Recent work has demonstrated an important link between intermediates of the citric acid cycle and the regulation of hypoxia-inducible factors ( HIF ). HIF plays a role in the regulation of oxygen homeostasis, and is a transcription factor that targets angiogenesis, vascular remodeling, glucose utilization, iron transport and apoptosis. HIF is synthesized consititutively, and hydroxylation of at least one of two critical proline residues mediates their interaction with the von Hippel Lindau E3 ubiquitin ligase complex, which targets them for rapid degradation. This reaction is catalysed by prolyl 4-hydroxylases . Fumarate and succinate have been identified as potent inhibitors of prolyl hydroxylases, thus leading to the stabilisation of HIF. 
Alcoholic hypoglycemia is due to inhibition of gluconeogenesis by ethanol and alcoholic ketosis is due to accumulation of beta hydroxy butyrate by increased concentrations of NADH. Thus alcoholic hypoglycemia and alcoholic ketosis are the sequential events occurring one after another in alcoholism and liver can replenish its function on supply of glucose and the most salient feature of liver is that changes in liver can be seen only after chronic alcoholism associated which is also with malnutrition. Further research is required to know the mechanism in liver that helps to maintain the reduced hepatic redox state during alcoholism longer than expected.
Global control of gluconeogenesis is mediated by glucagon ( released when blood glucose is low ); it triggers phosphorylation of enzymes and regulatory proteins by Protein Kinase A (a cyclic AMP regulated kinase) resulting in inhibition of glycolysis and stimulation of gluconeogenesis. Recent studies have shown that the absence of hepatic glucose production has no major effect on the control of fasting plasma glucose concentration. Compensatory induction of gluconeogenesis occurs in the kidneys and intestine, driven by glucagon , glucocorticoids , and acidosis.