Department Of Veterans Affairs Sample Glucose Level Tracking Sheet

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Sample Glucose Level Tracking Sheet
Target Blood Glucose Levels for People With Diabetes
Before meals
70 to 130
1 to 2 hours after the start of a meal
less than 180
My Target Blood Glucose Levels
Before meals
______ to ______
1 to 2 hours after the start of a meal
less than______
Daily Diabetes Record
Week Starting __________
Other
Breakfast
Medicine
Lunch
Medicine
Dinner
Medicine
Bedtime
Medicine
Notes:
blood
blood
blood
blood
blood
(Special
glucose
glucose
glucose
glucose
glucose
events,
sick days,
exercise)
Mon
Tues
Wed
Thurs
Fri
Sat
Sun
______________________________________________________________________
Center for Engineering & Occupational Safety and Health, and
Occupational Health Strategic Healthcare Group, Office of Public Health (10P3)
Veterans Health Administration, Department of Veterans Affairs
VA/VHA Employee Health Promotion Disease Prevention Guidebook, July 2011
Enclosure 61

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