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A grey market supplier can truthfully claim their product is 99% pure by HPLC while that same product contains endotoxin levels that would disqualify it from any legitimate pharmaceutical application

They also confirmed the presence of melanotan-2

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(PubMed) Beal MF, Oakes D, Shoulson I, et al

Mitigation strategies include frequent glucose monitoring when changes are made to insulin dosage, oral hypoglycemic medications, meal patterns, physical activity, and in cases of renal or hepatic impairment or hypoglycemia unawareness, with consideration for dose reduction