Hyperinsulinemia is one of the hallmarks of insulin resistance, and insulin was demonstrated to be an important stabilizer of HIF-1α both in hypoxia and in normoxia [101,145]; it seems that the activation of the PI3K/AKT pathway in hypoxic conditions determines HIF-1α accumulation [145,146] not through the inhibition of HIF prolyl-hydroxylation [69], but through the augmentation of HIF-α protein translation [147]. Here, HIF1A is linked to hyperinsulinism.