Preview Glucose Chart

IN-WBGC-0117 E CMAP HIN HIN-C-0003-16

Weekly blood glucose chart

Name: _____________________________________________

Physician’s name: ___________________________________

Medication types: ____________________________________

 Talk to your doctor about your specific glucose results

Normal results for blood glucose readings

Date After breakfast After lunch After dinner Other Insulin/medication

Notes about day:

(Skipped meals, exercise, food

intake)

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

Glucose:

Time:

HTML Preview Glucose Chart page number 1.