by Vinod
(Vadidara, India)
QUESTION: 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?
A fasting blood sugar of 145 mg/dL (8.1 mmol/L) is in the diabetes range if it was measured by a laboratory after at least 8 hours without calories.
One abnormal result does not always confirm diabetes. If you do not have clear symptoms of high blood sugar, your doctor will usually confirm the result with another fasting laboratory test, an HbA1c, or another accepted diabetes test.
Your two-hour reading of 105 mg/dL (5.8 mmol/L) is not high, but it does not cancel out the fasting result. Whether you need medication cannot be decided from these two readings alone, especially at age 81.
Answer by Dr. Albana Greca, MD, MMedSc
Hi Vinod,
I would pay particular attention to the fasting result of 145 mg/dL. Before deciding whether you have diabetes or need medicine, I would first confirm how the tests were performed and look at your HbA1c and overall health.
| Reading | Result | Meaning |
|---|---|---|
| Fasting | 145 mg/dL | In the diabetes range if confirmed by laboratory testing |
| 2 hours after a meal | 105 mg/dL | Not high, but does not rule out diabetes |
For nonpregnant adults, laboratory fasting plasma glucose is generally interpreted as follows:
| Fasting glucose | Interpretation |
|---|---|
| Below 100 mg/dL | Normal range |
| 100–125 mg/dL | Prediabetes range |
| 126 mg/dL or higher | Diabetes range when confirmed as recommended |
Your fasting result of 145 mg/dL is above the diagnostic threshold for diabetes. Our information on fasting blood sugar between 127 and 200 mg/dL helps place this number in context.
If 145 was measured with a home glucose meter rather than a laboratory test, I would not diagnose diabetes from that reading alone. Home meters are useful for monitoring, but diagnosis should be based on appropriate laboratory testing.
It may seem confusing that your fasting glucose is 145 mg/dL while your reading two hours after eating is only 105 mg/dL. Blood sugar can change during the day, and food, activity, insulin release, medicines, and normal meter variation can all affect the result.
A glucose check two hours after an ordinary meal is not the same test as the two-hour oral glucose tolerance test used to diagnose diabetes. The 105 mg/dL result therefore does not cancel out the fasting value.
An HbA1c of 6.5% or higher is also in the diabetes range when confirmed as required. Comparing fasting glucose with HbA1c gives a clearer picture than two home readings.
Not necessarily. I would not decide that you need medication simply because of one fasting reading of 145 mg/dL.
At age 81, diabetes treatment should be individualized. Your doctor should consider your HbA1c, repeated glucose readings, kidney and heart health, other medical conditions, current medicines, mobility, independence, and especially your risk of low blood sugar.
Some people may need nutrition and activity changes together with medication. Others may initially be managed without adding medicine. If medication is needed, the safest choice depends on your overall health rather than on your age or one glucose number alone.
Treatment targets are not the same for every older adult. A healthy, independent person may have tighter goals, while someone with frailty, several chronic illnesses, memory problems, or a high risk of hypoglycemia may need more relaxed targets.
This is why I would focus on both glucose control and avoiding dangerously low blood sugar. Our blood sugar level chart shows why diagnostic ranges and personal treatment targets are not the same thing.
Vinod, if your fasting glucose of 145 mg/dL was a true laboratory fasting result, it is high enough to be in the diabetes range. However, I would confirm the diagnosis before deciding on treatment.
Your two-hour reading of 105 mg/dL is reassuring because it is not elevated, but it does not rule out diabetes. The next sensible step is a repeat fasting laboratory glucose and HbA1c, followed by an individualized discussion with your doctor about whether medication is necessary and what treatment goal is safest for you.
Medical review: Dr. Ruden Cakoni, MD, Endocrinologist
Last reviewed: August 2026.
Educational safety note: This answer is for general diabetes education only and does not replace personal medical advice, diagnosis, or treatment. Do not start, stop, or change diabetes medicines, supplements, diet, or exercise plans without discussing them with your healthcare provider.
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