How to Use the Daily Diabetes Record Page

Use copies of the record page to keep track of blood glucose checks, medicines, and notes about things that affect your blood glucose. Make one copy of the record page for each week. This record will help you see whether your diabetes plan is working. Review your record with your health care providers.

Blood Glucose Checks

Talk with your health care provider and decide on the best times to check blood glucose. You may be checking blood glucose before meals, after meals, or at bedtime. Write down your results.

If needed, draw a line in the boxes under "Breakfast," "Lunch," and "Dinner" to make room for blood glucose check results before and after a meal, like this example:

See "What should my blood glucose numbers be?" for information about target blood glucose levels.

Medicines

Under the heading marked "Medicine," write the name of your diabetes medicines and the amounts taken.

Notes

Write down things that affect your blood glucose level. Some examples are

• eating more or less than usual
  
  
• forgetting to take your diabetes medicine
  
  
• exercising (write down what kind and for how long)
  
  
• being sick or upset about something (being under stress)
  
  
• going to a social event or other special event, or being on vacation

Daily Diabetes Record Page

View and print a daily diabetes record page.

My Health Care Provider Team Members

Print out this chart and record names, addresses, and phone numbers.

	Name and Address	Phone Number
Doctor
Diabetes Dietitian Educator
Diabetes Nurse Educator
Eye Doctor
Dentist
Foot Doctor
Pharmacist
Counselor

source: http://diabetes.niddk.nih.gov/dm/pubs/complications_control/index.htm