... pre-existing increased insulin resistance and dysfunction of beta cells. Insulin resistance is present in the acutely ill [13,15,18,28] in different intensity, but the factors determining the extent of ... insulin resistance byinducing the release of stress hormones. They also alterinsulin receptor signalling [12-16] and create insulinresistance. Due to these actions, glucose uptake in fat and muscle ... value in the Recommendations of the American Heart Association [35] and the trigger for initi-ation of insulin treatment for ICU patients recommendedby the American College of Endocrinology...