This chapter is built to avoid both. The forms are short and each one has a purpose. You can use one for a fortnight, put it away, and come back to it when something changes. A log is useful in one situation above all: when it lets you and your care team see a pattern that a single reading could never show. A number on its own is only a moment. A week of numbers, with a few notes beside them, is a story.
Section 18.1 explains what is worth recording and what is not. Section 18.2 contains the forms: a daily log, a weekly pattern sheet, a low-glucose event log, a monthly check, a yearly check-up tracker, and an appointment sheet. Section 18.3 shows, with an invented example, how to read a week of readings without judging yourself.
18.1 What Is Worth Writing Down
Record for a reason
Ask yourself what question the log should answer. "Why is my morning number high?" is a good question. "Record everything, just in case" is not, because it produces a pile of numbers that nobody has the time to read. Chapter 12 described how meters and sensors show your glucose, and how time in range, alarms, and trends give you a picture of a whole day. A paper or phone log adds what the device cannot know: what you ate, how you slept, whether you walked, what medicine you took, and how you felt.
Four kinds of entries are usually enough. The first is glucose readings at the times your team suggested. The second is context: a few words about the meal, activity, sleep, or illness around a reading. The third is medicine, written as your team told you to record it. This book gives no doses, so the forms have a column for your medicine and leave the details to your prescriber. The fourth is how you feel. A single number for mood or stress (Chapter 16) helps you see that a bad week of readings often follows a bad week of sleep.
Which readings, and when
Your care team decides the best schedule for you, and it will differ between someone on insulin, someone on tablets, and someone managing prediabetes with food and activity. Some patterns are common. Before-meal readings and readings one to two hours after the start of a meal show how your food, medicines, and activity work together. A fasting reading shows the state you wake up in. A bedtime reading shows where you begin the night (Chapter 10).
The targets on the forms are left blank on purpose. Many organisations publish targets, and Chapter 4 described them: for many non-pregnant adults, the American Diabetes Association lists before-meal glucose of 80 to 130 mg/dL (4.4 to 7.2 mmol/L) and a peak after-meal glucose below 180 mg/dL (10.0 mmol/L), and it also says that less strict goals may suit some people.[@adaguide2023] Your own targets should be set with your team, and written on the top of the form.
To change units, divide a mg/dL value by 18 to get mmol/L, or multiply a mmol/L value by 18 to get mg/dL (Chapter 4).
If you use a sensor
If you wear a continuous glucose monitor, the device already logs your glucose every few minutes. You then need only a light notes log for meals, activity, and events, and the sensor report for the numbers. The international consensus on sensor data suggests at least 14 days of data with the sensor worn most of the time before you read the summary, and it sets time in range of 70 to 180 mg/dL (3.9 to 10.0 mmol/L) above 70 percent as a common goal for adults with type 1 or type 2 diabetes, with individual targets set by your team.[@battelino2019] You can copy the time in range, time below range, and the average from the report onto the weekly sheet.
Keep it light
If logging starts to feel heavy, that is a signal worth listening to. Chapter 16 described diabetes distress and burnout, and Chapter 12 described alarm fatigue and sensor anxiety. You do not need to log every day for ever. A common approach, which is a suggestion and not a rule, is to log intensively for one or two weeks before an appointment or after a change, and then to log less. Ask your team how much they need from you, and give yourself permission to stop when you have your answer.
18.2 The Forms
Copy or print the pages that you need. If you prefer a spreadsheet or a notes app, copy the column headings. Write the units you use at the top, and leave the targets to be filled in with your care team: before-meal target …………, after-meal target ………….
Form 1: Daily log
Use one page for a day. Fill in the moments your team asked for and leave the others blank. In "What I ate or did", a few words are enough, such as "rice, dal, vegetables, walk 15 minutes".
| Moment | Time | Glucose | What I ate or did | Medicine (as prescribed) | Notes |
|---|---|---|---|---|---|
| Before breakfast | |||||
| 2 h after breakfast | |||||
| Before lunch | |||||
| 2 h after lunch | |||||
| Before dinner | |||||
| 2 h after dinner | |||||
| Bedtime | |||||
| Night (if awake) |
Blank form. Write what your team asked you to record; the book gives no doses.
Form 2: Weekly pattern sheet
Copy the week's numbers from the daily logs, or from the sensor report. Put an "L" in the "Lows" column if you had a reading under 70 mg/dL (3.9 mmol/L) or felt the signs of a low (Chapter 13).
| Day | Fasting | Before lunch | Before dinner | 2 h after main meal | Bedtime | Lows (Y/N) | Active minutes | Sleep (h) | Mood 1-5 |
|---|---|---|---|---|---|---|---|---|---|
| Mon | |||||||||
| Tue | |||||||||
| Wed | |||||||||
| Thu | |||||||||
| Fri | |||||||||
| Sat | |||||||||
| Sun |
Blank form. Mood is 1 (very low) to 5 (very good); "Active minutes" is the total of walking and other activity that day.
Form 3: Low-glucose event log
Write down every low, however small. A low is information about your treatment, not a failure. Chapter 13 explains what to do during a low; this form is for afterwards. It helps your team see the cause, such as a delayed meal, more activity than usual, alcohol, or a change in medicine.
| Date, time | Reading | What I felt | What I did | What came before | Told my team (Y/N) |
|---|---|---|---|---|---|
Blank form. If a low needed another person's help, or you lost consciousness, tell your team the same day (Chapter 13).
Form 4: Monthly check
Once a month, take five minutes to check the basics, and add one win and one question.
| Check | Month 1 | Month 2 | Month 3 |
|---|---|---|---|
| Weight or waist | |||
| Home blood pressure (if advised) | |||
| Days I checked my feet | |||
| Medicines and refills sorted | |||
| Test strips, sensors, needles in stock | |||
| Glucagon or fast sugar in date and to hand | |||
| Sleep: nights of 7 hours or more | |||
| Mood or distress, 1 (low) to 5 (high) | |||
| One thing that went well | |||
| One thing to ask my team |
Blank form. "Days I checked my feet" follows the daily foot check in Chapter 15.
Form 5: Yearly check-up tracker
The list follows the yearly calendar in Chapter 14. Write the date, the result with its units, and when it is due again. If a test is not part of your care, write "not needed" so that you know it was a decision and not an omission.
| Check | Date done | Result | Next due |
|---|---|---|---|
| HbA1c and glucose review | |||
| Blood pressure | |||
| Cholesterol | |||
| Kidneys: uACR and eGFR | |||
| Eyes | |||
| Feet and nerves | |||
| Liver (FIB-4) | |||
| Teeth and gums | |||
| Vaccines | |||
| Emotional wellbeing screen | |||
| Vitamin B12 (if on metformin) |
Blank form. Checks and frequencies are from the calendar in Chapter 14; your team may change them for you.
Form 6: Appointment sheet
Fill it in before you go, and take it with you.
- My three main concerns. What worries me most right now? …………
- What I have noticed. Patterns from my log or sensor: …………
- Lows in the last month. How many, and when? …………
- Medicines. Any that I skip, stop, or have trouble with, and why? (Say it plainly. Missing doses is common, and your team would rather know.) …………
- My questions. For example: What are my targets? Which checks are due? Could any of my medicines cause lows? Do I have glucagon and does my family know how to use it? Is there a sick-day plan in writing? …………
- How I have been feeling. Tired, low, stressed, or worried about diabetes? …………
18.3 Reading Your Log
Three questions
Look at a week of numbers with three questions, in this order. First, where do the numbers sit compared with the targets you and your team set? Second, when are they highest or lowest, and what came before? Third, is there a change that could help, and who should decide it: you, or your team? Questions about food and activity you can often test on your own, one change at a time. Questions about medicines belong to your prescriber.
An invented example
The week below is made up to show the method. It does not describe a real person, and the notes are examples.
| Day | Before breakfast | 2 hours after dinner | Note |
|---|---|---|---|
| Mon | 132 mg/dL (7.3 mmol/L) | 168 mg/dL (9.3 mmol/L) | Usual dinner, 15-minute walk |
| Tue | 118 mg/dL (6.6 mmol/L) | 182 mg/dL (10.1 mmol/L) | Dinner late; no walk |
| Wed | 141 mg/dL (7.8 mmol/L) | 210 mg/dL (11.7 mmol/L) | Bigger rice portion; no walk |
| Thu | 127 mg/dL (7.1 mmol/L) | 158 mg/dL (8.8 mmol/L) | Usual dinner, walk |
| Fri | 125 mg/dL (6.9 mmol/L) | 175 mg/dL (9.7 mmol/L) | Usual dinner, walk |
| Sat | 136 mg/dL (7.6 mmol/L) | 195 mg/dL (10.8 mmol/L) | Dinner out with family |
| Sun | 122 mg/dL (6.8 mmol/L) | 160 mg/dL (8.9 mmol/L) | Usual dinner, walk |
Invented readings. Averages were calculated from the seven values: before breakfast about 129 mg/dL (7.2 mmol/L); two hours after dinner about 178 mg/dL (9.9 mmol/L). Conversion: mg/dL divided by 18.
Step one: compare with targets. Four of the seven morning readings are inside the 80 to 130 mg/dL range given for many adults, and the other three are a little above it.[@adaguide2023] The after-dinner readings average 178 mg/dL, and 3 of the 7 are above 180 mg/dL. Step two: look at when. The three highest after-dinner readings came on the days with no walk, a bigger portion of rice, or a meal out, and the lowest came on days with a walk. Step three: decide what is worth testing. This person could try a 15-minute walk after dinner on the days with a bigger meal, and could measure the rice portion once (Chapter 17). If the readings stay high, they would take the log to their care team and ask whether anything else needs to change.
Notice what the log does not say. It does not say that the person failed, and it does not prove that the walk caused the lower readings. Seven days is a small sample. A log gives clues, and testing the clue for another week is how you find out.
When not to wait for your next appointment
Contact your team sooner if you see a pattern of lows, or any low that needed help from another person; if readings stay well above your targets for several days; if you are ill and cannot keep fluids down or your ketones are high (Chapter 13); or if you are worried and cannot say why. Call emergency services for the situations described in Chapter 13: unconsciousness, a seizure, or vomiting with high ketones. A log is never a substitute for care.
Science Corner: Why patterns beat single numbers Glucose changes from minute to minute with food, movement, stress, sleep, and illness, and a single fingerstick captures only one instant. That is why HbA1c, which reflects an average over about three months, and sensor measures such as time in range are used together with individual readings (Chapter 4).[@battelino2019] A log is a low-tech version of the same idea: several readings at the same moment of the day, on different days, show whether a number is a fluke or a habit.
Key Takeaways
- A log is useful when it answers a question. Decide what you want to learn, record only what helps, and stop when you have your answer.
- Four kinds of entries are usually enough: glucose readings at the times your team suggested, a few words of context, your medicines as prescribed, and how you feel.
- Targets are personal. Write the ones you agree with your care team at the top of the form, and do not compare yourself with anyone else.
- A week of readings shows patterns that one number cannot. Look for when the numbers are highest or lowest and what came before.
- Change one thing at a time, and ask your team before changing anything that involves medicines.
- If logging feels heavy, log for a short time and rest. Distress about numbers is a reason to talk to your team, not a reason to try harder.
- Bring your log and your questions to appointments, and contact your team sooner if you notice a pattern of lows or readings that stay high.
Action Points
- Pick one question. Write down the question you want your log to answer over the next two weeks.
- Write your targets. Ask your care team for your targets and write them at the top of Form 1.
- Log for two weeks. Use Form 1 or Form 2 for 14 days, then look at the three questions in Section 18.3.
- Complete Form 5. Fill in the date of your last eye, foot, kidney, and cholesterol checks, and note what is overdue.
- Prepare Form 6. Fill in the appointment sheet before your next visit, and take it with you.
This book is intended for education and does not replace personal medical advice. If you have diabetes or take glucose-lowering medication, please consult your healthcare team before changing your diet, exercise, or treatment.