IL6 and chronic obstructive pulmonary disease: Interestingly, smoking has also been related to the development of insulin resistance.8, 9, 10 Additionally, cytokines, such as interleukin-6 and tumor necrosis factor alpha soluble receptor, which are elevated in COPD, have been associated with the development of insulin resistance in liver and muscle tissues; as a result, COPD has been postulated as a risk factor for DM.11, 12, 13, 14