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Controlando la glucosa


¿Su diabetes está bajo control?
Many things can affect blood glucose, from the foods you eat, to how active you are, to taking your diabetes medicines as prescribed. However, there are times when your blood glucose levels may change seemingly without reason.
This short questionnaire can help you and your médico see areas in which you are doing well and areas in which you may need more help managing your diabetes. After completing the questionnaire, print your results and share them with your médico at your next appointment.
Please take a moment to print your answers. At the bottom of the printed document you’ll find spaces to add additional questions that you may have for your médico as well as other information about your treatment plan and goals. Use your answers to start a discussion with your médico about your treatment, goals, and concerns.

Question 1 of 9
I check my blood glucose levels as often as my médico recommends.
You chose:
Never
Sometimes
Always
Answer


















My name : 
My next médico appointment : 
My current medications : 
  
  
My HbA1c goal : 
My weight : 
My blood pressure :  
Daily calorie intake goal : 
Activity/exercise target (i.e.,amount
of time and days a week) :
 
  
  
Questions or concerns for my
médico :