Why am I given 1000 mg metformin while my friend gets only 1 mg glimepiride?

This confusion is very common, and the worry is understandable. The key thing to remember is this.

Milligrams do not reflect strength or severity. They only reflect the dose needed for that specific drug.

Different diabetes medicines work in completely different ways, and their effective doses are not comparable just by numbers.

Let me explain with a simple example.

One gram of gold and one kilogram of iron are very different in value and effect, even though the numbers look opposite. The same logic applies to medicines.

• Metformin works mainly by reducing insulin resistance, especially in people who are overweight or have fatty liver. It is a mild but foundational drug, so it is used in larger milligram doses, commonly 500 to 2000 mg per day.
• Glimepiride works by stimulating the pancreas to release insulin. It is a much more potent drug per milligram, so it is prescribed in very small doses, often 0.5 to 2 mg.

So 1 mg of glimepiride can be as powerful, or sometimes more powerful, than 1000 mg of metformin in terms of sugar lowering. That is why comparing numbers can be misleading.

Why you and your friend got different drugs:

• You may have more insulin resistance or be overweight, so metformin suits you better.
• Your friend may need more insulin release, so glimepiride was chosen.
• Risk of low sugars, lifestyle, meal patterns, and long-term safety are also considered.

Diabetes treatment is always individualized. One size never fits all. A higher number on the tablet strip does not mean worse diabetes.

The most important thing is not the number written on the tablet, but whether your sugars are coming into target safely.