INS and Hyperglycemia: Keeping in mind the concept of hypercytokinemia and hyperglycemia in septic patients together with the results reported by Fischoeder et al., in which insulin was found to be a potent inducer of MMP-9 activity in primary human monocytes [37], we hypothesize that MMP-9 levels may serve as a marker to help stratify septic patients to an intensive versus conventional insulin therapy group.