Hepatic glycogen synthesis from intact hexose (direct pathway) relative to that from gluconeogenic precursors (indirect pathway) was quantified in ad libitum-fed rats. Following 2 H 2 O administration and overnight feeding, the livers were removed and glycogen 2 H-enrichment was measured by 2 H NMR. Six controls and six rats rendered hyperglycemic by streptozotocin (STZ; fasting blood glucose ؍ 385 ؎ 31 mg/dl) were studied. The indirect pathway contribution, estimated as glycogen hydrogen 5 relative to hydrogen 2 enrichment, was 54% ؎ 4% for control rats-similar to values from healthy, meal-fed humans. In STZtreated rats, the indirect pathway contribution was significantly higher (68% ؎ 4%, P < 0.05 vs. controls), similar to that of Type 1 diabetic (T1D) patients. In conclusion, sources of hepatic glycogen synthesis in rats during ad libitum nocturnal feeding were quantified by analysis of glycogen enrichment from 2 Hepatic glycogen is synthesized from glucose by two distinct pathways ( Fig. 1): the classical direct pathway from glucose involving intact hexose units, and the indirect pathway involving 3-carbon precursors (1-4). In humans, direct and indirect pathway contributions are quantified by analysis of plasma glucose and UDP-glucose enrichment following infusion of a glucose tracer as part of an intravenous glucose load (1,5) with corrections for recycling of the labeled carbon (6). The tracer can also be given as part of a meal (7,8) to study the pathways of glycogen repletion under normal feeding conditions. This approach is poorly suited to study hepatic glycogen synthesis in ad libitum fed rats since they tend to feed intermittently over the entire dark period of the diurnal cycle (9). While there have been studies of glycogen synthesis under artificial substrate delivery conditions, such as glucose infusion (10) or after a glucose load (11,12), we are unaware of any reported measurement of direct and indirect pathway activities in rats during their natural feeding routine. Since postprandial hepatic glycogen levels are sensitive to dietary composition (13,14), measurement of direct and indirect pathway activities under baseline conditions is essential for evaluating the effect of disease or other interventions on these fluxes.To quantify hepatic glycogen repletion via direct and indirect pathways during ad libitum feeding, we analyzed the positional 2 H-enrichment of hepatic glycogen following the administration of 2 H 2 O at the start of the feeding cycle. Under these conditions, both direct and indirect pathway precursors of glycogen become enriched with 2 H from 2 H 2 O (15). Glycogen derived from glucose via the direct pathway will be enriched in position 2 as a result of extensive exchange between glucose-6-phosphate (G6P) and fructose-6-phosphate (F6P), catalyzed by G6P-isomerase (16). Glycogen synthesized via the indirect pathway will be enriched in both the 2 and 5 positions, the latter due to exchange/addition of water and metabolite hydrogens at the triose phosphate level. On this basis,...