YOUR BLOOD SUGAR LOG – WEEK OF ___ /___ /______ to ___ /___ /______ My target blood sugar ranges: ______ mg/dL to ______ mg/dL to ______ mg/dL
MEDICATION/ DOSE
BLOOD SUGAR AT BREAKFAST
Pre-meal Post-meal
FOOD/CARB
MEDICATION/ DOSE
BLOOD SUGAR AT LUNCH
Pre-meal Post-meal
FOOD/CARB
__________ mg/dL BEFORE meals __________ mg/dL 2 HOURS AFTER meals
MEDICATION/ DOSE
BLOOD SUGAR AT DINNER
Pre-meal
Post-meal
M COMMENTS
T COMMENTS
W COMMENTS
TH COMMENTS
F COMMENTS
SA COMMENTS
SU COMMENTS NOTES
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US.GLT.15.06.280
FOOD/CARB
MEDICATION/ DOSE
BLOOD SUGAR BEFORE BEDTIME
