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Studies suggest that the two peptides may also work together to reduce oxidative stress

Structured Illumination Microscopy was performed using a Zeiss Elyra PS1 microscope using a 63 1.4 (n.a.) plan apo chromate oil immersion lens and 5 phases and 5 rotations of the illumination pattern

Dean OM, Gray K, Dodd S, Villagonzalo KA, Brown E, Tonge B, Berk M, et al

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conversely, insulin can bind IGF1R with lower affinity than it has for the insulin receptor IGF1R and the insulin receptor can form heterodimers that bind both ligands IGF1 has actions distinct from those of growth hormone in carbohydrate, lipid and protein metabolism

Although most studies show an association with Metformin and B12 deficiency, most of the data is observational