The hexosamine biosynthetic pathways product, UDP-GlcNAc, is utilized by OGT to catalyze the addition of O-GlcNAc. This pathway integrates information about the concentrations of various metabolites including amino acids, carbohydrates, fatty acids, and nucleotides. Consequently, UDP-GlcNAc levels are sensitive to cellular metabolite levels. OGT activity is in part regulated by UDP-GlcNAc concentration, making a link between cellular nutrient status and O'-GlcNAc.
Glucose deprivation causes a decline in UDP-GlcNAc levels and an initial decline in O-GlcNAc, but counterintuitively, O-GlcNAc is later significantly upregulated. This later increase has been shown to be dependent on AMPK and p38 MAPK activation, and this effect is partially due to increases in OGT mRNA and protein levels. It has also been suggested that this effect is dependent on calcium and CaMKII. Activated p38 is able to recruit OGT to specific protein targets, including neurofilament H; O-GlcNAc modification of neurofilament H enhances its solubility. During glucose deprivation, glycogen synthase is modified by O-GlcNAc which inhibits its activity.