Spreadsheet: 4af4cbda-4327-4eaa-ab85-45807c1e27fd
Sheet: Sheet1

INSULIN - BLOOD GLUCOSE LOG | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25 | Unnamed: 26
Blood Glucose Target Number: |  |  |  | 120 |  |  |  |  |  | Blood Glucose Target Range | 80 | to | 150 |  |  |  |  | Correction Dose: + / - _____1.0____units for every _____50_____ points
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Trace
Pump Basal Rates: |  |  |  |  |  |  |  | Basal Dosage: |  | Lantus |  | Bolus Dosage or Before Meals: |  |  | Humalog |  | Other: |  |  |  |  |  |  |  |  | Low
1 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Medium
2 |  |  |  |  |  |  |  | AM: |  |  |  | Break: |  |  |  |  |  |  |  |  |  |  |  |  |  | High
3
4 |  |  |  |  |  |  |  | PM: |  |  |  | Lunch: |  |  |  | CHILDREN'S HOSPITAL PHONE NUMBERS
5 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | NON-URGENT |  | 4142663380
6 |  |  |  |  |  |  |  | Bed: |  |  |  | Dinner: |  |  |  | AFTER-HOURS |  | 4142662000
7 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Have Operator Page Doctor On Call
 |  |  | Low |  |  | Normal |  |  | High |  |  | Bed: |  |  |  | EMERGENCY |  | 4142662860
INSULIN DOSAGE |  |  |  |  |  |  |  |  | BLOOD GLUCOSE READINGS
Date-Day | Type | B | SN | L | SN | D | Bed | Night |  | B | SN | L | SN | D | Bed | Night 1 | Night 2 | Notes
date-Day | Bolus |  |  |  |  |  |  |  | Time
 | Extra |  |  |  |  |  |  |  | BG
wed | Basal |  |  |  |  |  |  |  | Carbs
 | 0 |  |  |  |  |  |  |  | Ketone
 | Type | B | SN | L | SN | D | Bed | Night |  | B | SN | L | SN | D | Bed | Night 1 | Night 2 | Notes
 | Bolus |  |  |  |  |  |  |  | Time
 | Extra |  |  |  |  |  |  |  | BG
Thur | Basal |  |  |  |  |  |  |  | Carbs
Notes: | 0 |  |  |  |  |  |  |  | Ketone
Date-Day | Type | B | SN | L | SN | D | Bed | Night |  | B | SN | L | SN | D | Bed | Night 1 | Night 2 | Notes
 | Bolus |  |  |  |  |  |  |  | Time
 | Extra |  |  |  |  |  |  |  | BG
Fri | Basal |  |  |  |  |  |  |  | Carbs
Notes: | 0 |  |  |  |  |  |  |  | Ketone
Date-Day | Type | B | SN | L | SN | D | Bed | Night |  | B | SN | L | SN | D | Bed | Night 1 | Night 2 | Notes
 | Bolus |  |  |  |  |  |  |  | Time
 | Extra |  |  |  |  |  |  |  | BG
Sat | Basal |  |  |  |  |  |  |  | Carbs
Notes: | 0 |  |  |  |  |  |  |  | Ketone
Date-Day | Type | B | SN | L | SN | D | Bed | Night |  | B | SN | L | SN | D | Bed | Night 1 | Night 2 | Notes
 | Bolus |  |  |  |  |  |  |  | Time
 | Extra |  |  |  |  |  |  |  | BG
Sun | Basal |  |  |  |  |  |  |  | Carbs
Notes: | 0 |  |  |  |  |  |  |  | Ketone
Date-Day | Type | B | SN | L | SN | D | Bed | Night |  | B | SN | L | SN | D | Bed | Night 1 | Night 2 | Notes
 | Bolus |  |  |  |  |  |  |  | Time
 | Extra |  |  |  |  |  |  |  | BG
Mon | Basal |  |  |  |  |  |  |  | Carbs
Notes: | 0 |  |  |  |  |  |  |  | Ketone
Date-Day | Type | B | SN | L | SN | D | Bed | Night |  | B | SN | L | SN | D | Bed | Night 1 | Night 2 | Notes
 | Bolus |  |  |  |  |  |  |  | Time
 | Extra |  |  |  |  |  |  |  | BG
Tue | Basal |  |  |  |  |  |  |  | Carbs
Notes: | 0 |  |  |  |  |  |  |  | Ketone
Bolus | 0 |  | Extra | 0 |  | Basal | 0 |  | Wkly Avgs
 |  |  |  |  |  |  |  |  |  | Total Target Ranges |  |  | Total Below Target |  |  | Total Above Target
 |  |  |  |  |  |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
 |  |  |  |  |  |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
 |  |  |  |  |  |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
 |  |  |  |  |  |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
 |  |  |  |  |  |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
 |  |  |  |  |  |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
 |  |  |  |  |  |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
 |  |  |  |  |  |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0