Specifically, hyperinsulinemia directly activates insulin receptors and the IGF-1/2 receptors on tumor cells, thereby stimulating the PI3K/AKT/mTOR and rat sarcoma/mitogen-activated protein kinase (RAS/MAPK) signaling pathways to further promote tumor cell growth and survival (11, 31). The gene discussed is IGF1; the disease is hyperinsulinism.