Bedford Commons, OB/GYN
Please call or fax in blood sugars twice weekly:
Phone: 603-668-8400 Fax: 603-626-7368
 Diet controlled
 Glyburide (please document current dosing below)
 Insulin Dependent (please document current insulin dosing and insulin type below)
Blood Glucose Tests
Date
FBS
AM
Meds/
insulin
Name _________________
Before
lunch
breakfast Meds/
insulin
1 hr. BS
after
Gestational Diabetes Guidelines
Fasting 60-90 mg/dl
Last printed 2/10/09a, D:\81899904.doc
Before meals
1 hr. BS
after
lunch
90-100 mg/dl
Before
dinner
Meds/
insulin
1 hr. BS
after
dinner
DOB____________
PM
Meds/
insulin
1 hours after meals
comments
<140 mg/dl