Forms for Current Diabetes Center Patients
Blood Glucose Log
Blood Glucose and Medication Log
SPANISH Blood Glucose Log (Spanish)
Blood Glucose and Medication Log (Spanish)
Blood Glucose Reporting Instructions
-Pregnant patients, please report your readings every Sunday and Wednesday.
-All other patients, please report your readings every Sunday.
- Include your name, date of birth and return phone number.
- Indicate the date you are beginning to report your test results: (*See example below.)
- Report your test results for all days between report dates and add any information you want the nurse to consider in the review, i.e. you were sick, missed a dose of medication, gave wrong dose of insulin, etc.
- If you didn’t test at a requested time, just report “no test” and give reason if needed related to care, i.e. ran out of test strips.
- If you had a low blood glucose that you treated, state how you treated the low blood glucose and also subsequent BG readings you may have done.
- Please mark your book when you report your last reading so that you begin the new report where you left off from the prior call.
- If you need the nurse or dietician to call you back (non-emergency), please let them know and your call will be returned as soon as possible.
*Here is an example of a call: This is (your name) . I’m starting with the breakfast reading for Monday, July 21. That reading was 108. My lunch reading was 120. I forgot to take it before dinner. When I checked it before bedtime, it was 72, and I drank some extra juice with my bedtime snack. On Tuesday, I took it at 7:30 before breakfast and it was 130, at noon it was 200, and before dinner it was 240. I’ve got a sore throat and I may have a fever. I will be at work for the rest of the day, so call me back there at (615) 000-0000.
IN CASE OF EMERGENCY, PLEASE CALL 911 OR GO TO YOUR NEAREST EMERGENCY ROOM.
ALL OTHER URGENT AND EMERGENT SITUATIONS:
Please call the Diabetes Center at (615) 284-2800 to speak with a clinician.
If you need to speak to a clinician
regarding an URGENT MATTER after office hours, please contact the
on-call Diabetes Nurse by calling (615) 284-2800, option 8. Ask the
operator to page the on-call Diabetes Nurse. Your call will be returned
within the hour. If your call is in relation to pain or medical
procedure, please contact your physician.