Glucose Monitoring Log Form

The Glucose Monitoring Log Form is a clinical tool designed for systematic tracking of blood glucose levels in patients with diabetes mellitus or those at risk for glycemic abnormalities. It captures fasting glucose readings, pre-meal and post-meal values, bedtime glucose levels, and the timing and context of each measurement. The form also records insulin type, dosage, and administration time, as well as oral hypoglycemic medication schedules, providing a complete picture of glucose-medication interaction patterns.

Beyond individual readings, the form includes fields for documenting the most recent HbA1c result, target glucose ranges personalized to the patient's clinical profile, and the occurrence of hypoglycemic or hyperglycemic episodes including severity, symptoms, and corrective actions taken. Dietary and activity notes associated with each reading help identify patterns and triggers that inform treatment adjustments and patient self-management education.

Used by endocrinology practices, primary care diabetes management programs, certified diabetes educators, and hospital glycemic management teams, this form supports ADA Standards of Care for glucose monitoring documentation. It is appropriate for type 1 and type 2 diabetes patients, gestational diabetes monitoring, steroid-induced hyperglycemia tracking, and post-transplant diabetes surveillance where tight glycemic control is critical for patient outcomes.