Additionally, hyperinsulinemia indirectly raises the levels of sex steroids, leading to an increase in the risk of postmenopausal breast and endometrial cancers.121 The insulin effect on cancer progression may explain the increased risk of cancer in antidiabetics that elevate insulin levels, such as sulfonylureas, compared to other antidiabetic treatments like GLP-1a and SGLT-2i, which do not raise insulin to the same extent.134,135 High glycemic index foods, which contribute to elevated insulin levels, have been associated with an increased risk of diabetes-related cancers. This evidence concerns the gene INS and hyperinsulinism.