Q: Around one and a half years back, my sugar levels suddenly shot up to 372 mg/dL (fasting) and 451 mg/dL (post prandial). After consulting a diabetologist, I am regularly taking Ismat 500 mg twice a day. My fasting blood sugar level ranges between 113 mg/dL to 121 mg/dL for the past 18 months. As per the diabetologist, this is an acceptable range. However, the laboratory shows it out of range, according to them, reference range is 70-110 mg/dL. Recently, they have revised the reference range to 74-100 mg/dL and showed my fasting count of 114 mg/dL as high. When I questioned them about reducing the higher reference limit to 100 (which was 110 earlier), they told me that reference range changes according to the kit used. Does fasting blood sugar value depend on kit used or is the reference range (normally indicated 80-120) universal? Secondly, my postprandial (PP) blood sugar reading is invariably lower than fasting level. Last time, it was 97 mg/dL pp v/s 114 mg/dl fasting. Why is it so? One would expect that 2 hours after eating, sugar level will actually go up. Why is it not so in my case?

A:In a normal non-diabetic person the sugar level is 70-100 mg/dL and in diabetics with medications 100-110 mg/dL is ideal. The level should be as low normal as possible, but the problem is that lower the level achieved, greater are the chances of developing hypoglycaemia; hence reasonable low level of blood sugar without risk of hypoglycaemia is acceptable. Check your HbA1c, if it is < 7 its very good and if it is < 6.5, it is excellent. About PP sugar being lower than fasting may be a normal phenomenon for some or it may be due to drugs. If you are not getting pre-meal hypoglycaemia, then it is okay for you.