TNF and diabetes mellitus: In addition, systemic vascular resistance accompanied by oxidative stress and inflammation activates signaling molecules, such as nuclear factor–kappa B (NF-ĸB), and other mediators of stress-sensitive pathways, such as interleukin-1 and -6 and tumor necrosis factor-alpha (TNF-α), all of which can modify glucose and lipid metabolism, increase insulin resistance, and lead to DM [26].