HTML Preview Weekly Blood Glucose Chart page number 1.
Weekly blood glucose chart
Name: _____________________________________________
Normal results for blood glucose readings
Physician’s name: ___________________________________
Medication types: ____________________________________
Talk to your doctor about your specific glucose results
Date
After
breakfast
After lunch After dinner Other Insulin/medication
Notes about day:
(Skipped meals, exercise, food
intake)
Glucose: Glucose: Glucose: Glucose: Glucose:
Time: Time: Time: Time: Time:
Glucose: Glucose: Glucose: Glucose: Glucose:
Time: Time: Time: Time: Time:
Glucose: Glucose: Glucose: Glucose: Glucose:
Time: Time: Time: Time: Time:
Glucose: Glucose: Glucose: Glucose: Glucose:
Time: Time: Time: Time: Time:
Glucose: Glucose: Glucose: Glucose: Glucose:
Time: Time: Time: Time: Time:
Glucose: Glucose: Glucose: Glucose: Glucose:
Time: Time: Time: Time: Time:
Glucose: Glucose: Glucose: Glucose: Glucose:
Time: Time: Time: Time: Time:
Member Services 1-855-690-7800 (TTY 1-800-855-2880)
www.anthem.com/wimedicaid
WI-WBGC-0714