IGF1 and cancer: The excess glucose supports cancer cells’ increased energetic and biosynthetic needs.10 It has been reported that high glucose (HG) triggers several direct and indirect mechanisms that cooperate to promote cancer progression, such as induction of epithelial mesenchymal transition (EMT),11 increased levels of insulin/IGF-1 and inflammatory cytokines in circulation,12, 13, 14 increased leptin and pro-survival AKT/mTOR signaling15 and enhancement of WNT/β-catenin signaling.16 Together, these studies reveal that hyperglycemia per se has an important impact on cancer cells.