If a type 2 diabetic can maintain a1c scores <6 through exercise & diet alone, what are the pluses & minuses of taking metformin 500mg twice a day?

Maybe not necessary.: You can find different opinions on this matter but my take on is that if your A1c is less than 6 with diet and exercise only,and you are also losing weight I would not keep you on the medication.However, you might find other experts recommending staying on it for other added benefits especially cardiovascular.I still feel that if you are keeping a good level of BG and a healthy weight it is fine.

Depends: Hi. If you're keeping your A1c in the 5's with diet and exercise, you don't need metformin. The only benefit(s) might be augmenting diet &amp; exercise to prevent worsening of control over time, and/or liberalizing diet a little bit. Keep up your awesome healthy lifestyle! I hope you don't smoke (PLEASE stop if you do!). We docs out here are very proud of people like you who control diabetes!