INS and hyperinsulinism: The underlying pathophysiological mechanisms of DM related to carcinogenesis are poorly understood but are probably multifactorial, including hyperglycemia facilitating neoplastic proliferation [9], hyperinsulinemia promoting carcinogenesis through its effects on insulin and/or IGF-I receptors [5–8], and inflammatory cytokines secreted by adipose tissue enhancing malignant progression [10].