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Time BG Meal (food/drink) Carbs Medication Dosage Activity Duration Other
S M
T W
TH
F S
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d
ate
Name:
iPro2 serial number:
Meter brand:
Meter ID:Time BG Meal (food/drink) Carbs Medication Dosage Activity Duration Other
S M
T W
TH
F S
|
d
ate
Time BG Meal (food/drink) Carbs Medication Dosage Activity Duration Other
S M
T W
TH
F S
|
d
ate
Time BG Meal (food/drink) Carbs Medication Dosage Activity Duration Other
S M
T W
TH
F S
|
d
ate
First day: Take your first two blood glucose tests at
: and : , and at least
once more before midnight.
Throughout the study: Test your blood glucose at least four times a day, for example: before breakfast, lunch, dinner, and bedtime.
Last day: Test your blood glucose at least three times. Return date: Please return devices with completed log sheet on / at : .
Patient Log Sheet
Notes:
6025497-0U1_d
Time BG Meal (food/drink) Carbs Medication Dosage Activity Duration Other
S M
T W
TH
F S
|
d
ate
Time BG Meal (food/drink) Carbs Medication Dosage Activity Duration OtherS
M T
W T
H F
S
|
dat
e
Time BG Meal (food/drink) Carbs Medication Dosage Activity Duration Other
S M
T W
TH
F S
|
d
ate
Time BG Meal (food/drink) Carbs Medication Dosage Activity Duration Other
S M
T W
TH
F S
|
d
ate
