In addition to the risk of renal failure, DM is also associated with a higher incidence of hepatocellular carcinoma (HCC) in patients with chronic liver disease,26 especially in those with a younger age and in those who smoke and use insulin.27 The presence of DM has also been reported to increase the risk of mortality due to HCC.28 However, increased coffee consumption seems to reduce the risk of HCC and chronic liver disease.29 Here, INS is linked to hepatocellular carcinoma.