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

A1c is measured as a percentage, not in mmol/L. The two measures are completely different. An A1c of 5.5% is an average blood sugar of 6.2 mmol/L (112 mg/dl).

My bad. I'm going to go back to measuring in teaspoons, then.

i hate to say it. i dont care what system we use. just tell me what numbers im NOT supposed to get :)

The Euro worked out real well didn't it. I'll stick with mg/dl and Europe can keep mM.

It was not the conversion to Euro that made the currency fail!! I blame the politicians ;) Many countries where able to accomplish the switch and now you can go anywhere in Europe and don't have to exchange money, makes it way easier to understand where you are financially... even if it is in the gutter

It would be nice to be able to understand each other when talking BG instead of having to pull up a conversion chart, same thing with units of measurement.

It is obvious that many US people have the mentality of "i do it my way and i don't care what you think", that is why you really have to make and effort to be liked when you are out of your country and that's why they tend to pin Canadian flags over their backpacks in Europe. Only time and new generations can change that mentality.

Whoa! How did you get from preferring whole numbers to decimal places to being rude travelers?? Not that Americans can't sometimes be ethnocentric and overbearing but don't you think that is a major generalization you just made?

Some of us don't "pin Canadian flags over our backpacks" we just make an attempt to be polite and both respectful of and interested in the local culture, thereby making inroads against the 'ugly american" stereotype!

Hey he insulted the Euro, I felt I had to stick up for it :)

Yes, it is indeed a generalization, maybe I should apologize if it feels like an attack on your country. Not all US born are rude travelers or have the same mentality, US is a HUGE place! However, let me be honest about this, when I take the average of all the Americans (USA) that I've met, the general feeling that I get is that rather have the world spin around them kind of attitude.

Now back on topic... you, like me, have lived in different continents and among different cultures. So I believe, matter of preference aside, that you could learn to adapt to a different scale of measuring your BG's or a new currency. I personally don't care if its mmols or mg/dl. If it has a decimal or 3 figures, I still have to convey this info to my medical team and they have to understand me. And if wherever I travel to they use a different system then I'm back to square one, pulling out my charts and trying to be bilingual on yet another language.

Sorry if I get a little testy on this topic, it hits close to home for me, I not only travel back an forth a lot but also have to convert metric to imperial every day in my line work.

When I read the Euro comment last night I sort of chuckled and said to myself that's going to tick someone off as well it should have. Like you said it's not the EURO that is the problem it's the politicians that have run it into the ground. I'm not qualified to discuss European politics so I will not do so. Americans should not point fingers since we are headed down the same if we don't see the light.

As far as American's wanting the world to revolve around us I don't see it. Europe should not base it's opinion of America on the behavior of the Americans that visit their continent. The average American is proud of their American heritage and if they are of European decent they are proud of that also. The same can be said African Americans, Asian Americans, Latin Americans or what ever their heritage is. We have been successful because of the influence of so many cultures. Our system and lifestyle works for us so we don't wish to be told that it is inferior. I would not for one minute try to tell someone else how to conduct their business and I don't think the average American will either.

Gary S

Just a little jab back at the comment in the original Discussion that really annoyed me.

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

If it there is good basis (e.g. better patient outcomes) for making a change then great. But one thing you can't say about the US is that we are lazy. That is just an European elitist view.

I'd just as soon use mg/dl. It's still metric, and it's actually understandable to anyone who has any experience with the metric system, without going into moles, which are chemistry measures, and not as accessible to the average person. Anything can be understood as mg/dl, whereas the number of millimoles per liter will vary according to the substance being measured. I just don't see any reason to add the extra layer of complexity.

And by the way, they use mg/dl in Japan, too. People who think the mmol/L system is universal except in the US are wrong.

I'm not from the U.S., so this whole discussion is moot for me since we already use mmol/L in Canada.

But I just wanted to say that the whole "complexity" thing just depends on what you are used to. I've been using mmol/L since I was diagnosed over 20 years ago, and there is nothing confusing about it, even for young kids. And the idea that mmol/L ranges somehow look "less impressive" than mg/dl ranges is moot, too. In fact, when I see a triple digit number on my meter (5.8 versus 11.4, for example) it catches my attention WAY more than seeing a 105 versus a 205 does. It's just a matter of what you are used to using and responding to.

I also think the "precision" argument (the fact that 5.4 versus 5.5 is 97 and 99, with no 98) is moot considering that home glucose meters are not nearly that precise. I don't think having 97 and 99 but no 98 would make any difference, who really cares about a 1 point difference (I mean really!)?

I do think the change would cause some disruption for a time, if it happened. Interestingly, in the blindness community there is a massive project to "merge" all the braille codes used in English-speaking countries (currently each country uses its own code, so resources can't be easily shared). There was a massive project initiated by the U.S. to address this problem, with a unified code as the goal, which was successfully developed. Now, every country involved has accepted the new code—which, yes, will be disruptive during the switchover for current braille readers—EXCEPT for the U.S., who is now looking at developing their "own" code, which defeats the entire purpose of the project in the first place ... In this age of globalization, I must admit that this is a bit frustrating! (Okay, vent over.) Interestingly, I have come to a point where I can pretty much translate blood sugar values between mmol/L and mg/dl in my head, since 99% of people in the DOC are from the U.S. and thus that's what I most commonly encounter on forums. I didn't even realize there were two systems until I got online!

I know there are other units that differ between countries (cholesterol and a lot of other blood measurements). Is there any attempt to unify these worldwide, regardless of which system ends up being accepted? It would be kind of nice to have just one unit of measurement to work with, whichever it was.

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