الفهرس 
Liver cirrhosis
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Abstract
Liver cirrhosis is the final common pathway of almost all liver diseases. The liver plays apivotal role in maintaining glucose Homeostasis in both the fed and Fasted states .Most patients with cirrhosis show impaired glucose tolerance despite normal fasting blood glucose level, and there is a higher prevalence of overt diabetes Mellitus in cirrhosis than in the general population.Most chronic patients have severe insulin resistance and exhibit increased fasting insulin level. Reduction of glycogen synthesis is a major intracellular abnormality responsible for the insulin resistant in cirrhotic patients .The ability of the cirrhotic liver to meet the increased fuel requirement of muscular contractions may be limited as the cirrhotic patients have a slightly lower plasma glucose concentration throughout the exercise session. Progressive hypoglycaemia during exercise in cirrhotic patients is prevented by a shift in oxidation fuels from glucose to lipid. Insulin levels are known to decline with acute exercise of mild or severe intensity in both normal individuals and in cirrhotic patients.