M
T
W
T
F
S
S
A
vg.
Date
BREAKF
AST
LUNCH
DINNER
BEDTIME
OTHER
NOTES
Blood
Glucose
Insulin/
Medication
Blood
Glucose
Insulin/
Medication
Blood
Glucose
Insulin/
Medication
Blood
Glucose
Insulin/
Medication
Blood
Glucose
Target Range for Blood Sugar set with your Healthcare Professional
Wakeup Time
_____________ Before Meals _____________
After Meals _____________
At Bed
T
ime _____________
Contr
ol D Contr
ol D Contr
ol D Contr
ol D Contr
ol D Contr
ol D Contr
ol D
Contr
ol D
21
Control D
HAIDEN
Summary of Contents for Control D
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