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Given the stimulation effects of melanotan 1 and melanotan 2 on melanocytesor the cells that can develop into cutaneous malignant melanoma (CMM), numerous national health organizations have issued safety warnings regarding these peptides

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A Add a second oral agent (such as a sulfonylurea, thiazolidinedione, sodium-glucose cotransporter-2 inhibitor, or dipeptidyl peptidase 4 inhibitor), a glucagon-like peptide-1 (GLP-1) receptor agonist, or basal insulin if metformin at a maximum tolerated dose does not achieve the HbA1c target over 3 months