His first recommendation still would be diet
and exercise in combination with a low glycemic or low carbohydrate diet
. There are of course side effects associated with Metformin as all medications, the most common of which are gastrointestinal and some potential for thyroid, specifically TSH, issues.
He has not been in the office today---but as I said, I will go over the articles sent and let you know what he has to say in this regard.