What does blood sugar of 18.1 mean after dinner? how can this be lowered? currently on metformin and glicazide?

Check the lab result and make sure the "18.1" is not 181. A blood sugar of "18.1 after dinner" is not compatible with consciousness.

A blood sugar of 18.1mmol/L is equal to 325mg/dl (what we use in the US!)-so, the blood sugar is quite high after dinner. It is important to follow a low carbohydrate diet and check your blood sugars before meals and 2 hours post-meals. Your may need to see an endocrine doctor if your blood sugars are consistently above 200 and if your HgA1C is higher than 8. A nutritionist may be helpful for diet

I meant to agree with Dr. Ferranti's analysis and advice.