IGF1R and Hypoglycemia: Furthermore, FOXO1 is involved in stimulating hepatic gluconeogenesis in states of hypoglycaemia via the phosphoinositide-3-kinase/protein kinase B (PI3K/Akt) signalling pathway, whilst in hyperglycaemia, insulin signalling via insulin, like growth factor-1 (IGF-1) and its receptor (IGF-1R), stimulates PI3K/Akt-dependent phosphorylation of FOXO1, leading to subsequent suppression of gluconeogenesis (Tsuchiya and Ogawa, 2017).