TNF and Hyperglycemia: Hyperglycemia also increases the release of proinflammatory cytokines, such as interleukin 1β (IL-1β), IL-6, IL-18, tumor necrosis factor alpha (TNF-α), and transforming growth factor β1 (TGF-β1), which favor cardiac myocyte apoptosis and the development of diabetic cardiomyopathy.