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Multiple human studies have confirmed zero impact on fasting glucose, insulin, HbA1c, or IGF-1 levels (Thompson et al., 2004)

AOD9604 RCT summary and clinical efficacy Annals of Clinical and Laboratory Science (PubMed) Effect of intraarticular AOD9604 with hyaluronic acid in rabbit osteoarthritis model DrugBank AOD9604 drug summary

You should only perform self-injection after receiving proper training from a healthcare professional

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Several studies have documented elevated B12 levels in patients with various forms of liver disease, including alcohol-related liver disease, viral hepatitis, and hepatocellular carcinoma

Metformin Metformin, an antihyperglycemic agent used as first-line treatment for prediabetes and diabetes, might reduce the absorption of vitamin B12 and significantly reduce serum vitamin B12 concentrations