INS and Hyperglycemia: Patients receiving metformin also had a significantly higher plasma concentration of insulin (20, 21).As the existence of insulin resistance is suggested even in non-obese patients, for example with a BMI of 25 (22, 23), metformin therapy can be considered for the treatment of such patients as well(24).In case of critically ill patients,insulin resistance is seen along with hyperglycemia;therefore, treatment with metformin may introduce new strategies in treatment of hyperglycemia and its adverse effects.