IGF1 and obesity due to melanocortin 4 receptor deficiency: The effect of obesity and DM on the development and progression of pancreatic cancer appears to be mediated by adipokines, reactive oxygen species (ROS), inflammatory cytokines, and insulin resistance, which result in activation of insulin-like growth factor-1 (IGF-1) and mammalian target of rapamycin (mTOR) pathways (reviewed in [10]).