A blood sugar level of 181 after a 2-hour glucose tolerance test is generally considered high. The normal range for blood sugar levels during this test is typically below 140 mg/dL. However, it's important to consult with your healthcare provider for an accurate interpretation of your results, as they may vary depending on individual factors such as age, health conditions, and other medications you may be taking. Your healthcare provider will be able to provide further guidance and recommend any necessary follow-up tests or treatments based on your specific situation.