In critical illness the generation of neuroendocrine responses by acute insults like the stress of surgery and anaesthesia, trauma or sepsis, alters carbohydrate metabolism, causes excessive secretion of counter-regulatory hormones like catecholamines, cortisol, glucagon, and growth hormone, promotes insulin resistance, increases hepatic glucose production via enhanced glycogenolysis and gluconeogenesis and impairs peripheral glucose utilization and insulin action. This evidence concerns the gene INS and Sepsis.