[Insulin sensitivity and stress]

Metabolic adaptation is part of the response to stress and participate to produce a favorable state for cure. Carbohydrate metabolism is profoundly altered with an increase in basal cellular glucose uptake and utilization and in endogenous glucose production; insulin sensitivity is decreased. Glucose tolerance is altered and hyperglycemia develops. This state of hyperglycemia is most obviously directed to satisfy the increased need of the injured organs and of the inflammatory cells. The role of the cytokines in association to the stress hormones is important to these metabolic adaptations. This article reviews the main features of glucose homeostasis and the potential mechanisms leading to stress induced insulin resistance.