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Any combination use should be guided by available research data

"It's really concerning to us that it's being prescribed off-label at a time when people are not able to access their medication for type 2 diabetes

The most effective approach is intravenous (IV) administration

These autophosphorylation events and conformational changes create multiple docking sites for a variety of endogenous substrates including members of the insulin receptor substrate (IRS) family which associate with IGF-1R via PTB and SH2 domains, growth receptor binding protein-2 (Grb2) which binds to specific motifs in the IGF-1 receptor as well as in IRS, and the p85 subunit of phosphatidyl inositol-3 kinase (PI3K) which binds to other specific motifs within IRS