The patients were followed-up at every month, and earlier if needed. Besides repeating the anthropometric measurements, blood glucose, urine examination, liver function tests (LFT) and serum lactate were measured. The Glycosylated haemoglobin (A1C) and serum lipids were estimated at every two month. At each follow-up visit the patients were questioned in detail about their diet and exercises, and deficiency, if any, were corrected. They were also questioned in detail about any side effects. Only those cases where we were satisfied about their diet and exercise adherence and regular intake of metformin were included in the outcome analysis. All patients possessed mobile phones. A message (SMS) was sent on their mobile phones every 15 days reinforcing the importance of diet and regular exercise. A SMS was also sent on their mobile phone if they were overdue on their appointment. In subjects in whom there was weight loss of more than 10% and A1C goal (≤6%) was achieved, the dose of metformin was reduced.