Ask HN (Azure users): SQL Database or SQL VM

Hi guys, we are considering using Azure to host a medium-sized (in terms of traffic and DB/IO read/write) Web app, and wondering if anyone can share their opinion and experience. Azure offers two main options for SQL Server databases: SQL Database (which seems like a managed high-availability database on a cluster) and SQL VM (which seems like an unmanaged/self-managed instance on a VM). In terms of cost and basic needs, SQL Database should be sufficient for us for now, but I'm not convinced about it's performance (plenty of posts about slowness, even for simple queries & small datasets). SQL VM will obviously be faster and more efficient, but the relatively higher cost is a prohibition. What do you guys suggest? How has your experience been with either (or both) SQL Database and/or SQL VM?