IGF1 and hyperinsulinism: Several mechanisms have been proposed to explain the link between type 2 DM and colorectal cancer including the insulin-like growth factor (IGF-1)-hyperinsulinemia theory which implies that elevated insulin and free IGF-1 levels increase the proliferation and decrease the apoptosis of colon cancer cells [46]–[47], which involves with mitogen activated protein kinases, extracellular signal regulated kinase, phosphatidylinositol-3-kinase, protein kinase B and mammalian target of rapamycin (mTOR).