Am I Diabetic? - fasting sugar 122, PP level of 103 after eating rice and orange juice

by Chandra
(Pune)






Question: I had my complete body checkup two days back. My fasting Sugar level is 122 mg/dl and the PP level after two hours of breakfast (steamed rice food and orange juice) the level is 103 mg/dl. The doctor says its a pre diabetes stage and advised me for HbA1C test.


My question is why my fasting level is high when compared to PP level a total diff of around 20 mg/dl.


Six month back my fasting was 117 mg/dl and PP 132 mg/dl but Doc didn't advised me anything and said everything is normal. My Dad has diabetes.




Quick Answer



Your fasting glucose of 122 mg/dL is in the prediabetes range, not the diabetes range. The earlier fasting result of 117 mg/dL was also in the prediabetes range. A two-hour value of 103 mg/dL after breakfast is reassuring, but it does not cancel the fasting results or prove that you do not have prediabetes.


Fasting glucose and after-meal glucose measure different parts of glucose regulation. The HbA1c test your doctor recommended is appropriate, and your family history makes follow-up especially important.




Answer by Dr. Albana Greca Sejdini, MD, MMedSc



What Do These Results Mean?


For a properly performed laboratory fasting plasma glucose test after at least eight hours without calories, the usual diagnostic categories for nonpregnant adults are:



  • Below 100 mg/dL: usual normal fasting range

  • 100–125 mg/dL: prediabetes, also called impaired fasting glucose

  • 126 mg/dL or higher: diabetes range when confirmed appropriately


Therefore, both 117 and 122 mg/dL fall within the prediabetes range. You cannot be diagnosed with diabetes from these values alone, but they should not be described as completely normal.



Why Can Fasting Glucose Be Higher Than the Two-Hour Reading?


This pattern can occur for several reasons:



  • Overnight liver glucose release: while you are fasting, the liver releases stored glucose to supply the brain and other organs.

  • Dawn phenomenon: early-morning hormones such as cortisol, growth hormone and glucagon can increase liver glucose output and temporarily increase insulin resistance.

  • Different tests measure different physiology: fasting glucose mainly reflects overnight liver glucose production and fasting insulin sensitivity. A two-hour meal reading reflects the combined effects of the meal, insulin release, movement and the exact testing time.

  • Normal day-to-day variation: sleep, stress, illness, hydration, recent exercise and laboratory variation can affect glucose.


Your body may release enough insulin after breakfast to bring glucose down by two hours even though fasting glucose remains mildly elevated.



The PP Test Is Not the Same as an Oral Glucose Tolerance Test


A two-hour reading after rice and orange juice is a post-meal measurement. It can provide useful information, but the amount and absorption of carbohydrate are not standardized.


The diagnostic two-hour glucose test uses a measured 75-gram glucose drink. Its usual cutoffs are below 140 mg/dL for normal glucose tolerance, 140–199 mg/dL for prediabetes and 200 mg/dL or higher for diabetes when confirmed. Those criteria should not be applied directly to an ordinary breakfast.



Why HbA1c Is Helpful


HbA1c estimates average glucose exposure over roughly the previous two to three months. General diagnostic categories are:



  • Below 5.7%: usual normal range

  • 5.7–6.4%: prediabetes range

  • 6.5% or higher: diabetes range when confirmed appropriately


HbA1c and fasting glucose may not always agree. If the results are discordant, your clinician may repeat the abnormal test, order another laboratory fasting glucose or consider a formal oral glucose tolerance test. Conditions such as anemia, altered red-blood-cell turnover and some hemoglobin variants can also affect HbA1c interpretation.



What Should You Do Next?



  1. Complete the laboratory HbA1c test recommended by your doctor.

  2. Confirm that the fasting tests followed at least eight hours without food or caloric drinks.

  3. Discuss whether repeat fasting plasma glucose or a 75-g oral glucose tolerance test is needed.

  4. Review blood pressure, waist measurement, cholesterol, sleep, activity and medicines with your clinician.

  5. Continue sustainable habits: regular physical activity, mostly minimally processed foods, adequate fiber, sensible portions and avoidance of sugary drinks.


Because your father has diabetes and your fasting glucose has been elevated twice, regular monitoring is important even if HbA1c is currently below the prediabetes threshold.




Do not diagnose or treat yourself from one post-meal number. Seek prompt medical assessment if you develop excessive thirst, frequent urination, unexplained weight loss, vomiting, marked weakness, confusion or repeatedly much higher glucose readings.




Related Questions




Related Resources




References




Answered by: Dr. Albana Greca Sejdini, MD, MMedSc

Medically reviewed by: Dr. Ruden Cakoni, MD, Endocrinologist

Last reviewed: July 2026


Medical disclaimer: Educational only—not personal medical advice. Diagnosis and treatment should come from a qualified clinician who knows the patient’s medical history.



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