Sheet1HUMALOG/NOVOLOG AND LANTUS OSF Pediatic Diabetes Resource Center Fax: 309-682-8152

Name: ________________________________DOB: _________________________________Meal insuline ______________Correction insulin __________Date: _________________ (Total carb grams + _______ = dose) (Blood sugar - _________ ________ = dose)Time of Day:MN1A234567891011121234567891011Blood SugarTotal Carbs (gm)MealHumalog/NovologCorrectionHumalog/NovologTotal doseHumalog/NovologLantusActivity

FoodFoodFoodAmtBreakfast Time: ________CarbGramsAmtLunch Time: ________CarbGramsAmtDinner Time: ________CarbGrams

Morning Snack Time: ________Afternoon Snack Time: ________Evening Snack Time: ________

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