What Is Normal Blood Sugar?

Physicians focus so much on disease that we sometimes lose sight of what’s healthy and normal.  For instance, the American Diabetes Association defines “tight” control of diabetes to include sugar levels as high as 179 mg/dl (9.94 mmol/l) when measured two hours after a meal.  In contrast, young adults without diabetes two hours after a meal are usually in the range of 90 to 110 mg/dl (5.00–6.11 mmol/l).

What Is a Normal Blood Sugar Level?

The following numbers refer to average blood sugar (glucose) levels in venous plasma, as measured in a lab.  Portable home glucose meters measure sugar in capillary whole blood.  Many, but not all, meters in 2010 are calibrated to compare directly to venous plasma levels.

Fasting blood sugar after a night of sleep and before breakfast: 85 mg/dl (4.72 mmol/l)

One hour after a meal: 110 mg/dl (6.11 mmol/l)

Two hours after a meal: 95 mg/dl (5.28 mmol/l)

Five hours after a meal: 85 mg/dl (4.72 mmol/l)

(The aforementioned meal derives 50–55% of its energy from carbohydrate)

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Ranges of blood sugar for young healthy non-diabetic adults:

Fasting blood sugar: 70–90 mg/dl (3.89–5.00 mmol/l)

One hour after a typical meal: 90–125 mg/dl (5.00–6.94 mmol/l)

Two hours after a typical meal: 90–110 mg/dl (5.00–6.11 mmol/l)

Five hours after a typical meal: 70–90 mg/dl (3.89–5.00 mmol/l)

Blood sugars tend to be a bit lower in pregnant women

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What Level of Blood Sugar Defines Diabetes and Prediabetes?  

According to the 2007 guidelines issued by the American Association of Clinical Endocrinologists:

Prediabetes: (or impaired fasting glucose): fasting blood sugar 100–125 mg/dl (5.56–6.94 mmol/l)

Prediabetes: (or impaired glucose tolerance): blood sugar 140–199 mg/dl (7.78–11.06 mmol/l) two hours after ingesting 75 grams of glucose

Diabetes: fasting blood sugar 126 mg/dl (7 mmol/l) or greater

Diabetes: blood sugar 200 mg/dl (11.11 mmol/l) or greater two hours after ingesting 75 grams of glucose

Diabetes: random (“casual”) blood sugar 200 mg/dl (11.11 mmol/l) or greater, plus symptoms of diabetes

If there’s any doubt about the diagnosis, testing should be repeated on a subsequent day. 

Compared to impaired fasting glucose, impaired glucose tolerance may be a better predictor of cardiovascular disease and death.  So some researchers and clinicians focus on preventing high blood sugar swings after meals.  The problem with prediabetes, which causes no symptoms early on, is that one of every four cases progresses to full-blown diabetes over the next 3–5 years. 

The numbers above do not apply to pregnant women.  Five percent of pregant women develop gestational diabetes that goes away soon after delivery. 

What Level of Hemoglobin A1c Defines Diabetes?

Another way to consider normal and abnormal blood sugar levels is to look at a blood test called hemoglobin A1c, which is an indicator of average blood sugar readings over the prior three months.  The average healthy non-diabetic adult hemoglobin A1c is 5% and translates into an average blood sugar of 100 mg/dl (5.56 mmol/l).  This will vary a bit from lab to lab.  Most healthy non-diabetics would be under 5.7%.

In December, 2009, the American Diabetes Association established a hemoglobin A1c criterion for the diagnosis of diabetes: 6.5% or higher.  Diagnosis of prediabetes involves hemoglobin A1c in the range of 5.7 to 6.4%.  The aforementioned blood sugar criteria can also be used.   

What Are Blood Sugar Goals During Treatment For Diabetes?

The 2007 guidelines of the American Association of Clinical Endocrinologists “encourage patients [both type 1 and 2] to achieve glycemic [blood sugar] levels as near normal as possible without inducing hypoglycemia [low blood sugar].”  Specifically:

Fasting blood sugar:  <110 mg/dl (6.11 mmol/l)

Two hours after a meal: <140 mg/dl (7.78 mmol/l)

Hemoglobin A1c: 6.5% or less

The American Diabetes Association recommends normal or near-normal blood sugar levels, and defines “tight control” as:

1) pre-meal and fasting glucose levels of 70–130 mg/dl (3.89–7.22 mmol/l)

2) sugars under 180 mg/dl (10.00 mmol/l) two hours after start of a meal

3) hemoglobin A1c under 7%. 

A hemoglobin A1c of 7% is equivalent to average blood sugar levels of 160 mg/dl (8.89 mmol/l).  Hemogobin A1c of 6% equals, roughly, average blood sugar levels of 130 mg/dl (7.22 mmol/l).  But remember, healthy non-diabetics spend most of their day under 100 mg/dl (5.56 mmol/l) and have hemoglobin A1c’s around 5%.

Diabetic experts actively debate how tightly we should control blood sugar levels.  For instance, Dr. Richard K. Bernstein—a type 1 diabetic himself—recommends keeping blood sugar levels under 90 mg/dl (5.00 mmol/l) almost all the time.  If it exceeds 95 mg/dl (5.28 mmol/l) after a meal, then a change in medication or meal is in order, he says. 

Here’s the over-simplified “tight control” debate.  On one hand, tight control helps prevent and may reverse some of the devastating consequences of diabetes.  On the other hand, tight control in diabetics on insulin and certain other diabetic medications may raise the risk of life-threatening hypoglycemia and may shorten lifespan in other ways.  

Blood Sugar Goals For My Personal Diabetic And Prediabetic Patients

Ideally, normal glucose levels before and after meals, with normal hemoglobin A1c.

Realistically, these are acceptable fall-back positions:

Fasting blood sugar: under 100 mg/dl (5.56 mmol/l)

One hour after meals: under 150 mg/dl (8.33 mmol/l)

Two hours after meals: under 130 mg/dl (7.22mmol/l)

Hemoglobin A1c: 6% or less

Treatment options for those not at goal include diet modification, weight loss, exercise, and medications.  Admittedly, those goals are not acceptable or achievable by everyone with diabetes.  Future studies may prove that such strict goals are not necessary to avoid the complications and premature death suffered by people with diabetes.  Tight control may be less important for elderly diabetics over 65–70.  But for now, if I were a young or middle-aged diabetic I’d shoot for the goals above.

Steve Parker, M.D.

Technical Notes

The gold standard for measuring glucose is a large chemistry analyzer in a lab, which measures values in plasma obtained from a vein with a needle.  The glucose level in capillary whole blood, obtained via fingerprick  and analyzed on a portable/home glucose monitor, is a different value, often 5–10 mg/dl higher than venous glucose.  As of 2010, a majority of home glucose monitors, but not all, are calibrated so as to be directly comparable to venous plasma glucose readings.  Read your monitor’s paperwork to find out about your device. 

Portable fingerstick glucose meters are not as accurate and as you might expect.  If your actual glucose level is 100 mg/dl, the meter may report it as 80 or 120 or anywhere in between, for example.  The meters tend to be less accurate at glucose values over 200 mg/dl.  Some devices are definitely more accurate than others.  Research the available devices before you acquire one.  

Outside the U.S., glucose is usually reported in units of mmol/l (millimoles per liter).  One mmol/l = 18 mg/dl.  To convert mg/dl to mmol/l, divide by 18 or multiply by 0.055. 

Last updated June 1, 2010

96 responses to “What Is Normal Blood Sugar?

  1. BJ

    I’ve read several articles and often mentioned is that Diet Sodas/Aspartame
    can CAUSE lots of various diseases such as diabetes, rashes, etc. Have you done any research on this??? I do consume up to 5 cans a day and have been recently told I have diabetes. No one in my family has ever had it.

    • BJ, I’ve not studied that issue. I personally limit my diet sodas to two daily, and many days I drink none. I tend to doubt there’s an unrecognized epidemic of illness caused by aspartame.

      -Steve

    • Brandy Mearnic, RN

      Hi BJ! Sugar, sodas, diet soda’s or anything with regular sugars or aspartame can NOT cause diseases such as diabetes. That is a misconception. Diabetes is caused by the lack of insulin in the pancreas. The pancreas can not provide enough insulin to keep the blood sugar’s of the body even and so diabetes sets in. Hope this info helps!

  2. barbara evans

    my glucose tested 116 with fasting blood test is that normal i am 69?

  3. Karen Norris

    I am almost 65 and from what I just read its not that important for me to have the tight tight control? I am almost anal in keeping my bs below 120 2hrpp and 140 1hrpp I am on a low carb of 50 or so carbs a day. Am I going overboard? Thanks Karen

    • Hi, Karen.
      It’s an extremely complicated situation. Be sure to get your own doctor’s opinion.

      Over the last few years, we’ve seen published studies suggesting that the average diabetic may have a better overall outcome, at least in terms of longevity, with hemoglobin A1c’s in the range of 6.5 to 7%, not lower. If you successfully achieve your goal glucose levels, you’d be in the 5 to 6% range.
      It’s difficult to be sure about this issue because of the multitude of issues involved, such as type 1 vs type 2 diabetes, underlying type of diet, co-existing illnesses, access to medical care, types on non-drug adjunctive medical care, exercise vs sedentary lifestyle, geographic location, which diabetic drugs are being used and for how long, etc. For instance, the ACCORD trial indicated higher death rates in diabetics with hemoglobin A1c under 7%. But ACCORD participants, at least some of them, were using rosiglitazone. Rosiglitazone was esssentially taken off the market in the U.S. a year ago because of excess cardiac deaths in users.

      In the ideal scientific study, we alter ONE variable and see what happens. It’s often hard to do that in clinical studies on humans.

      -Steve

  4. Thanks for your information. I have listened to you on Jimmy Moore’s podcasts and have also written about your work on livestrong.com. ;) I am actually diagnosed with PCOS and although I am just slightly overweight, I discovered that my 2-hr post-meal blood glucose levels were at 124 mg/dL after a meal of fish, non-starchy vegetables, butter and 2 squares of 85% dark chocolate (for a total of less than 12 g of carbs) (fasting BG ranges between 76 to 88 mg/dL, except for last night when they went up to 115 mg/dL while suffering from insomnia around 4am). I am currently eating a very low-carb diet, with <50 g of available carbs a day and believe that my blood sugar levels should not go that high after eating. What kind of target would you aim for? I am still trying to lose weight and manage my PCOS. Should I restrict my carbs even more?

    • Hi Aglaee. Thanks for chiming in.

      For legal and medical reasons, I can’t be specific about your situation since I don’t have the full picture and haven’t examined you. Be sure to work with your own personal physician.

      Nevertheless, if those were my numbers, I would’t be too terribly concerned. I wouldn’t cut my carbs any further at this point. I might get a 75-gram oral glucose tolerance test (after three days of eating at least 100-150 g of digestible carbs daily). That would tell me if I were in the prediabetic or diabetic range (at which point I’d have more concern).

      An exercise program with both aerobic and resistance training components may help reduce after-meal blood sugar levels.

      Hope this is helpful.

      -Steve

  5. Becky

    This is some very helpful information, thank you! I also have PCOS, 33 yrs, and a type II Diabetic on Metformin 500 x 2/day. (I also take Prometrium 12 days out of the month) I am obese and have been taking losing weight very seriously. I have noticed a slight trend where my fasting was 121 (It has never been that high), and then two hours after breakfast it will be around 105. I was sure to retest each time to see if I had a faulty test, and they were correct. Have you had cases where diet and excercise have altered blood sugar like this? I’m use to having a fasting blood sugar of 85-100, and 2 hour post breakfast of around 115. I have a doctors appointment on the 15th, but I would appreciate any input or advice you could give. Thank you!

  6. Hello, Becky.
    I can’t give you any personal advice since I’m not your personal physician. But I do have a few comments.
    You may be exhibiting the “dawn phenonmenon.” Here’s how it works. Insulin helps to keep blood sugar levels from rising too high. Everybody’s llver helps to deactivate insulin. For mostly mysterious reasons, some livers work more effectively to deactivate insulin in the early morning hours. Deactivation of insulin would allow blood sugars to rise, particularly fasting (early AM) levels. Eating breakfast then “wakes up” the pancreas so it produces more insulin. How to lower fasting glucoses under 100 mg/dl? An exercise program can help. Also eating relatively fewer carbs with the evening meal might help, moving those to earlier in the day, say lunchtime. There are a few other tricks, too.
    The dawn phenomenon effect may last till mid- or late-morning for some folks. I think that’s why Dr. Richard Bernstein recommends eating ony 6 g of digestible carb for breakfast, and 12 g for both lunch and dinner.
    Hope that helps.

    -Steve

  7. Rakesh singh

    after break fast by 80 min my suger level is 116. iam not taking any tablate
    Please tell me iam diabetes patients or not ?

  8. VICTOR

    WHAT IS THE NORMAL BLOOD SUGAR LEVEL & WHAT SHOULD BE MY DAILY DIET

  9. seb

    I have a Ac1 level of 5.4. I am 30 years old, have not been active for 6 months but am willing to restart today my training. Is 5.4 a good level?

  10. mwchow

    Hi,

    Does this look normal to you for an OGTT?

    HBAC1 : 5.2
    Fasting : 5.1
    C-peptide : 1.50 (1.06 – 3.53, Peak: 4-10)
    Insulin : 5.23 (4-16 fasting)

    1 Hr : G 10.3 (ref 6 – 9.4), Insulin 15 ulU/ml (4=16 fasting)
    2 Hr : G 6.5 (ref 4 – 7.4), Insulin 9.28 ulU/ml (4-16 fasting)

    Thanks…

  11. Floy O'Neal

    This web site sucks!!!!

  12. Muhammad Niaz

    on 12/3/12 at about 1300 hrs. Blood glucose after 5 hrs. fasting it was 67mg/dl and 2 hrs after meal it was 160 mg/dl . am i glucose patient

  13. blogger141

    I’ve just discovered this website and finally some light sheds on issues lately: whenever I eat, I feel like I am drugged afterwards(never tried, but I assume that’s how it is), I get EXTREMELY tired, sweaty, nauseated, can’t see well, can’t think at all and I just HAVE to lay down. If I can’t lay down, I go on beat for hours until I feel normal again. I discovered this: my pulse goes very high, in the 90’s after I eat, my blood pressure goes higher, 117/74(but normally is very low, like 90/55). Then, my sugar readings were: 116 before eating, then 1h after eating and 2h after eating is 146. Would I be considered a pre-diabetic? I am only in early 30’s, but we’ve been through a lot of stress past years, had four kids one after another, gained ~20lb… We eat pretty healthy, no processed foods, no sodas, no sugars, unless it comes from fruit. There are some diabetes and heart issues in the family history.

    • blogger141

      1h after eating was 154. I missed on writing it. Do I have reasons to be concerned?

    • Good to hear from you, blogger141.
      If those are your blood sugar readings (in mg/dl) while you’re feeling so bad, you can’t attribute the symptoms to blood sugar levels. You better check in with your personal physician for an accurate diagnosis.

      -Steve

  14. Bryce

    i am type 2 and last nite 2 1/2 hrs after dinner (hamberger helper) my reading was 76, where normally it is 117-119 with the same meal.what happened and should i be concerned? ( normally my readings are morning fastings are in the low 90s and after meals are in the 117-119 range) im taking Januvia 100 mg once a day

  15. Bryce

    sorry my email is brycebeaulieu@gmail.com not mail.com

  16. Anna

    I am not diabetic. I have gotten many blood tests done, including the glucose tolerance test to see how my sugar levels change. I got these tests done, because I have noticed that sometimes I get shaky or weak and wasn’t sure if this was because of low blood sugar levels. The lab work has come out normal, which is good. But why am I still sometimes feeling weak or shaky? I try to eat right and don’t want to be worried about my sugar levels fluctuating. what should I do?

  17. brant119

    I am a 65 year old male who is ytpe 2. I am on Amaryl and do not test. My personal doctor of 25 years checks AIC every 3 months. Last was 7.0. Has ranged from 6.5 to 7.5. My fasting sugar was 211 and I am scared especially after reading Mark Hymans book. I am 20 lbs overweight and have HBP and I do exercise regularly and count carbs. I am puzzled. Should I see a specialist? I also take Simvistatin and my cholesteol is borderline. Should I try Medt. diet and should I get more aggressive with a specialist? I have same MD for 25 years. No family history and my parents lived to 90 and 87. I plan to buy your book. Also why is eating cheese an issue. I have basically cut out pizza, rice and pasta-maybe once or twice a month for the latter 2 and I do not like sweets.

    I am just really puzzled.

  18. Rufus Groote

    There are some natural food supplements that can help improve low blood pressure like Licorice. *

    Remember to look out for this useful web portal
    http://www.healthmedicinelab.com/rash-on-neck/

  19. Jim Allan

    I have just been diagnosed with type 2 and am trying to get a handle on my blood sugar levels through testing periodically per my doctors instructions. I have been ranging before meals 90 to 104. Two housrs after meals I range between 100 and 104. First thing in the morning I range from 90 to 100.
    I am dieting and exercising. Am I wrong or are these good numbers? I am 66, have lost 10 Lbs in the last month since I began testing.

  20. Peggy Middleton

    My husband has a FBS level of 128 his A1C is 6.1. It has been running high 90’s to 112 over the last 5 years. He is 60, 6’2” and weighs 211 lbs. He is furious with our MD because she has “labeled” him diabetic, not pre-diabetic. She has not put him on any oral hypoglycemics and is going to check his labs in 3 months. She told him to exercise and loose 20 lbs. Is he diabetic or pre-diabetic?
    Thanks, Peggy

    • Hey, Peggy. It sounds frustrating. Here’s a page that will have the answer to your question. If there was only one single fasting blood sugar over 125 mg/dl, I’d say he’s more prediabetic than diabetic. But I don’t have all the data. Treatment approach to prediabetes and mild type 2 diabetes would be pretty much the same.

      -Steve

  21. Don Johnson

    I am 74 and have been a type 2 diabetic for some 20 years. I take a variety of pills and my average A1C is always over 7 but less than 8.

    It doesn’t matter what I eat or not eat for my evening meal, my blood sugar is always high in the morning around 160 to 180. After I eat, a couple of hours later, it is around 110 -140. I have had several surgeries in my stomach area and I think this might be a problem.

    I also have lots of lows, etc.

  22. Philo

    I can keep my blood sugar in check, although I had been having a real hard time the past six months or so. I would hit the sack with a blood sugar around 125-129, and wake up with it around 169 or so. I also wasn’t sleeping well. With some Internet research I learned that sleep deprivation does impact blood sugar. I had been napping on my break from work between 2pm and 5pm. I cut that nap out, started making sure I get at least 7 hours sleep at night, and now I’m back to normal for the most part.

  23. This is very helpful blog post and useful to see all the thresholds and targets in one place. Thank you.

    My hbA1C was at 6.0 and my fasting glucose was 6.0 in November. Since then I’ve been able to lower my average glucose to about 5.2 through a low carb diet (I haven’t been retested for hbA1C). Here is the difficulty that I have with the hbA1C 6.5 target that you set for your patients: they would still have abnormally high blood sugars and could suffer many of the adverse symptoms of diabetes. My numbers were in the prediabetic range and equal to lower end of the hbA1C target that you set (though admittedly my fasting glucose was higher). Yet, I suffered many symptoms of diabetes, including peripheral neuropathy, obesity, fatigue after meals, dry mouth, tendonitis, arthritis and diabetic dermopathy (shin spots). Thus, I feel it is essential to set a much more rigorous target for myself than you do for your patients. Since going on a low carb diet, some of the symptoms have mostly disappeared–notably the more classic diabetic symptoms–peripheral neuropathy, obesity (down 35 lbs), and arthritis.

    Your targets however are much better than the ADA and for that your patients should be grateful.

  24. Dee

    Hi my name is Dee, I am a type 1 diabetic. My numbers are between 120 and 139 over night. I am suppose to be taking insulin 40g twice a day just before my meal. When I take the 40 grams as prescribed I crash my numbers be in the low 60’s where i have to than get to some sugar. Now when I just excersize after meals my numbers drop in a normal range. Also my age is 51. What could the problem be?

  25. Md Moniruzzaman

    what is the minimum hba1c level to start any diabetic agent

  26. Thanks for the website. It clears up a lot of things my doctor has been trying to explain. Will be bookmarking this and will return often to visit.

  27. Hussain

    Is there a big effect if I leave my blood sugar as high as 250 mg/dl for more than two hours? e.g. five to six hours without exercising, in other word if I failed to exercise after two hours, is it still good to exercise after five to six hours or just skip the exercise for that meal?!
    Another thing is it better to exercise one hour after meal or two hours?
    Thanks for replying

  28. Hussain

    Thanks to Dr. Steve

    Thanks to Mr. Petros
    Believe me I’m doing my best, and that’s out of my hands, because of our culture. I’m still much better than my relatives and friends who are reaching up to 500. I know it’s very impossible for me to go down to 108 even in the morning after fasting.
    Thanks again and I’m very sorry for my poor English!

  29. Akiva Sherman

    I’m 63 years old male.
    This morning after meal I’ve checked my blood sugar and it was 101, In the mornings before eating, I checked for few days, and it tested 70, 71,75,76, and now 2 hours after I had food (tomato, two slices of turkey, peach and a banana it shows 102.
    I feel tiered and dizzy.
    what is normal blood sugar after such meal?

  30. Yousuf F. Choudhury

    I am 26 years old. My height is 173 cm but I weigh 88 kg. I have been self monitoring my blood sugar on and off though I have never visited doctor. I do so because my dad is also suffering from diabetic type 2. My CBG levels always come in the range 90-110. Should I be concerned?? I have one problem too. I am living a sedentary lifestyle as I am busy in studies. Please, advice.

  31. The ACCORD trial was discontinued because cardiac events were higher for the intensive therapy group with A1cs under 7.0. But this is because the intensive therapy group was taking more/higher doses of medication! What about getting a lower A1C without medication?

    I am a 61 year old male. In March 2012, I had an A1c of 6.6. It is now 5.0 without medication. I did it with low carb, whole food, no sugar diet with 5 to 7 hours a week of exercise… no medication! Went from over 30% body fat to under 12% with a 22BMI. Have a friend with even more dramatic results after sharing with him what I was able to do. He had an A1c of 10! (First 4 months he used medication, then went with diet and exercise alone and got much better results after only one week on Newcastle protocol with no medication.

    The 2011 Newcastle study basically confirmed your clinical Medfast experience and shows it’s possible to completely reverse diabetes symptoms without medication.

    http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm

    Would be interested in your comments on why ADA and AACE can’t figure this out. I’m not a physician but was a top research executive and know how to conduct an N of 1 trial.

    I don’t believe anything until I test it with my meter.

    Eat to the Meter!

    • Blaine, thanks for your inspirational comments.
      Why the ADA and AACE cant’ figure it out, I’ll just blame on “institutional inertia.” They’ve done things a certain way for years, and it’s slow to alter the course of the ship. I have no direct knowledge of how much influence the pharmaceutical industry has over the guideline developers. Clearly, using drugs instead of diet to control blood sugars benefits the drug sellers. The societal move to better diet and away from drugs (esp. in type 2 diabetes) will probably have to be led by the patients, I’m afraid.

  32. Madlyn

    At age 68, Dr says my fasting glucose level of 101 and 4 months later, 110 need to be reduced. I’m not overweight (5’8″ 145 lbs), b.p is 100/60, cholesterol is 233 with hdl over 80. Where do I find out which foods may make my glucose rise 10 pts? A glass of wine raises it how much? A potato or spaghetti for dinner – not much, of course, to keep my weight down. My mother and grandmother did not have diabetes and both were overweight – I’ve been careful with weight and now this worry – very frustrating!

    • Madlyn, the only way to see how different foods affect your particular blood sugar would be to get a home glucose meter and check it 1-2 hours after a meal. Unfortunately, the existing meters aren’t accurate enough to reliably detect a real difference of 10 mg/dl. Even the huge machines in labs may not be that accurate. In other words, I wouldn’t fret about a 9-10 mg/dl difference on only two separate occasions. If fasting blood sugars are repetitively in the 110 range, that’s cause for some concern. The a home meter makes more sense. Browse more on this site and you’ll find which foods tend to spike blood sugars.
      -Steve

  33. Eagle Squad KSA

    Dr Steve

    Good Day

    Here is My laboratory result last week

    After Fasting

    Hemoglobin A1C 7.6 %
    RBS IS 183 mg/dl after fasting

    I am taking my meds everyday and exercise daily
    Metformin 500.. Everyday im doing my exercise in threadmill for one hour and mention there that i burned 150 calories.. Every meal i ate 3/4 cup of rice and lots of vegetable..if you can give a diet method or advise for my meal…it is highly appreciated

    Do you think my blood sugar will goes down in my method?

  34. marcusflores

    I am male,69 years old. My latest fasting plasma glucose some days ago was 5.82 mmol/l. I did not ask for any hba1c to accompany it. Six months ago,however, my fasting plasma glucose was less at 4.99,that time plus hba1c reading of 5.4. Both tests were done by reliable hospital lab. Am i prediabetic or insulin-resistant in your view,judging from these numbers? Regards. Marcus Flores.

    • Hey, Marcus. Those aren’t enough data points to make a definitive diagnosis. So I wouldn’t label you as prediabetic at this point. Might be helpful to check a serum glucose 2 hours after a 75 gram oral glucose load. Or just check another fasting glucose and HgbA1c in six months. If any of this contradicts your personal physician, go with his ideas. He knows the full details of your situation.

      No way I can say if you have insulin resistance. If your body mass index is over 30, odds are about 7 in 10 that you are resistance.

      -Steve

  35. Lillian
    I just took my glucose reading and it has me concerned. My reading was E-5. I have never seen this before. What does this mean? I had an ultra sound done on Friday (11/8/13) and was told not to take my Metformen until I had my blood tested, after which my doctor is to tell me if I should start taking it again on Monday (11/11/13). What should I do if anything?

    • I’m just guessing E-5 is an error message. Check your machine’s user manual.
      The ultrasound/metformin thing also makes no sense to me.
      Contact your doctor with those questions.

      On a related note, when we do a CT scan with intravenous contrast, we always have the patient stay off metformin until 48 hours later so we an prove (with a blood test) that the contrast hasn’t damaged the kidneys.

  36. bsnarayana

    i have been diagnised once blood sugar 210 after meals but later i checked both fasting and post meal are at normal .recently i have gone for hba1c it is 5.8 and after one month it is reeated now it is 6.6 whether iam diabetic or need to meet doctorneed any di

  37. chriswattsh2o

    My 14 yr old son, who we tested twice, during a biology exercise, showed a 49 reading on my blood glucose meter. A walk in clinic dr. Said it was normal for teens blood to dip down to such a low level. I havent found info. To support his claim.

    • I’ve not seen a table of normal blood sugar values for young teens and I don’t practice pediatrics, so I don’t have much intelligent to say about your son’s 49 mg/dl. As long as he was feeling fine at 49, it may be nothing to worry about. Measurement error? I do know that some athletes during heavy exertion will dip below 50 and never know it.

  38. All. I wanted to know is if 76 was too low for a diabetic. It only told me averages. My nurse practioner says it is. Thanks
    I do injoy the info you have for someone my age.

    • Hi, Lillian. Blood glucose of 76 mg/dl is in the normal range. It’s not too low unless the patient is one of those who frequently and mysteriously becomes hypoglycemic, with potentially serious consequences.
      -Steve

  39. ann

    My brother was recently diangosed with type 2 diabetes and already has neouropy in his feet. Does this mean he has had this for a long time? Also should he seek out a diabetec dr. Or will a general practitioner do as well? The dr didnt help with diet , just gave him some melformin and said come back in 3 months, very frustrating!!!! – help please with some advise.

    • Hi, Ann.
      Many diabetics already have neuropathy or other complications at the time of diagnosis. Type 2 diabetes is often present for months or years before it’s diagnosed.
      Many, but not all, general practitioners are well-equipped to treat T2 diabetes. Simply prescribing metformin without doing anything else for a brand-new diabetic is inadequate.
      -Steve

  40. maria

    I had severe reactive hypoglycemia for a year and a half, to the point I couldn’t even eat anything without seeing very low numbers right after. I ended up in the ER several times, and even found out I had nocturnal hypoglycemia in the 40′s during the whole night and that I used to spent half of my day hypoglycemic. I was eating the SAD so after 3 months following the paleo diet I can say I rarely have an hypoglycemic episode. It started getting better and better. Well suffering from RH for more than a year certaintly caused me cortisol dysregulation as well and adrenal issues so I would like to know what is happening now is cause for concern or I should ignore it.
    My fasting blood sugar used to be 70 and now is always 90.
    3h after a meal my blood sugar used to be very low (I was probably extremely glucose dependent) and now it rises to 100-110. What I mean is if I eat a meal the pattern is for eg:
    before eating – 80
    1h after eating – 120
    2h after eating – 90
    3h after eating – 100-110
    Also my glucometer shows numbers around 110 every single night around 2-3am. When I wake up around 8.am it’s 90. Also, another question that really confuses me is that I’ve been eating a high protein breakfast with fat and a little bit of carbs for a couple of weeks now (not 50g of protein but fairly high protein) and after 1h my blood sugar is usually 110, sometimes goes up to 120. Why does this happen?
    Should I be concern about any of these new facts or is everything (finally) ok?
    Sorry for bothering and thank you for your help.
    Apologies for my english i’m from Spain

  41. nikita

    I’m concerned my daughter is hypoglycemic. She has a good majority of the symptoms and I have been checking her. Her numbers seem to be low and I’m also curious as to what a normal blood sugar should be in the middle ofthe night, like 1am…. Her levels barely get over a hundred, the lowest fasting she has had is 68 and the highest is 103. Any info would be appreciated. She does have an appointment on the 28th. Thank you for your time.

    • Hi, Nikita.
      I don’t know your daughter’s age and I don’t treat children. I don’t know the normal range for children’s blood sugars off the top of my head. I bet for kids between 6 and 18, the normal range is quite similar to adults. A middle-of-the-night blood sugar for a healthy adult who ate dinner at 8 PM would be roughly 70 to 100 mg/dl. 68 mg/dl is close enough to normal and usually wouldn’t cause symptoms. From 1 to 3 hours after a typical meal containing 50% of calories from carbohydrate, healthy adult blood sugars would range from 80 to 140-150 mg/dl.
      Keep that appointment with her doctor. And good luck.
      -Steve

      PS: To convert mg/dl to mmol/l, divide by 18. This only works for glucose.

  42. nikita

    I just recently bought a new meter because the other one broke, I’m not sure how accurate the other meter was, but with the new one she’s been running high fasting numbers. 103, 106, 109, and 116 today.

  43. Lori Chernyha

    My husband has reactive hypoglycemia and has developed diabetic shin spots, the kind that are red, scaly and indented. I knew diabetics got them but have you ever seen someone with reactive hypoglycemia develop them?

  44. Lori Chernyha

    It makes me wonder if diabetic shin spots can be due to insulin spikes rather than sugar spikes. Which are conditions of both hyper and hypoglycemics, right? Thanks, Lori

    • I had scabby shin spots for a couple of summers. My fasting glucose and Hba1c was in the prediabetic range. Roller coaster blood sugars even if not in the diabetic range can be sign of carbohydrate intolerance, and the result can be symptoms typical of diabetes. I also had peripheral neuropathy.

  45. Lori Chernyha

    The thing is my husband’s blood glucose never goes over 100, but can drop very low if he skips meals or consumes any carbs. So if I understand you correctly, it doesn’t matter in which direction blood glucose fluctuates, it just the fact that it fluctuates that causes the skin condition. If this is correct can he expect other complications associated with diabetes? I have read that uncontrolled reactive hypoglycemia can be a precursor to insulin resistance. Fortunately, he is taking his condition seriously, by avoiding carbs and not skipping meals he has managed to control the extreme fluctuations. He feels much better and has lost 20 of the 30 extra pounds he has been carrying around for the last few years. Thanks, Lori

  46. shah

    I am pregnant and testing my blood sugars for a week (i’m 32 weeks). I passed the 3 hour glucose test (my third hour was slightly elevated but they said I passed). Testing for a week just in case. Fasting has to be between 70-99 and one hour post meals have to be under 135. How many high readings would you consider someone to have GD? What if the high readings are only after breakfast? My breakfast ranges from 140-147, fasting is 90 or below, and other meals are 120 or below.

  47. Stephen Lowe

    My fasting blood sugar level is between 4.6 – 6.8. I have had cardiac surgery, and have high blood pressure. I am 72 years old. Since I have been taking cold Ceylon tea with cinnamon powder + sugar, daiy, my sugar level has reduced from 6+ to average 5. Your opinion please.

  48. Olan

    I have been told that metformin can cause kidney stones. Is there any truth to that?

  49. Lakshmi

    10 Hours Fasting blood glucose 7.13
    2 hour meal is 5.69
    HbA1c 5.7

    am I diabetic?

  50. Wm Thomas

    I have been a diabetic for 15 years and 62 yrs. old. Started as Type 2 and transitioned to Type 1 a few years ago. Not overweight and no family history. My AIC has been in the 7.5 range for some time. I am experiencing signs of peripheral neuropathy but also had two peroneal nerve entrapments (that have been repaired) and spinal stenosis which has not been treated. Does a 7.5 AIC level give concern for peripheral neuropathy or could the calf pain and ankle weakness be from other issues?

    • Hello, William. Yes, the calf pain and ankle weakness could be from peripheral neuropathy or spinal stenosis, among other possibilities. Work with your doctor on those; see a neurologist if needed for clarification. You don’t want your back operated on if the the problem is peripheral neuropathy!
      -Steve

    • I had debilitating peripheral neuropathy with an hbA1C of 6.0. When I went on a low carb diet, it got much better. Now I am doing Wahls Protocol to help the nerves grow back.

  51. dlmtleArt

    is it safe to eat the same carb counting meal plan as my diabetic family member? I thought it might be helpful for them if I did that.

    • d’Art, that question has too many variables for me to try to answer specifically yes or not. If the diabetic diet is well-designed and the non-diabetic is healthy overall, eating the same “carb counting meal plan” probably won’t be a problem.
      -Steve

  52. Dan Keat

    Hello Dr. Steve,

    I am a 23 year old male that is 5’10”, consistently less than 160 pounds, and very active, but for a while I have been feeling generally terrible. All my research kept pointing to diabetes, which I thought was impossible given my physical state and the lack of diabetes in my family, but to be on the safe side, I bought a blood sugar monitor and gathered the below results:

    Fasting bs level – 59
    1 hour after a bagel – 143
    2 hours after the bagel – 104
    3 hours after the bagel – 70
    1 hour after lunch – 79

    Are these normal levels? My Dad is a doctor, and he said that 143 is a bit high. I’ll be crushed if I have diabetes.

    Thank you.

  53. Bunny

    I woke up checked my fasting blood sugar and it was 81. I consumed 4 glucose tablets because I felt shaky. I checked it again and it was 148! I’m still hungry and want to eat breakfast but now I’m afraid it is too high?

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