The mechanismunderlying such conditioning might that chronic exposure to hyperglycemia causesdownregulation of the GLUT 1 and GLUT 3 transporters, which are stimulatedduring the acute phase of critical illness and whose activity contributes to thetoxicity of cellular glucose overload.(38) Additionally, factors not related to glycemic control,such as the existence of DM and the potential beneficial effects of insulin(anti-inflammatory and endothelial protective effects), may in part explain theso-called diabetes paradox. Here, INS is linked to diabetes mellitus.