One month blood sugar log 5 tests a day check 1 example date of birth zip code start date end date to submit your completed log to optumrx: fax: 1-800-384-3416 mail: p.o. box 8621, greenville, tx 75404-9912 e-mail: testinglogs optumrx.com week 1...
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Daily diabetes log week of: fasting blood sugar before/ after med/ lunch blood sugar before / after med/ dinner blood sugar med/ before med/ bed blood sugar comments diet, exercise, sickness, stress before/ after m o n t u e w e d t h r f r i s a...
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Name: date of birth: year month fasting blood sugar phone: lunch dinner blood sugar affter meal blood sugar before meal carb dose blood sugar affter meal breakfast carbs dose blood sugar after meal blood sugar before meal bedtime blood sugar level...
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How do i record and chart blood sugar levels? the purpose of this training sheet is to show you how you can record blood sugar levels and obtain comparison charts with carbohydrate intake during the day. recording blood sugar levels from the main...
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Log book draw on me this is your log book. use it daily for recording your blood sugar, and grams of carbohydrates (carbs). write down your blood sugar results on the page marked blood sugar log. include the type and amount of youve taken. on the...
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Blood glucose journal month/year ada blood glucose targets before breakfast: 70 to 130 mg/dl two hours after meals: below 180 mg/dl day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 breakfast before after my...
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5755 cedar lane, columbia, md 21044 diabetes visit form please fill out this form to the best of your ability and bring it with you to your first appointment. a business reply envelope may be provided if there is sufficient time for this form to...
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Blood glucose log patient 's name: telephone #: month: patient 's doctor: blood sugar testing should be done before meal date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 day a.m. noon p.m. bedtime ketones...
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Home blood pressure log you can complete the highlighted fields on this form online and then print the form for easy reference. only text that is visible on the form is printed; scrolled text will not print. any text you enter into these fields...
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800 east 21st street po box 5045 sioux falls, sd 57117-5045 (605) 322-8 ?diab?flo ? diab flo date type post-breakfast middle of noc post-breakfast dose and carb grams pre-breakfast post-dinner post-lunch breakfast glucoses post-dinner post-lunch...
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Your onetouch logbook week of: 9/8 circle the result each time you re above or below your target. add comments on diet, exercise, stress, etc. 1 breakfast day use this logbook to help you learn how food, medication, and exercise affect your blood...
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Diabetes blood sugar log my current a1c is: my a1c goal is: my target blood sugar: before meals: after meals: my physical activity goal: thursday wednesday tuesday monday date bg* lunch time dinner bg time bedtime bg time bg snack time bg comments...
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One month blood sugar log 10 tests a day to submit your completed log to optumrx: fax: 1-800-384-3416 mail: p.o. box 8621, greenville, tx 75404-9912 e-mail: testinglogs optum.com this log sheet is courtesy of diabetes activecare. check 1 week 1
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Fill in your daily blood glucose (bg) test results, list your daily meals and snacks and track the doses of and medications you take each day. name: mr #: diabetes blood sugar log date: bg med breakfast bg med lunch post post bg med dinner bedtime...
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