Stress Hyperglycemia, Insulin Treatment, and Innate Immune Cells

Figure 1

Schematic summary of hyperglycemia and insulin treatment regulation of innate immune cells. Overwhelming stress resulted from critical illness, such as severe burn, major surgery, or sepsis stimulates the release of cortisol, catecholamines, glucagon, and growth hormone, which increase hepatic glucose production and impair glucose consumption by peripheral tissues. Long-term stress-induced hyperglycemia induces hyperproinflammatory responses and depressed cell functions, which is linked to increased risk of mortality and morbidity. Insulin plays a different role in regulating innate immune cells including monocytes, macrophages, and neutrophils. It generally improves their cellular activities and attenuates their inflammatory responses.