INS and Insulin resistance: First, insulin and hyperglycemia may directly promote gastric cancer by overstimulating tumorigenic pathways such as PI3K/AKT/mTOR,27 insulin‐like growth factor‐1 (IGF‐1), strongly linked to insulin resistance, promotes gastric cancer cell proliferation and invasion via the Ras/RAF/MEK/ERK and JAK1/STAT3 cellular signaling pathways.28