INS and diabetes mellitus: Probable metabolic links between diabetes mellitus (DM) and cancer development are hyperglycemia, hyperinsulinemia, and chronic inflammation.The biochemical process of insulin signaling proceeds by insulin receptor autophosphorylation itself or by directly maintaining the substrate by activating multiple pathways including lipid kinase PI3K/Akt, Bax/Bcl-2, and mTOR leading to carcinogenesis by abnormal cell proliferation and retardation of apoptosis44,45.