It is known that diabetes is a secondary cause of osteoporosis, and IGF1/insulin signalling is reported to regulate postnatal bone remodelling via the PI3K/Akt pathway, as described above.88, 91 IGF1, which is a growth factor, could phosphorylate Akt and thereby inactivates FOXO transcription factors. This evidence concerns the gene AKT1 and diabetes mellitus.