Record Keeping

Better Records With Charts

Charts help you visualize a complete picture of the interactions between insulin doses, food intake, carb counts, and activity. They can also help pinpoint other things that affect your blood sugar, such as menses, stress, or an infection. Having a complete picture enables you to sort out what is causing unwanted changes in your blood sugar. Your control is determined by how well your insulin is matched to these changes. Charts allow you to:

• record everything that affects your control in one place.
• graph the rise and fall of your blood sugar in real time.
• see patterns in your readings.
• see the time of day when problems typically occur.
• pinpoint the causes for control problems.

Over time, charts tell you if you are getting where you want to go. They can be used as a guide to let you know whether the changes you make are really helping you gain better control. Writing things down as they occur improves your decisions. Whatever recording device you use, you want to identify patterns easily and be able to record in one place all the things that affect your control.

What should you put on your charts?

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 to do. Use colored markers to quickly spot differences in activities, events, and readings. 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 on your chart are:

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

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

Spot Patterns

Once a week, review your completed 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 ups and downs you were not previously able to explain.

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 readings to get your percentage. You should aim for being within your target range at least 75% of the time.

For example:

If you take 4 readings a day for a week, you end up with 28 overall readings. If 4 of these readings were outside your target range, you would divide 4 by 28 to get .14(14%). This means that 86% of your readings were within your target range.

Better Records With Logbooks

Many people use a logbook to record and track their blood sugar readings. One problem with standard logbooks is that they lack sufficient space to fill in everything that affects your blood sugar. An enhanced logbook improves the traditional logbook by enabling other important data. If you choose to use a logbook, always look for patterns, but understand that logbooks may not be as useful as charts for finding 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
• Give your best excuse for every reading that is out of your target range. Write related information in the margins or wherever space is available
• Look for lows first. Circle every low in your log book in red so they stand out. If frequent or severe lows are happening, these should always be stopped before attempting to stop 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 reading helps control the rest of the day.
• Look for the time of day when your readings are highest. Adjust your insulin to bring these high readings down.
• Do particular foods have specific effects on your blood sugar? Adjust insulin doses or carb amounts for foods that do.
• After one insulin dose has been increased or decreased, watch for a few days to see if other insulin doses are affected and how they need to be changed.

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 patter section at the bottom of the log helps you pick up patterns by having 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 days in one week, or low readings on two or more days can be considered a pattern.

When unwanted patterns occur, 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 this directly first. If your insulin doses are not correct or need to be adjusted, work with your physician to learn how to do so properly. After you make the necessary changes, do another log page to verify improvements.