# When will US switch bG units from mg/dl to mM?

I hope soon.

Pros? millimolar is more logical, used in Europe and elsewhere, easier to work with, used in research labs everywhere at the bench-level, the publication standard in peer-reviewed material in biochemistry and related fields, and ultimately better than milligrams per deciliter to express bG.

Cons? The US adopted the obsolete system in common practice and people are lazy to change from what they are familiar with.

How to convert? It's easy. Just remember the number 18 as a conversion factor until you get used to thinking of the new unit. It's this simple: 18 mg/dl = 1mM.

What's your opinion on a US switch-over? What say you? Make your case here.

Examples.

The euglycemic range is typically 3.9 - 10 mM.
(same as 70 - 180 mg/dl)

The desired clinical clustering of bG data is around 6.0 to 6.5 mM.
(same as 108 - 117 mg/dl)

Hypoglycemia is defined as bG <3.9 mM. (same as <70 mg/dl)

Severe Hypoglycemia is commonly described as bG <2.5 mM. (same as <45 mg/dl)

The range of bG meters is 1.1 to 33.3 mM which pretty much covers all values one is likely to encounter. (same as 19.9 to 599 mg/dl)

My own morning f(bG) meter reading today was 7.0 mM. (same as 126 mg/dl)

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### Replies to This Discussion

I adopted the term "metric" for the mmol/L system but actually mg/dL is also metric: Milligram (metric) per Deciliter (metric = 1/10 of a Liter). The fundamental difference is just how the concentration is expressed:

mg/dL: expresses the Milligrams per Deciliter
mmol/L: expresses the mols per Liter. 1 mol is equivalent to the number of atoms found in 12g of the carbon isotope 12C. BTW: why 12g and not 10g (head scratch)?

So one unit expresses weight the other the amount of atoms. In scientific terms the mmol/L is independent from the actual weight of the atoms. It expresses pure concentration in a fluid and thus it is favoured by scientists. In a weightless environment like the IIS you can only measure mmol/L.

Still I think this type of descriptive exactness is not important for us. It is important that things are measured metrically and both are measured this way. It is not the same as miles VS kilometers or feet VS meters.

You beat me to it... i was scratching my head here thinking, don't these people realize they are both metric units of measurement??

Actually I was referring to the metric system of measuring things like centimeters vs inches being superior, but did not state it very well. Although I do realize the numbers are equivalent, measuring in atoms does strike me as pretty cool :)

Interesting discussion! The other component of Aeon's "all new learning involves a little discomfort" argument is that it would also entail quite a bit of \$\$\$, reprinting leaflets to read "your goal should be 7.8..." instead of "140", training doctors- "we know everything...we don't need training...", training nurses, dietitians, family members "OMG, your BG is 4.2!" *dials 911...*, etc. In an economic crisis of which health concerns are a big part, I don't see an innovation like this getting a lot of traction.

I fail to see why either system is better or worse and see no reason to change just for the sake of change. I'm like Zoe in that I remember the attempts to go all metric in this country. The attempts all failed, life goes on and no one is any worse off because they failed.

As long as I can get a meter that will read in mg/dl then I will continue to use that system. If my doctor, heatlh dept or anyone else wishes to switch then that's just fine and I will be glad to let them do the math.

I live in the southern US and there is sometimes seen an amusing bumper sticker on cars that reads simply "WE DO NOT REALLY CARE HOW YOU DID THINGS UP NORTH" I hope I have not Pissed off any of my northern friends. It is after all just a joke to me and a statement of southern pride.

I see no reason to change just to be like someone else if the change will not bring improvement.

Gary S

I like the clock thing, it is a unit I could get use to. A repeating 12 hour clock makes no sense in a 24 hour day. Your ten hour clock is just a different division of a known quanity, a day. Good luck with that one too. :-)

Gary S

Good thing I am not in charge of anything but taking out rubbish, because I would put the whole world on a base 10 clock too. An hour would be 1/10 of a day. And an hour would have 100 minutes.

Oh excellent, not only are the trains now running on time, they're running on metric time. Remember this time people, 80 past 2 on April 47th, it's the dawn of a new enlightenment.

I think the rest of the world needs to switch to teaspoon per gallon.

I understand that to a mathematically trained person such as yourself that this makes perfect sense. But in everyday life both units of measure are abstract since the average person does not use either deciliters or moles in their daily life. As the saying goes "I would not know a deciliter if it walked up and bit me". Same could be said of a mole.

Again I fail to see the difference.

Gary S

I don't think the problem is the measurement, it's the target. 4-7 is a bit too broad to "aim" at. I would prefer resources be poured into marketing more aggressive targets and positive attitudes towards achieving them than in spending resources changing a scale. I still prefer 3 digit #s to 2 digit numbers. Except those two digit numbers < 100...

And don't forget the Celcius /Fahrenheit calculation ...more to ponder over ?? I may admit having lived in the Netherlands till age 23 , it all seems in my mind easier " to get " :)

As an American, I agree, it is very tempting to ignore any number that contains a decimal point. There is one big advantage of measuring in mmol/l's, though. A1C is measured in mmol/l. So, if you just try to keep your BG to the same value as you want your A1C, say 4-5.5 for very tight control, you're all set. In that regard, it's actually, a lot simpler than mg/dl. That said, will we actally switch? Of course not.

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