subtrates for gluconeogensis and proprionyl CoA into mitochondria.

Insulin is a hormone that is needed for kreb cycle to function properly. In metabolism of glucose are three steps:

1. glycolysis in which the glucose is converted to pyruvate

2. kreb's cycle - pyruvate is converted to oxaloacetate by pyruvate carboxylase enzyme.

3. Electron transport chain.

In diabetes when there is deficiency of insulin, kreb's cycle won't work properly and thus the end product of glycolysis i.e pyruvate will be in excess in blood. Excess of pyruvate will lead to deficiency of pyruvate carboxylase which will lead to lactic acidosis. Also in case of anaerobic condition, the pyruvate will be converted to lactate.

medium-chain acyl-CoA dehydrogenase, MCAD, is a deficiency of enzymes that break down medium-chain fats such as coconut oils.

Fat cells, also known as adipocytes, have two types of enzymes, both of which are affected by insulin. The names of these two enzymes are pyruvate dehydrogenase and acetyl-CoA carboxylase.

James M. McKim has written:

'The effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on acetyl-CoA carboxylase and other lipogenic enzymes' -- subject(s): Enzymes, Toxicology, Tetrachlorodibenzodioxin