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This enzyme needs copper

[4] A more potent, binding-protein-resistant analog such as IGF-1 LR3 would, by mechanism, be expected to retain this hypoglycemic potential, and because it evades the buffering system that normally tempers free IGF-1 activity, the metabolic effect could in principle be less predictable

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Beyond that, the warnings and precautions section shapes the assessment: acute pancreatitis, acute gallbladder disease, acute kidney injury due to volume depletion, severe gastrointestinal adverse reactions, hypersensitivity reactions, and pulmonary aspiration during general anesthesia or deep sedation