Under Malaysia’s Ministry of Health guideline, a normal fasting blood sugar (bacaan gula normal) is below 6.1 mmol/L, a normal 2-hour result after a glucose drink is below 7.8 mmol/L, and a normal HbA1c is below 5.7%. A fasting result of 6.1 to 6.9 mmol/L or an HbA1c of 5.7% to below 6.3% is prediabetes. A fasting result of 7.0 mmol/L or higher, a random result of 11.1 mmol/L or higher, or an HbA1c of 6.3% or higher is in the diabetes range. These figures are for adults who are not pregnant, and pregnancy uses lower numbers. This guide has the full chart, explains why Malaysian numbers differ from those on many websites, and covers home meter readings, pregnancy, targets if you have diabetes, and when to get help.
Ringkasan: Berapa bacaan gula normal?
- Semasa puasa: bawah 6.1 mmol/L
- 2 jam selepas minum air glukosa (OGTT): bawah 7.8 mmol/L
- HbA1c: bawah 5.7%
- Pradiabetes: puasa 6.1–6.9 mmol/L atau HbA1c 5.7% hingga bawah 6.3%
- Kencing manis: puasa 7.0 mmol/L ke atas, rawak 11.1 mmol/L ke atas atau HbA1c 6.3% ke atas
Sumber: Garis Panduan Amalan Klinikal Pengurusan Diabetes Mellitus Jenis 2 (Edisi ke-6, 2020), Kementerian Kesihatan Malaysia.
Carta bacaan gula normal
These are the diagnostic values in Malaysia’s guideline for adults, based on blood taken from a vein (CPG, 2020):
| Test | Normal | Prediabetes | Diabetes range |
|---|---|---|---|
| Fasting blood sugar (puasa, at least 8 hours) | Below 6.1 mmol/L | 6.1 to 6.9 mmol/L | 7.0 mmol/L or higher |
| 2-hour glucose drink test (OGTT) | Below 7.8 mmol/L | 7.8 to 11.0 mmol/L | 11.1 mmol/L or higher |
| Random blood sugar (rawak, any time) | Below 7.8 mmol/L | 7.8 to 11.0 mmol/L needs a glucose drink test | 11.1 mmol/L or higher |
| HbA1c (average over about 3 months) | Below 5.7% (below 39 mmol/mol) | 5.7% to below 6.3% (39 to 44 mmol/mol) | 6.3% or higher (45 mmol/mol or higher) |
One high result does not always mean diabetes. If you have symptoms, one abnormal result is enough. If you have no symptoms, the guideline requires two abnormal results, either from separate samples or a glucose result and an HbA1c from the same sample (CPG, 2020). For the symptoms and causes, see our guide to kencing manis.
If your meter or lab report shows mg/dL, 1 mmol/L is about 18 mg/dL. So 6.1 mmol/L is about 110 mg/dL, 7.0 mmol/L is about 126 mg/dL, 7.8 mmol/L is about 140 mg/dL and 11.1 mmol/L is about 200 mg/dL.
HbA1c: apa maksudnya?
HbA1c shows your average blood sugar over the past 2 to 3 months (Diabetes UK; CPG, 2020). You do not need to fast for it, and it can be done at any time of day (CPG, 2020). Your result can also be shown as an estimated average glucose (American Diabetes Association):
| HbA1c | Estimated average glucose (mg/dL) | About (mmol/L) |
|---|---|---|
| 6% | 126 | 7.0 |
| 6.5% | 140 | 7.8 |
| 7% | 154 | 8.6 |
| 8% | 183 | 10.2 |
| 9% | 212 | 11.8 |
| 10% | 240 | 13.3 |
The mg/dL figures are from the American Diabetes Association. We converted them to mmol/L by dividing by 18.
Bila HbA1c mungkin tak tepat
Some situations common in women can affect the result. Malaysia’s guideline says HbA1c is not appropriate for diagnosing diabetes if you (CPG, 2020):
- have anaemia caused by low iron or vitamin B12 (see our guide to kurang darah);
- are taking iron supplements, which may falsely lower HbA1c;
- have a haemoglobin condition, such as thalassaemia (NIDDK also says the test can be unreliable if you or your family have this);
- have severe chronic kidney disease (stage 4 or 5), chronic liver disease or rheumatoid arthritis;
- are taking medicines that can raise blood sugar quickly, such as steroids.
Tell your doctor if any of these apply to you, as they may use a glucose test instead. HbA1c alone is also not a good enough test for gestational diabetes (CPG, 2017).
Kenapa angka berbeza di internet?
If you have read different numbers online, you are not imagining it. Countries set different cut-off points:
| Source | Normal HbA1c | Prediabetes | Diabetes range |
|---|---|---|---|
| Malaysia (CPG, 2020) | Below 5.7% | 5.7% to below 6.3% | 6.3% or higher |
| United States (American Diabetes Association) | Below 5.7% | 5.7% to 6.4% | 6.5% or higher |
| United Kingdom (Diabetes UK) | Below 6.0% (42 mmol/mol) | 6.0% to 6.4% (42 to 47 mmol/mol) | 6.5% or higher (48 mmol/mol) |
Malaysia chose 6.3% because of local evidence. In a study of 4,400 Malaysian adults, 6.3% gave the best balance of accuracy for all three major ethnic groups, while using 6.5% had a sensitivity of only 36.7%, which the guideline calls unacceptably low (CPG, 2020). In simple terms, a 6.5% cut-off would miss more people with diabetes.
Fasting cut-offs differ too. The American Diabetes Association counts 100 to 125 mg/dL (about 5.6 to 6.9 mmol/L) as prediabetes, while Malaysia’s guideline starts at 6.1 mmol/L. If you live in Malaysia, use the Malaysian figures and ask your doctor about your own result.
Bacaan gula di rumah (finger-prick meter)
A finger-prick meter measures capillary blood, not blood from a vein. Malaysia’s guideline uses it as a first check where lab tests are not readily available. If a finger-prick reading is 5.6 mmol/L or higher when fasting, or 7.8 mmol/L or higher at any other time, you need a confirmatory test: a fasting blood test, a glucose drink test or an HbA1c (CPG, 2020).
So a home reading can tell you to see a doctor, but it does not diagnose diabetes. A single reading after a big meal or when you are unwell may also be higher than usual: illness, stress, sugary or starchy food, being less active and some medicines such as steroids can all raise blood sugar in people with diabetes (NHS).
Bacaan gula ibu mengandung
Blood sugar targets are lower in pregnancy. These are Malaysia’s figures (CPG, 2017):
| Reading | Figure |
|---|---|
| Gestational diabetes diagnosed if fasting | 5.1 mmol/L or higher |
| Gestational diabetes diagnosed if 2-hour result after glucose drink | 7.8 mmol/L or higher |
| Target before meals, if you have gestational diabetes | 5.3 mmol/L or lower |
| Target 1 hour after meals | 7.8 mmol/L or lower |
| Target 2 hours after meals | 6.7 mmol/L or lower |
Your own targets may differ, so follow your doctor’s advice. For the full guide, see kencing manis semasa mengandung.
Sasaran bacaan gula jika ada kencing manis
If you have type 2 diabetes, you are aiming for a target rather than the normal range (CPG, 2020):
| Reading | Target |
|---|---|
| Fasting or before meals | 4.4 to 7.0 mmol/L |
| After meals (at least 90 minutes after) | 4.4 to 8.5 mmol/L |
| HbA1c, for most adults | Below 7.0% |
| HbA1c, if recently diagnosed, younger, healthier and at low risk of hypos | 6.5% or lower |
| HbA1c, if older, with serious other conditions or prone to severe hypos | 7.1% to 8.0% |
Targets are set individually to lower the risk of hypos (CPG, 2020), so yours may be different. Do not skip or change your diabetes medicine without advice from your doctor or care team (NHS).
Bacaan gula rendah (hypo)
Low blood sugar is usually below 4 mmol/L (NHS). Symptoms include feeling hungry, dizzy, anxious or irritable, sweating, shaking, tingling lips, palpitations, feeling tired or weak, blurred vision and confusion (NHS).
If you have diabetes (NHS):
- have something sugary straight away, such as a small glass of fruit juice or a sugary fizzy drink, or glucose tablets;
- check your blood sugar again after 10 to 15 minutes;
- if it is still below 4 mmol/L, have another sugary drink or snack and check again after 10 minutes.
If someone is unconscious or having a seizure, call 999. Do not give them food or drink. It is rare to get low blood sugar if you do not have diabetes, so see a doctor if you get symptoms such as shaking, sweating, a fast heartbeat and confusion (NHS).
Bacaan gula terlalu tinggi: bila perlu ke hospital
Symptoms of high blood sugar include feeling very thirsty, peeing a lot, feeling weak or tired, blurred vision and losing weight (NHS). See a doctor if you have these symptoms and have not been diagnosed with diabetes (NHS).
Call 999 or go to the emergency department if you think you have high blood sugar and you (NHS):
- feel sick, are vomiting or have stomach pain;
- are breathing faster than usual, or your heart is beating faster than usual;
- feel drowsy or are struggling to stay awake;
- have breath with a fruity smell;
- feel confused or have difficulty concentrating;
- have a high level of ketones in your blood or urine.
Do not drive yourself; ask someone to take you (NHS).
Siapa perlu buat ujian gula?
Up to half of people with diabetes have no symptoms, and national survey data found that 48.6% of people with diabetes had not been diagnosed when they were screened (CPG, 2020). So do not wait until you feel unwell. Malaysia’s guideline recommends yearly screening if you are 30 or older, or at any adult age if you have risk factors (CPG, 2020).
You should be tested if you have (CPG, 2020):
- a history of gestational diabetes;
- prediabetes (test every year);
- overweight or obesity (BMI of 23 or higher, or a waist of 80 cm or more for women) together with any of these: a parent, brother, sister or child with type 2 diabetes; high blood pressure; heart disease; low physical activity; a baby weighing 4 kg or more at birth; a mother who had gestational diabetes; PCOS; or dark velvety skin at the neck or armpits (acanthosis nigricans).
You can ask for a test at a klinik kesihatan or a GP.
Kalau bacaan pradiabetes, apa perlu buat?
Prediabetes means your blood sugar is higher than normal but not yet in the diabetes range. Your doctor may suggest a glucose drink test to find out more (CPG, 2020), and you should be tested every year (CPG, 2020).
This is a good time to act. In a large US trial of adults with raised blood sugar, a lifestyle programme aiming for 7% weight loss and at least 150 minutes of activity a week cut the rate of type 2 diabetes by 58% over about 3 years (Knowler 2002). A few places to start:
- watch your portions of rice and noodles; our Malaysian food calorie guide can help;
- choose drinks with less sugar; see the best and worst Malaysian drinks;
- build up to 150 minutes of activity a week.
Frequently asked questions (FAQ)
Berapa bacaan gula normal (what is a normal blood sugar level)?
Under Malaysia’s guideline, a normal fasting blood sugar is below 6.1 mmol/L, a normal 2-hour result after a glucose drink (OGTT) is below 7.8 mmol/L, and a normal HbA1c is below 5.7% (CPG, 2020). These are for adults who do not have diabetes and are based on blood taken from a vein at a laboratory or clinic.
Berapa bacaan gula normal selepas makan (what is normal after eating)?
The closest guideline figure is the 2-hour result of a glucose drink test (OGTT): below 7.8 mmol/L is normal, 7.8 to 11.0 mmol/L is prediabetes and 11.1 mmol/L or higher is diabetes (CPG, 2020). An ordinary meal is not the same as this test, so one high reading after food does not diagnose anything. If you already have diabetes, the Malaysian target is 4.4 to 8.5 mmol/L, measured at least 90 minutes after a meal (CPG, 2020).
Bacaan gula 7 bahaya ke (is a reading of 7 dangerous)?
It depends on when you took it. A fasting result of 7.0 mmol/L or higher from a vein is in the diabetes range and needs follow-up (CPG, 2020). A reading of 7 some time after eating is below the 7.8 mmol/L level at which the guideline asks for a confirmatory test after a random finger-prick reading (CPG, 2020). A reading of 7 is not an emergency by itself, but a high fasting result should be checked by a doctor.
HbA1c normal berapa (what is a normal HbA1c)?
In Malaysia, a normal HbA1c is below 5.7% (below 39 mmol/mol). From 5.7% to below 6.3% (39 to 44 mmol/mol) is prediabetes, and 6.3% (45 mmol/mol) or higher is the diabetes range (CPG, 2020). If you have no symptoms, a repeat test or a second abnormal test is needed to confirm diabetes (CPG, 2020).
Kenapa Malaysia guna HbA1c 6.3%, bukan 6.5% (why 6.3% and not 6.5%)?
A Malaysian study of 4,400 adults found that 6.3% worked better for all three major ethnic groups in the country: using 6.5% had a sensitivity of only 36.7%, which the guideline considers unacceptably low, compared with 42.5% at 6.3% (CPG, 2020). In other words, 6.5% would miss more people with diabetes. Websites from the US and UK use 6.5% (American Diabetes Association; NHS), which is why you may see different numbers online.
Bacaan gula rendah berapa (what is a low blood sugar reading)?
Low blood sugar (a hypo) is usually below 4 mmol/L (NHS). Symptoms include hunger, sweating, shaking, dizziness, feeling irritable, tingling lips, palpitations, blurred vision and confusion (NHS). If you have diabetes, take something sugary straight away and check again after 10 to 15 minutes (NHS). It is rare if you do not have diabetes, so see a doctor if you get these symptoms (NHS).
Berapa bacaan gula normal ibu mengandung (what is normal in pregnancy)?
Pregnancy uses lower numbers. Under Malaysia’s guideline, gestational diabetes is diagnosed with a fasting result of 5.1 mmol/L or higher, or a 2-hour result of 7.8 mmol/L or higher after a glucose drink. If you have gestational diabetes, the targets are 5.3 mmol/L or lower before meals, 7.8 mmol/L or lower 1 hour after meals, and 6.7 mmol/L or lower 2 hours after meals (CPG, 2017).
Berapa jam kena puasa sebelum ujian gula (how long should I fast before a blood sugar test)?
Fast for at least 8 hours, usually overnight (CPG, 2020). You can drink plain water during this time (MedlinePlus). You do not need to fast for an HbA1c test, and it can be done at any time of day (CPG, 2020; MedlinePlus).
Bacaan gula sasaran pesakit kencing manis berapa (what is the target if I have diabetes)?
Under Malaysia’s guideline, the targets for most adults with type 2 diabetes are 4.4 to 7.0 mmol/L when fasting or before meals, 4.4 to 8.5 mmol/L at least 90 minutes after meals, and an HbA1c below 7.0% (CPG, 2020). Targets are individual: 6.5% or lower may suit younger people recently diagnosed, and 7.1% to 8.0% may suit older people or those at risk of hypos (CPG, 2020). Follow the target your doctor sets with you.
Disclaimer
This article is for general information only and is not a substitute for advice from a doctor. Ask your doctor to explain your own results, and do not change any medicine without medical advice.
References
- Clinical Practice Guidelines: Management of Type 2 Diabetes Mellitus, 6th Edition (2020) — Ministry of Health Malaysia, Malaysian Endocrine & Metabolic Society
- Clinical Practice Guidelines: Management of Diabetes in Pregnancy (2017) — Ministry of Health Malaysia (MaHTAS)
- Diabetes diagnosis — American Diabetes Association
- Understanding A1C — American Diabetes Association
- What is HbA1c? — Diabetes UK
- Prediabetes — Diabetes UK
- High blood sugar (hyperglycaemia) — NHS
- Low blood sugar (hypoglycaemia) — NHS
- Blood glucose test — MedlinePlus, US National Library of Medicine
- Hemoglobin A1C (HbA1c) test — MedlinePlus, US National Library of Medicine
- A1C test — National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- Knowler WC, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
