Metabolic adaptation is part of the response to stress and participate to p
roduce a favorable state for cure. Carbohydrate metabolism is profondly alt
ered with an increase in basal cellular glucose uptake and utization and in
endogenous glucose production;insulin sensitivity is decreased. Glucose to
lerance is altered and hyperglycemia develops. This state of hyperglycemia
is most obviously directed to satisfy the increased need of the injured org
ans and of the inflammatory cells. The role of the cytokines in association
to the stress hormones is important to these metabolic adaptations. This a
rticle reviews the main features of glucose homeostasis and the potential m
echanisms leading to stress induced insulin resistance.