Hi, Thanks for using the HCM. I am happy to address your questions, gemer 1 contains metformin hydrochloride (ER) 500 mg, glimepiride 1 mg. Metformin is effective only in the presence of insulin, and its major effect is to decrease liver glucose output. In addition, metformin increases insulin-mediated glucose utilization in peripheral tissues (such as muscle and liver), particularly after meals, and has an antilipolytic effect that lowers serum free fatty acid concentrations, thereby reducing substrate availability for gluconeogenesis. As a result of the improvement in glycemic control, serum insulin concentrations decline slightly. Glimepiride primarily lowers blood glucose by stimulating the release of insulin from pancreatic beta cells. Bind to the sulfonylurea receptor in the pancreatic beta-cell plasma membrane, leading to closure of the ATP-sensitive potassium channel, thereby stimulating the release of insulin. Not being prescribed by doctors are individualised approach which differs from one to the other clinicians based on their experience. Hope I have answered your query. If you have any further questions I will be happy to help. Thanks