Blood Sugar Log printable pdf download

Blood Sugar Log

Patient Name: _________________________________________________

Weight: ________________ Phone: _______________________________

Please list all diabetes medications and dosages, including number of times taken per day. If applicable, indicate

your glucose and carbohydrate correction factors. Insulin pump patients, please record your basal rates.

Insulin Units

Blood Sugars

Comments

Date

Noon

Bed

Noon

Bed

AM=Before Breakfast (fasting); Noon=Before lunch; PM=Before dinner; Bed=Before bedtime.

Recording your blood sugar readings will help you manage your diabetes better. It will help you understand

your blood sugar patterns, how certain foods and situations affect your blood sugar, and how much medication

you require. It will also help your health care providers adjust your medications when necessary.

Phone: 801-964-3697 (Salt Lake County), 801-734-8972 (Utah County) | Fax: 801-964-3698

3336 South 4155 West, Suite 306, West Valley City, UT 84120 | 1055 North 300 West, Suite 212, Provo, Utah 84604

PGU049-1011

Blood Sugar Log