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Theres no single answer to the sermorelin vs CJC-1295 vs ipamorelin question it depends on research goals

CJC-1295 No DAC is explained in more detail here

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Conversely, overfeeding increases intra-portal insulin levels that enhances hepatic GH sensitivity to a degree where relatively low GH secretion is sufficient to maintain ambient hepatic IGF-I synthesis and secretion, and normal circulating IGF-I levels ( Figure 1 This review summarizes how changes in hepatic exposure to intra-portal insulin in health and disease states modulates the GH/IGF-I axis

Indeed, a 2023 case study described a woman with type 2 diabetes who became pregnant while taking Mounjaro (tirzepatide) and birth control pills