Spreadsheet: 8016bf08-e173-4aef-8ee2-af1869f885d0
Sheet: Sheet1

Pump - Comment Sheet | 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
Date | Basal Rates: |  |  |  |  |  | Insulin per Carb |  |  | Correction Factor |  |  | Comments
 | MN to _______  --> _______ |  |  | ______ to ______ --> _______ |  |  | Breakfast |  |  | 1 unit for ______ pts          Target BG (mg/dl) ______ |  |  | ______Site Change - Time _____                                                        _____check if no change to doses
 | ______ to ______ --> _______ |  |  | ______ to ______ --> _______ |  |  | Lunch
 | ______ to ______ --> _______ |  |  | 24 hr Total Insulin ________ |  |  | Dinner
 | ______ to ______ --> _______ |  |  | 24 hr Total Basal ________ |  |  | Snack
Date | Basal Rates: |  |  |  |  |  | Insulin per Carb |  |  | Correction Factor |  |  | Comments
1900-01-01 00:00:00 | MN to _______  --> _______ |  |  | ______ to ______ --> _______ |  |  | Breakfast |  |  | 1 unit for ______ pts          Target BG (mg/dl) ______ |  |  | ______Site Change - Time _____                                                        _____check if no change to doses
 | ______ to ______ --> _______ |  |  | ______ to ______ --> _______ |  |  | Lunch
 | ______ to ______ --> _______ |  |  | 24 hr Total Insulin ________ |  |  | Dinner
 | ______ to ______ --> _______ |  |  | 24 hr Total Basal ________ |  |  | Snack
Date | Basal Rates: |  |  |  |  |  | Insulin per Carb |  |  | Correction Factor |  |  | Comments
1900-01-02 00:00:00 | MN to _______  --> _______ |  |  | ______ to ______ --> _______ |  |  | Breakfast |  |  | 1 unit for ______ pts          Target BG (mg/dl) ______ |  |  | ______Site Change - Time _____                                                        _____check if no change to doses
 | ______ to ______ --> _______ |  |  | ______ to ______ --> _______ |  |  | Lunch
 | ______ to ______ --> _______ |  |  | 24 hr Total Insulin ________ |  |  | Dinner
 | ______ to ______ --> _______ |  |  | 24 hr Total Basal ________ |  |  | Snack
Date | Basal Rates: |  |  |  |  |  | Insulin per Carb |  |  | Correction Factor |  |  | Comments
1900-01-03 00:00:00 | MN to _______  --> _______ |  |  | ______ to ______ --> _______ |  |  | Breakfast |  |  | 1 unit for ______ pts          Target BG (mg/dl) ______ |  |  | ______Site Change - Time _____                                                        _____check if no change to doses
 | ______ to ______ --> _______ |  |  | ______ to ______ --> _______ |  |  | Lunch
 | ______ to ______ --> _______ |  |  | 24 hr Total Insulin ________ |  |  | Dinner
 | ______ to ______ --> _______ |  |  | 24 hr Total Basal ________ |  |  | Snack
Date | Basal Rates: |  |  |  |  |  | Insulin per Carb |  |  | Correction Factor |  |  | Comments
1900-01-04 00:00:00 | MN to _______  --> _______ |  |  | ______ to ______ --> _______ |  |  | Breakfast |  |  | 1 unit for ______ pts          Target BG (mg/dl) ______ |  |  | ______Site Change - Time _____                                                        _____check if no change to doses
 | ______ to ______ --> _______ |  |  | ______ to ______ --> _______ |  |  | Lunch
 | ______ to ______ --> _______ |  |  | 24 hr Total Insulin ________ |  |  | Dinner
 | ______ to ______ --> _______ |  |  | 24 hr Total Basal ________ |  |  | Snack
Date | Basal Rates: |  |  |  |  |  | Insulin per Carb |  |  | Correction Factor |  |  | Comments
1900-01-05 00:00:00 | MN to _______  --> _______ |  |  | ______ to ______ --> _______ |  |  | Breakfast |  |  | 1 unit for ______ pts          Target BG (mg/dl) ______ |  |  | ______Site Change - Time _____                                                        _____check if no change to doses
 | ______ to ______ --> _______ |  |  | ______ to ______ --> _______ |  |  | Lunch
 | ______ to ______ --> _______ |  |  | 24 hr Total Insulin ________ |  |  | Dinner
 | ______ to ______ --> _______ |  |  | 24 hr Total Basal ________ |  |  | Snack
Date | Basal Rates: |  |  |  |  |  | Insulin per Carb |  |  | Correction Factor |  |  | Comments
1900-01-06 00:00:00 | MN to _______  --> _______ |  |  | ______ to ______ --> _______ |  |  | Breakfast |  |  | 1 unit for ______ pts          Target BG (mg/dl) ______ |  |  | ______Site Change - Time _____                                                        _____check if no change to doses
 | ______ to ______ --> _______ |  |  | ______ to ______ --> _______ |  |  | Lunch
 | ______ to ______ --> _______ |  |  | 24 hr Total Insulin ________ |  |  | Dinner
 | ______ to ______ --> _______ |  |  | 24 hr Total Basal ________ |  |  | Snack