In vivo insulin levels can be as high as 2.8 nM after glucose intake.37 The concentration used in previous studies of insulin enhancement of in vitro AML cell proliferation was 1–10 μg/ml.11,38 Our selected insulin concentration and time of insulin exposure were based on pilot studies of the effects of insulin on PI3K-Akt-mTOR activation in primary human AML. The gene discussed is AKT1; the disease is acute myeloid leukemia.