Fasting Blood Sugar 145 at Age 81: Am I Diabetic?

by Vinod
(Vadidara, India)





Original question from Vinod (Vadodara, India):


“I am 81 years old. My fasting blood sugar is 145 mg/dL, and my blood sugar two hours after a meal is 105 mg/dL. Am I diabetic, and do I have to take medicines?”



Quick Answer: A fasting plasma glucose of 145 mg/dL (8.1 mmol/L) is in the diabetes range if it was measured in a laboratory after at least 8 hours without calories. If you do not have clear symptoms of high blood sugar, the diagnosis should usually be confirmed with a second abnormal test. Your two-hour reading of 105 mg/dL is not high, but it does not cancel out the fasting result. Whether you need medicine depends on confirmation of the diagnosis, your HbA1c, overall health, kidney function, other medicines, and your risk of low blood sugar.


Written by Dr. Albana Greca, MD, MMedSc



Hi Vinod,



I would pay particular attention to the fasting result of 145 mg/dL. Before deciding that you definitely have diabetes or need medicine, I would first confirm whether this was a true fasting laboratory test and compare it with an HbA1c or another accepted diabetes test. Our guide to blood tests used to diagnose diabetes explains why a home meter reading and a laboratory diagnostic test are not interchangeable.



What Does a Fasting Blood Sugar of 145 Mean?



For nonpregnant adults, fasting plasma glucose below 100 mg/dL is in the normal range, 100–125 mg/dL is in the prediabetes range, and 126 mg/dL or higher is in the diabetes range when confirmed as recommended.



Your result of 145 mg/dL is therefore above the diagnostic threshold. Our page on fasting blood sugar from 127 to 200 mg/dL places this number in context, while the normal fasting blood sugar guide explains the difference between diagnostic ranges and treatment targets.



If the 145 mg/dL result came from a home glucose meter, I would not diagnose diabetes from that reading alone. Home meters are mainly for monitoring; diagnosis should be based on appropriate laboratory testing.



Why Is Your Blood Sugar 105 After Eating?



Your two-hour result of 105 mg/dL is not elevated. However, a glucose check two hours after an ordinary meal is not the same as the two-hour oral glucose tolerance test used to diagnose diabetes.



Food amount, activity, your own insulin response, medicines, and normal meter variation can all affect an after-meal reading. The 105 mg/dL value is reassuring but does not rule out diabetes. Our guide to blood sugar levels after eating explains how everyday post-meal readings differ from diagnostic testing.



Which Tests Should You Have Next?



If you do not have classic symptoms of hyperglycemia, I would usually confirm the result rather than diagnose diabetes from one measurement. A repeat laboratory fasting plasma glucose and an HbA1c are reasonable next steps.



An HbA1c of 6.5% or higher is also in the diabetes range when

confirmed as required. Our HbA1c guide explains what the percentages mean and how they relate to average glucose.



If two tests disagree, the abnormal result should generally be repeated and interpreted in context rather than averaging the two numbers.



Do You Have to Take Diabetes Medicine?



Not necessarily, but I would not assume that diet alone will be enough. At age 81, treatment should be based on your overall health and functional status, not age alone.



Your doctor should consider your HbA1c, repeated glucose readings, kidney and heart health, other medical conditions, current medicines, mobility, independence, nutrition, and risk of hypoglycemia. Some older adults can begin with nutrition and suitable activity, while others benefit from medication from the start.



What Should Blood Sugar Targets Be at Age 81?



There is no single target for every 81-year-old. For otherwise healthy older adults with intact cognitive and functional status, current guidance often uses an HbA1c goal around 7.0–7.5%. For people with multiple illnesses, frailty, or cognitive or functional limitations, a less stringent goal such as below 8.0% may be appropriate. In very complex or poor health, avoiding hypoglycemia and symptomatic high glucose becomes more important than pursuing a strict HbA1c number.



This is why our acceptable blood glucose level guide emphasizes individualized targets, while the blood sugar level chart separates diagnostic cutoffs from day-to-day treatment goals.



What I Would Do Next




  1. Confirm the fasting result with a laboratory test if the 145 mg/dL reading came from a home meter or has not been confirmed.

  2. Ask for an HbA1c to see whether glucose has been elevated over the previous several months.

  3. Review kidney function and current medicines if treatment is being considered.

  4. Bring both glucose readings to your doctor and discuss the safest treatment goal for your overall health.

  5. Do not start diabetes medicine on your own.




Important Safety Note: Seek prompt medical care if high glucose is accompanied by vomiting, severe dehydration, confusion, marked weakness, difficulty breathing, or another acute illness. Older adults can become dehydrated or unwell quickly.



Doctor’s Note: Vinod, if 145 mg/dL was a true laboratory fasting result, it is high enough to be in the diabetes range. I would confirm the diagnosis before deciding on treatment. Your two-hour reading of 105 mg/dL is reassuring, but it does not rule out diabetes. The most useful next step is a repeat fasting laboratory glucose and HbA1c, followed by an individualized discussion about whether medicine is needed and what target is safest for you.


Educational safety note: This answer provides general diabetes education and does not replace personal diagnosis or treatment. Do not start, stop, or change diabetes medicines, supplements, diet, or exercise plans without discussing them with your healthcare professional.



Related Questions





Related Resources





Last reviewed: September 2026



Click here to post comments or follow up

Ask the Doctor now? Simply click here to return to Diabetes Test and Levels.