Better Record Keeping with Diabetes

Better Record Keeping with Diabetes Charts and Apps

Blood sugar charts and applets help you visualize how your insulin doses, medications, food intake, carb counts, and activity affect your glucose readings. They help pinpoint other factors that affect your blood sugar, such as menstruation, stress, or an infection. Having this larger picture allows you to identify what leads to unwanted changes in your readings. Your A1c level. The frequency of hypoglycemia and overall control are determined by how well your insulin is matched to these lifestyle factors. Charts let you:

• Record the things that are within your control in one place
• Graph the rises and falls in your blood sugar in real-time
• See the patterns in your readings
• See at what time of day problems typically happen
• Pinpoint the causes for unwanted ups and downs

Over time, charts help you determine if you are making progress toward your goals, serving as an excellent guide to assess whether the changes you make are effective. Writing things down as they occur improves your decision-making. Any device you use should help you easily identify patterns and let you record all the things that affect your control in one place.

What Should You Record?

The more information you put on your charts, the easier it is to control your blood sugars. Keep your charts or other recording tools handy so that recording and reviewing are easy. Use colored markers to identify differences in activities, events, and readings quickly. Highlighting highs and lows is particularly valuable. For each high and low, record what you think led to the particular problem. Some important topics that should be included in your chart are:

• activities
• blood sugars
• insulin doses
• foods and carb counts
• comments about emotions, stress, medications, etc…

Download a sample Smart Chart or an empty chart to test with your own information.

Look for Your Patterns

Once a week, review your applet or charts for patterns of high and low blood sugars. As you gather information, patterns will become apparent to you and your health care team. You will finally be able to see logical explanations for the ups and downs that you were previously unable to understand.

Another way to monitor your overall control is to find the total percent of your readings that fall within your target ranges. Once a week, add up the total number of readings you have recorded and circle all the readings above your target range in one color and all the readings below your target range in another color. Divide the number of readings outside your range by your total number of readings to determine your percentage. A good goal is to stay within your target range 75% of the time without having severe lows.

For example:

If you check 4 times a day for a week, you end up with 28 overall readings. If 4 of these readings happen to be outside your target range, you would divide 4 by 28 to get 0.14 or 14% of your readings. This means that 86% of your readings are within your target range.

Get Better Records With A Logbook

Many people use a logbook to record and track their blood sugar readings. One problem with standard logbooks is that they often lack sufficient space to record everything that affects your blood sugar. An enhanced logbook improves the traditional logbook by allowing for the inclusion of other important data. If you choose to use a logbook, always look for patterns; however, understand that logbooks may not be as practical as charts in identifying causes and solutions. Here are some tips for using logbooks to improve your control:

• Although recording is done across a logbook, patterns are found by looking up and down the page. Check whether your readings remain in your target range at each time of day.
• Provide your best justification for every reading that falls outside your target range. Write related information in the margins or wherever space is available.
• Look for lows first. Circle every low in your logbook in red so they stand out. If frequent or severe lows are happening, these should always be stopped before attempting to prevent other patterns.
• Do highs often follow lows? Try eating 20 grams of fast carbs (glucose tabs, Sweet Tarts, etc.) to treat your lows instead of unmeasured amounts of carb.
• After stopping lows, control the pre-breakfast reading next. A good pre-breakfast read helps set the tone for the rest of the day.
• Look for the time of day when your readings are highest. Adjust your insulin to lower these high readings.
• Do particular foods have specific effects on your blood sugar? Adjust insulin doses or carbohydrate amounts for foods that require adjustments.
• After one insulin dose has been increased or decreased, monitor for a few days to determine if other insulin doses require adjustment and how they should be adjusted.

Download a sample enhanced logbook or download a blank copy.

Look For The Patterns In Your Readings

Logbook patterns can be spotted by looking up and down the page for errant readings at a particular time of day. The pattern section at the bottom of the log helps identify patterns when you record how many readings were above or below your target range that week. Add up all the highs and lows that fall outside your target range for each time of day and write these numbers at the bottom of each column. High readings at the same time of day on three or more consecutive days in one week, or low readings on two or more consecutive days, can be considered a pattern.

If you see an unwanted pattern, ask yourself if there is any reason other than the doses of insulin you are taking. If you identify something, it will be easier to deal with it first. If your insulin doses are incorrect or need adjustment, work with your physician to learn how to make the necessary changes properly. After making the required changes, create another log page to verify that the improvements have been implemented.