Published · Bahria Diabetes Center
In short
- Normal fasting sugar is below 100 mg/dL, and a normal HbA1c is below 5.7%.
- Fasting 100–125 mg/dL or HbA1c 5.7–6.4% is prediabetes — borderline sugar.
- Fasting 126 mg/dL or more, or HbA1c 6.5% or more, points to diabetes, but a diagnosis usually needs two abnormal results.
- Once you have diabetes the targets change: for most adults, 80–130 mg/dL before meals and under 180 mg/dL after.
The tests on a Pakistani lab report
Most labs in Lahore offer three sugar tests. Fasting blood sugar (FBS) is taken after at least eight hours without food or any drink with calories; water is fine. Random blood sugar (RBS) is taken at any time, whatever you have eaten. HbA1c reflects your average glucose over roughly the past three months and doesn't need fasting.
A fourth test, the oral glucose tolerance test (OGTT), measures sugar two hours after a drink containing 75 g of glucose. It is used in pregnancy and when other results are borderline.
Normal, prediabetes and diabetes
| Test | Normal | Prediabetes | Diabetes |
|---|---|---|---|
| Fasting blood sugar | Below 100 mg/dL | 100–125 mg/dL | 126 mg/dL or more |
| HbA1c | Below 5.7% | 5.7–6.4% | 6.5% or more |
| 2 hours after 75 g glucose (OGTT) | Below 140 mg/dL | 140–199 mg/dL | 200 mg/dL or more |
| Random blood sugar | — | — | 200 mg/dL or more, with symptoms |
One high reading isn't a diagnosis. Unless the sugar is unmistakably high — a random reading of 200 mg/dL or more with thirst, frequent urination and weight loss — the ADA asks for two abnormal results: two different tests from the same sample, or the same test on two occasions.
What about sugar after a meal?
In someone without diabetes, glucose rises after eating and then comes back down. The only formal after-meal cut-off is the OGTT's: below 140 mg/dL two hours after the glucose drink is normal.
A random reading taken an hour after a plate of biryani will naturally be higher than a fasting one. That is why a random reading below 200 doesn't rule diabetes out, and why a fasting test or HbA1c is the better check.
Targets once you have diabetes
For most adults with diabetes, the ADA's 2026 targets are 80–130 mg/dL before meals, under 180 mg/dL one to two hours after starting a meal, and an HbA1c below 7%. With a glucose sensor (CGM), the aim is more than 70% of the day between 70 and 180 mg/dL.
These are starting points, not rules. Older people, people living alone and anyone who has had severe hypos often do better with looser targets; in pregnancy they are tighter. Your own targets should come from your doctor.
Below 70 mg/dL is low at any time of day. Our guide to low blood sugar explains what to do.
When to get tested
The ADA advises testing everyone from the age of 35, and earlier for adults of Asian ancestry with a BMI of 23 or more plus one other risk factor — a parent, brother or sister with diabetes, high blood pressure, heart disease, polycystic ovaries or an inactive life. South Asians get diabetes at lower body weights, so don't wait for symptoms.
Common questions
- Is a fasting sugar of 110 normal?
- No — by the ADA's criteria it is in the prediabetes range (100–125 mg/dL). The World Health Organization starts impaired fasting glucose at 110 instead, so some labs flag it differently. Either way, it is worth an HbA1c test and a conversation about lifestyle.
- What is a normal sugar level 2 hours after eating?
- Below 140 mg/dL two hours after a standard 75 g glucose drink is normal. After an ordinary meal there is no official cut-off, but if you have diabetes the target is under 180 mg/dL one to two hours after starting to eat.
- Do I need to fast for an HbA1c test?
- No. HbA1c can be taken at any time of day. Fasting is needed only for a fasting sugar test — at least eight hours without food or any drink with calories.
- Can an HbA1c result be wrong?
- It can mislead. Some haemoglobin variants, anaemia, pregnancy, G6PD deficiency, and kidney disease treated with dialysis can all shift HbA1c away from the true average, so in those situations doctors rely on glucose readings as well.
Sources
- American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2026. Diabetes Care 2026;49(Suppl 1):S27–S49. doi.org/10.2337/dc26-S002
- American Diabetes Association Professional Practice Committee. 6. Glycemic goals, hypoglycemia, and hyperglycemic crises: Standards of Care in Diabetes—2026. Diabetes Care 2026;49(Suppl 1):S132–S149. doi.org/10.2337/dc26-S006
- World Health Organization, International Diabetes Federation. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia. Geneva: WHO; 2006. www.who.int/publications/i/item/definition-and-diagnosis-of-diabetes-mellitus-and-intermediate-hyperglycaemia