Gary Scheiner, MS, CDE - Integrated Diabetes



|Gary Scheiner, MS, CDE |Weekly Diabetes Record |

|Integrated Diabetes Services | |

|Phone: (610) 642-6055 Fax: (610) 642-8046 | |

Instructions: Fill in information in gray boxes only. Check blood sugar before the meals noted.

Date: |Breakfast | |Lunch | |Dinner | |Bedtime | |Notes | | Blood Sugar | | | | | | | | | | | Food

(specify

quantities)

Exercise? | | | | | | | | | | |

Date: |Breakfast | |Lunch | |Dinner | |Bedtime | |Notes | | Blood Sugar | | | | | | | | | | |Food

(specify

quantities)

Exercise? | | | | | | | | | | |

Date: |Breakfast | |Lunch | |Dinner | |Bedtime | |Notes | | Blood Sugar | | | | | | | | | | |Food

(specify

quantities)

Exercise? | | | | | | | | | | |

Date: |Breakfast | |Lunch | |Dinner | |Bedtime | |Notes | | Blood Sugar | | | | | | | | | | |Food

(specify

quantities)

Exercise? | | | | | | | | | | |

Date: |Breakfast | |Lunch | |Dinner | |Bedtime | |Notes | | Blood Sugar | | | | | | | | | | |Food

(specify

quantities)

Exercise? | | | | | | | | | | |

Date: |Breakfast | |Lunch | |Dinner | |Bedtime | |Notes | | Blood Sugar | | | | | | | | | | |Food

(specify

quantities)

Exercise? | | | | | | | | | | |Pavilion:logbook with rotating pattern

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