IGF1R and pulmonary fibrosis: The exact mechanism by which DM affects the development of lung cancer is unclear, and epithelial-to-mesenchymal transition (EMT) pathway-mediated lung fibrosis under activation of the inflammatory factor transforming growth factor beta1(TGF-β1) [55] with high insulin like growth factor 1 receptor (IGF-1R) and insulin receptor substrate 2 (IRS-2) protein expression [56] may be a potential factor.