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** Check Ketones if BS is > 240

 Lantus Morning Insulin _2.0_ @ _ _AM Humalog for BS Humalog for Carbs

Site ________ BS < 180 = 0 UNIT 10g = .5 UNITS


BS 180-200 = 0.25 UNIT 20g = 1.0 UNITS
BS 200-280 = 0.5 UNIT 30g = 1.5 UNITS
 Pre-Breakfast Blood Sugar _____ @ ______AM BS 280-300 = 0.75 UNIT 40g = 2.0 UNITS
BS 300-380 = 1.0 UNIT 50g = 2.5 UNITS
BS 380-450 = 1.25 UNITS 60g = 3.0 UNITS
BREAKFAST BS > 450 = 1.5 UNITS
Humalog Insulin___ @ ____AM / Site _____

Total Carbs : _____


Free Carbs : _____

 Morning Snack ________________________ Humalog for BS Humalog for Carbs

BS < 180 = 0 UNIT 15g = .5 UNITS


BS 180-200 = 0.25 UNIT 30g = 1.0 UNITS
BS 200-280 = 0.5 UNIT 45g = 1.5 UNITS
 Pre-Lunch Blood Sugar _____ @ ______ PM BS 280-300 = 0.75 UNIT 60g = 2.0 UNITS
BS 300-380 = 1.0 UNIT 75g = 2.5 UNITS
BS 380-450 = 1.25 UNITS 90g = 3.0 UNITS
LUNCH BS > 450 = 1.5 UNITS
Humalog Insulin___ @ ____PM

Total Carbs : _____


Free Carbs : _____

 Afternoon Snack _____________________ Humalog for BS Humalog for Carbs

BS < 180 = 0 UNIT 15g = .5 UNITS


BS 180-200 = 0.25 UNIT 30g = 1.0 UNITS
BS 200-280 = 0.5 UNIT 45g = 1.5 UNITS
 Pre-Dinner Blood Sugar _____ @ ______ PM BS 280-300 = 0.75 UNIT 60g = 2.0 UNITS
BS 300-380 = 1.0 UNIT 75g = 2.5 UNITS
BS 380-450 = 1.25 UNITS 90g = 3.0 UNITS
DINNER BS > 450 = 1.5 UNITS
Humalog Insulin___ @ ____PM

Total Carbs : _____


Free Carbs : _____

 Pre-Bedtime Blood Sugar _______ @ _____PM


 Lantus Evening Insulin _ __@ _____PM

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