TNF and diabetes mellitus: Elevated extracellular osmolarity directly stimulates tumor necrosis factor (TNF) and interleukin (IL) 1, 6, and 8 secretion, contributing to varying disorders related to a strong inflammatory response, such as chronic arthritis and inflammatory bowel diseases [6], and also to liver disorders, insulin resistance, diabetes, hypertension, cardiovascular diseases, and carcinogenesis [3,7].