Sugar Data

designed for patients of Diabetes & Metabolism, PC

Please input all data as accurately as possible

Basal insulin for non-pump users is usually Ultralente[or NPH]

Bolus insulin is usually Humalog [or Regular]

**Please enter all times in 24:00 format [i..e., 9:00AM = 09:00; 3:00PM = 15:00; 6:00PM = 18:00, etc.]**

 

Your Name (*required)

***Please enter your e-mail address***:-E-mail (*required)

Your Telephone Number

I use the following types of insulin: Ultralente (U) NPH (N) Humalog (H) Regular (R)

Velosulin (V) 70/30 (*) 90/10 (**) Lente (L) Glargine (G)

Enter the first date :


  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
Enter the date :


  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
Enter the date :


  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
Enter the date :


  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
Enter the date :


  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
Enter the date :


  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
Enter the date :


  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?
  •  
  •  
  •  
  •  
  • time of BS:
  • -- hh:mm:ss
    • Blood sugar?

    • Carb count?

    • Insulin basal?

    • Insulin bolus?

Comments:

Copyright Diabetes&Metabolism PC 1991-2000.
Last revised: August 23, 2006

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