Type 1 Diabetes Daily Management Plan

Personal Information

• Name: _________________
• Date of Birth: _________________
• Emergency Contact: _________________
• Healthcare Provider: _________________

Blood Glucose Monitoring

Target Blood Glucose Ranges

• Before meals: 80-130 mg/dL
• 2 hours after meals: <180 mg/dL
• Bedtime: 90-150 mg/dL

Testing Schedule

• Before each meal
• 2 hours after meals
• Before bedtime
• Before exercise
• When feeling symptoms of low/high blood sugar

Insulin Management

Basal Insulin

• Type: _________________
• Usual dose: _________ units
• Time(s) of day: _________________

Bolus Insulin

• Type: _________________
• Insulin-to-carb ratio: 1 unit per _____ grams
• Correction factor: 1 unit lowers blood glucose by _____ mg/dL

Hypoglycemia Treatment (Blood Glucose <70 mg/dL)

1. Test blood glucose
2. Consume 15g fast-acting carbohydrates:
   • 4 oz juice
   • 4 glucose tablets
   • 1 tube glucose gel
3. Wait 15 minutes
4. Retest blood glucose
5. Repeat if necessary

Sick Day Management

Additional Monitoring

• Check blood glucose every 2-4 hours
• Check ketones if blood glucose >250 mg/dL
• Continue insulin as prescribed

Exercise Guidelines

Before Exercise

• Check blood glucose
• If <100 mg/dL: Eat 15g carbs
• If >250 mg/dL: Check ketones

Emergency Contacts

• Primary Care Provider: _________________
• Endocrinologist: _________________
• Emergency Number: _________________

Supplies to Maintain

• Blood glucose meter and strips
• Insulin and syringes/pen needles
• Glucose tablets/gel
• Ketone testing supplies
• Glucagon emergency kit