Not only is the alphabet confusing here (Хдш дхвщ ся шге ьвзгьфеш ъдхокясхж геие–that’s what it looks like when I typed the sentence above again on the Cyrillic keyboard), but I learned of another life-changing difference today between Bulgaria and the US. I brought lots of insulin with me to Bulgaria, so I won’t be needing any for probably six months, but I only had a few weeks left of test strips, so I knew that I needed to find how to get more sometime this week. I’ve now talked to two different doctors and have a better idea of what I need to do once we get our residency permits in order to go to the doctor, have labwork done and get prescriptions. But I also learned that, like in the US, you don’t need a prescription for testing supplies. I also found out that there is a drug-rep office for Accu-Chek near where we live, so today I went there with a Bulgarian friend to find out what the next step would be. Unfortunately, they don’t sell supplies in Bulgaria for the meter I have, but I was able to buy a new one with test strips directly from the drug-rep hassle-free (This was a little weird, since I’ve never bought a meter in the US, as local diabetes educators give them out for free).
Now for the fun part. For diabetics in the US, blood-sugars as measured in milligrams per deciliter (mg/dL). The normal, non-diabetic range is 90-120mg/dL. Hypoglycemic is below 50mg/dL and hyperglycemic is really anything over 150mg/dL. Well guess what? In Bulgaria, it’s not measured in mg/dL, but rather in mmol/L, or millimoles per liter, which according to one diabetes website is “the world standard.” They comment:
“World standard”, of course, means that mmol/L is used everywhere in the world except in the US.
In this scale, 5.5 mmol/L is equivalent to perfect (100mg/dL). Check out this pic of my first reading with my new Accu-Chek meter. Right on the money!
Don’t let this number scare you. It’s not 57 or 5.7 mg/dL, but 5.7 mmol/L, which is like 102 mg/dL. Perfect! The normal range is 5-6 mmol/L. Hypoglycemic is less than 3 mmol/L; hyperglycemic is greater than 8 mmol/L. Confusing, isn’t it? Now I know that the US has been difficult about changing to the metric system, but isn’t this a little extreme? Mg/dL is the metric system. Why can’t we just all get along and use the same system? Fortunately, it’s not that bad, because you can always multiply by 18 to get the US system (e.g. 5.5 mmol/L * 18 = 99 mg/dL). Also, meters don’t measure accurately enough to fit the US system. A measurement of 100 mg/dL on most meters may really be anywhere from 98-102. The mmol/L system only measures to the tenth spot. Since each .1 mmol/L corresponds to 1.8 mg/dL, the mmol/L scale is more appropriately precise. The best thing about my new meter is that it requires very little blood. I could have had one like it in the US, but I chose to use the glucometer with the test-strip drums, which is still behind the times in the amount of blood it requires.
This post may seem like a lot of unimportant details, but to me, these decimal points and units are quite critical, life or death, really. I’m excited about learning this new system and am hoping that numbers like 2, 3, 4, 5, 6, 7, 8 will be easier to identify with than 25, 50, 80, 100, 120, 150, 180. Only time will tell.
-James, the younger