TNF and Hyperglycemia: Furthermore, one of the primary reasons responsible for the trend may be related to the stress state, in which a temporary insulin resistance is driven by many complex factors such as counter-regulatory hormones like glucagon, cortisol, catecholamines, and the activation of pro-inflammatory factors like tumor necrosis factor-α (TNF-α), IL-6 (29, 30), consequently provoking the hyperglycemia.