Low Blood Sugar Level Record
Topic Overview
Use this form to record a low blood sugar level problem. Fill out a record each time this happens. Take the completed form(s) to the doctor. If you (or your child with diabetes) is having low blood sugar problems, the diabetes medicine dose may need to be adjusted or the medicine may need to be changed.
Date: ____________ Time: __________
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Time that the last dose of medicine was given and the amount:
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Symptoms, if any:
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How long symptoms lasted:
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Blood sugar levels during the problem:
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Activity before low blood sugar:
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Kind and amount of glucose or sucrose tablets or solution or other quick-sugar food that was taken:
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Was glucagon given? __ Yes __ No
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Was emergency care needed? __ Yes __ No
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Date: ____________ Time: __________
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Time that the last dose of medicine was given and the amount:
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|
Symptoms, if any:
|
|
How long symptoms lasted:
|
|
Blood sugar levels during the problem:
|
|
Activity before low blood sugar:
|
|
Kind and amount of glucose or sucrose tablets or solution or other quick-sugar food that was taken:
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|
Was glucagon given? __ Yes __ No
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Was emergency care needed? __ Yes __ No
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Credits
Current as ofJuly 25, 2018
Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Rhonda O'Brien, MS, RD, CDE - Certified Diabetes Educator
Current as of:
July 25, 2018
Author:
Healthwise Staff
Medical Review:E. Gregory Thompson, MD - Internal Medicine & Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Rhonda O'Brien, MS, RD, CDE - Certified Diabetes Educator
