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Serum ghrelin level tends to be lower in diabetic patients when compared with healthy subjects. Ghrelin is important to achieve a good glycemic control in both hypo and hyper glycemia and also for preventing beta- cells apoptosis. Glibenclamide using patients had slightly higher ghrelin levels when compared to that of control diabetic group and this increment was weakly related to the dose and duration. While metformin usage will increase serum ghrelin levels when compared to that of control diabetic group and this increment was related to the dose and duration. Elevation of ghrelin level could be one of the mechanisms by which metformin increase insulin sensitivity and produce a better glycemic control. Metformin could cause weight loss by its effect on postprandial suppression of ghrelin level and by its effect on gastric emptying without affecting the fasting total serum ghrelin level.