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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Credits
Current as ofApril 16, 2019
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: April 16, 2019
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
