by Ashok Koul
(Jammu, J&K, India)
Question from Ashok, age 66:
Hello Sir,
I am 66 yrs of age, Type 2 diabetic for last eight years. My BS fasting ranges from 107 to 115, but PP BS level now ranges from 185 to 196.
I am taking metformin 500 two times for last six years. HbA1C remains up to 6.
Please guide whether to change the medicine or continue as it is. Also the reasons for PP level touching 200.
Quick Answer
A post-meal glucose of 185–196 mg/dL is slightly above the common target of less than 180 mg/dL for many adults with diabetes when measured 1–2 hours after the beginning of the meal. It is not usually an emergency by itself, and it does not automatically mean that metformin has failed. Because your fasting readings and reported A1C are low, do not increase, stop, or replace metformin on your own. First confirm the testing time and look for a repeated pattern, then review the record with your diabetes clinician.
Answer by: Dr. Albana Greca Sejdini, MD, MMedSc
For many nonpregnant adults with diabetes, commonly used goals are 80–130 mg/dL before meals and a peak post-meal glucose below 180 mg/dL. These are general targets, not pass-or-fail cutoffs. A reading of 185–196 mg/dL is modestly above the common post-meal target, but its meaning depends strongly on when it was measured.
| Testing time | How to interpret the result |
|---|---|
| Less than 1 hour after starting the meal | The reading may be near the normal meal-related peak and cannot be compared directly with a 2-hour target. |
| 1–2 hours after starting the meal | 185–196 mg/dL is slightly above the common target of less than 180 mg/dL for many adults with diabetes. |
| More than 3 hours after eating | A persistent reading near 200 deserves review because glucose would usually be moving toward the pre-meal range. |
Measure from the first bite, not from the end of the meal. Wash and dry your hands before testing because food residue can falsely raise a finger-stick result.
Not from these values alone. Metformin 500 mg twice daily is a common regimen, but the correct dose depends on kidney function, tolerability, the formulation used, other illnesses, and the overall glucose pattern. Medication changes should be individualized by the prescribing clinician.
Your reported A1C of about 6% suggests a low average glucose over the preceding two to three months. At age 66, the A1C goal should be individualized according to general health, kidney and heart disease, functional status, treatment burden, and risk of low glucose. For many otherwise healthy older adults, an A1C goal below 7.0–7.5% is reasonable. A lower result may still be acceptable when achieved safely, particularly with metformin alone, but there is no reason to intensify treatment merely to correct a few borderline post-meal readings.
A1C is an average, so brief after-meal rises can occur even when the A1C is low. However, if many readings are near 200 while the laboratory A1C remains about 6%, ask the clinician to compare the meter with a laboratory glucose test. Anemia, recent blood loss or transfusion, kidney or liver disease, and some inherited hemoglobin variants can make A1C less reliable. Hemoglobin variants are more common in parts of India and may produce falsely high or low results with certain A1C methods.
Seek faster medical advice
Contact a clinician promptly if glucose repeatedly rises above 250–300 mg/dL, or if high readings occur with excessive thirst, frequent urination, vomiting, abdominal pain, breathing difficulty, confusion, severe weakness, dehydration, or ketones.
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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