Food, Insulin & Blood Glucose Log
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1Food, Insulin & Blood Glucose Log
Blood
Food Consumed
Total Grams
Units of Insu-
Units of Insulin
Total Units
Blood Glucose
Glucose
of Carbohy-
lin taken for
taken to cover
Adminis-
2 Hours Later
Prior to
drates
Correction
Food
tered
(goal < 140mg/dl)
Meal
(SF 1:____)
(I:C 1:____)
Breakfast
Snack
Lunch
Snack
Dinner
Snack
Elizabeth DeRobertis, MS, RD, CDN, CDE
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Parent category: Miscellaneous