Making Sense of BGM Data for a Basal-Bolus Insulin User
Standard fasting or pre-meal glucose target range:
80–130 mg/dL or custom range: ________________
Standard post-meal glucose target range:
80–180 mg/dL or custom range: ________________
| Date | Fasting or Pre-breakfast | Post-breakfast or Pre-lunch | Post-lunch or Pre-dinner | Post-dinner or Bedtime | |
| TIME | |||||
| GLUCOSE | |||||
| CARBS | |||||
| INSULIN | |||||
| NOTES | |||||
| Date | Fasting or Pre-breakfast | Post-breakfast or Pre-lunch | Post-lunch or Pre-dinner | Post-dinner or Bedtime | |
| TIME | |||||
| GLUCOSE | |||||
| CARBS | |||||
| INSULIN | |||||
| NOTES | |||||
When your fasting or pre-breakfast glucose is consistently high:
Consider eating fewer carbs with dinner. Consider being more active in the evening. If the glucose doesn’t come down with your own efforts, discuss an adjustment of your insulin dose with your diabetes care team.
| Date | Fasting or Pre-breakfast | Post-breakfast or Pre-lunch | Post-lunch or Pre-dinner | Post-dinner or Bedtime | |
| TIME | |||||
| GLUCOSE | |||||
| CARBS | |||||
| INSULIN | |||||
| NOTES | |||||
| Date | Fasting or Pre-breakfast | Post-breakfast or Pre-lunch | Post-lunch or Pre-dinner | Post-dinner or Bedtime | |
| TIME | |||||
| GLUCOSE | |||||
| CARBS | |||||
| INSULIN | |||||
| NOTES | |||||
When your post-meal glucose is consistently high:
Consider eating fewer carbs with your meals. Discuss an adjustment of your insulin dose with your care team.
| Date | Fasting or Pre-breakfast | Post-breakfast or Pre-lunch | Post-lunch or Pre-dinner | Post-dinner or Bedtime | |
| TIME | |||||
| GLUCOSE | |||||
| CARBS | |||||
| INSULIN | |||||
| NOTES | |||||
| Date | Fasting or Pre-breakfast | Post-breakfast or Pre-lunch | Post-lunch or Pre-dinner | Post-dinner or Bedtime | |
| TIME | |||||
| GLUCOSE | |||||
| CARBS | |||||
| INSULIN | |||||
| NOTES | |||||
When you have frequent hypoglycemia:
Discuss an adjustment of your insulin dose with your care team.
Basal insulin name: ____________________________
Morning dose: ________units
Evening dose: ________units
Bolus insulin name: ____________________________
Dosing type:
□ fixed dose with meals
□ insulin-to-carb ratio
□ correctional scale
Fixed dose
Breakfast dose: ___units
Lunch dose: ___units
Dinner dose: ___units
Insulin-to-carb ratio
Breakfast dose: ___units/g
Lunch dose: ___units/g
Dinner dose: ___units/g
Correctional scale
Add 1 unit of insulin for every ___mg/dL over ___mg/dL.
Always follow the instructions for taking your insulin provided to you by your health care team. Have a plan to treat hypoglycemia (glucose <70 mg/dL) and a plan for days when you are sick. Report all serious hypoglycemia.
Making Sense of CGM Data for a Basal-Bolus Insulin User
Before meals, use current glucose data and trend arrow in calculating insulin doses and deciding whether to deliver doses before or after eating.
Two hours after meals, determine whether correctional insulin is needed.
At bedtime, use current glucose data and trend arrow to decide whether corrective action is needed to prevent nighttime hypoglycemia or hyperglycemia.
During and after exercise, monitor glucose every 15–30 minutes to prevent hypoglycemia.
During sick days, monitor glucose levels at least every 4 hours. Vitamin C and aspirin may affect the accuracy of glucose readings with FreeStyle Libre and Medtronic CGM devices. (FreeStyle Libre 2 is not affected by aspirin.)
| . | Time in range . | Time below range . | Time above range . |
|---|---|---|---|
| Definition | The percentage of your readings between 70 and 180 mg/dL | The percentage of your readings <70 mg/dL (low) or <54 mg/dL (very low) | The percentage of your readings >180 mg/dL (high) or >250 mg/dL (very high) |
| Standard Target | >70% | <4% low; <1% very low | <25% high; <5% very high |
| Custom Target | |||
| Your data/date | |||
| Your data/date | |||
| Your data/date |
| . | Time in range . | Time below range . | Time above range . |
|---|---|---|---|
| Definition | The percentage of your readings between 70 and 180 mg/dL | The percentage of your readings <70 mg/dL (low) or <54 mg/dL (very low) | The percentage of your readings >180 mg/dL (high) or >250 mg/dL (very high) |
| Standard Target | >70% | <4% low; <1% very low | <25% high; <5% very high |
| Custom Target | |||
| Your data/date | |||
| Your data/date | |||
| Your data/date |
Bolus insulin name: ____________________________
Dosing type:
□ fixed dose with meals
□ insulin-to-carb ratio
□ correctional scale
| Medtronic | Dexcom | FreeStyle Libre | Trend Meaning | Glucose Value | Actions to Help You Stay or Get in Range |
| Glucose rising >3 mg/dL/min | High | Take correctional insulin if you have not already done so in the past 2 hours. If you will eat, you can take your bolus insulin for your meal before you start eating; do not consume food, snacks, or drinks containing carbs until the trend arrow levels off. | |||
| Glucose rising 2–3 mg/dL/min (>2 mg/dL/min for FreeStyle Libre) | In range | Your glucose is fine right now but rising; check back in 15 minutes. If you will eat, you can take your bolus insulin for your meal before you start eating; do not consume food, snacks, or drinks containing carbs until the trend arrow levels off. | |||
| Glucose rising 1–2 mg/dL/min | Low | Your glucose is currently low but moving in the right direction; check back in 5 minutes. If you will eat, you can take your bolus insulin for your meal after you start eating; do not take your bolus until your glucose is out of the low range. | |||
| No arrow | ➔ | ➔ | Glucose changing slowly <1 mg/dL/min | High | Take correctional insulin if you have not already done so in the past 2 hours. If you will eat, you can take your bolus insulin for your meal before you start eating; do not consume food, snacks, or drinks containing carbs until the trend arrow levels off. |
| In range | If you will eat, you can take your bolus insulin for your meal before you start eating. | ||||
| Low | Your glucose is currently low; to correct it, consume fast-acting carbs (usually 4 oz of juice or 3–4 glucose tablets); check back in 5 minutes. If you will eat, you can take your bolus insulin for your meal after you start eating; do not take your bolus until your glucose is out of the low range. | ||||
| Glucose falling 1–2 mg/dL/min | High | Your glucose is currently high but moving in the right direction; check back in 15 minutes. If you will eat, you can take your bolus insulin for your meal after you start eating; do not take your bolus until the trend arrow levels off. | |||
| Glucose falling 2–3 mg/dL/min (>2 mg/dL/min for FreeStyle Libre) | In range | Your glucose is fine right now but falling; check back in 5 minutes. If you will eat, you can take your bolus insulin for your meal after you start eating; do not take your bolus until the trend arrow levels off. | |||
| Glucose falling >3mg/dL/min | Low | Your glucose is currently low; to correct it, consume fast-acting carbs (usually 8 oz of juice or 6–8 glucose tablets); check back in 5 minutes. If you will eat, you can take your bolus insulin for your meal after you start eating; do not take your bolus until your glucose is out of the low range. |
| Medtronic | Dexcom | FreeStyle Libre | Trend Meaning | Glucose Value | Actions to Help You Stay or Get in Range |
| Glucose rising >3 mg/dL/min | High | Take correctional insulin if you have not already done so in the past 2 hours. If you will eat, you can take your bolus insulin for your meal before you start eating; do not consume food, snacks, or drinks containing carbs until the trend arrow levels off. | |||
| Glucose rising 2–3 mg/dL/min (>2 mg/dL/min for FreeStyle Libre) | In range | Your glucose is fine right now but rising; check back in 15 minutes. If you will eat, you can take your bolus insulin for your meal before you start eating; do not consume food, snacks, or drinks containing carbs until the trend arrow levels off. | |||
| Glucose rising 1–2 mg/dL/min | Low | Your glucose is currently low but moving in the right direction; check back in 5 minutes. If you will eat, you can take your bolus insulin for your meal after you start eating; do not take your bolus until your glucose is out of the low range. | |||
| No arrow | ➔ | ➔ | Glucose changing slowly <1 mg/dL/min | High | Take correctional insulin if you have not already done so in the past 2 hours. If you will eat, you can take your bolus insulin for your meal before you start eating; do not consume food, snacks, or drinks containing carbs until the trend arrow levels off. |
| In range | If you will eat, you can take your bolus insulin for your meal before you start eating. | ||||
| Low | Your glucose is currently low; to correct it, consume fast-acting carbs (usually 4 oz of juice or 3–4 glucose tablets); check back in 5 minutes. If you will eat, you can take your bolus insulin for your meal after you start eating; do not take your bolus until your glucose is out of the low range. | ||||
| Glucose falling 1–2 mg/dL/min | High | Your glucose is currently high but moving in the right direction; check back in 15 minutes. If you will eat, you can take your bolus insulin for your meal after you start eating; do not take your bolus until the trend arrow levels off. | |||
| Glucose falling 2–3 mg/dL/min (>2 mg/dL/min for FreeStyle Libre) | In range | Your glucose is fine right now but falling; check back in 5 minutes. If you will eat, you can take your bolus insulin for your meal after you start eating; do not take your bolus until the trend arrow levels off. | |||
| Glucose falling >3mg/dL/min | Low | Your glucose is currently low; to correct it, consume fast-acting carbs (usually 8 oz of juice or 6–8 glucose tablets); check back in 5 minutes. If you will eat, you can take your bolus insulin for your meal after you start eating; do not take your bolus until your glucose is out of the low range. |
Basal insulin name: ____________________________
Morning dose: ________units
Evening dose: ________units
Always follow the instructions for taking your insulin provided to you by your health care team. Have a plan to treat hypoglycemia (glucose <70 mg/dL) and a plan for days when you are sick. Report all serious hypoglycemia.
Fixed dose
Breakfast dose: ___units
Lunch dose: ___units
Dinner dose: ___units
Insulin-to-carb ratio
Breakfast dose: ___units/g
Lunch dose: ___units/g
Dinner dose: ___units/g
Correctional scale*
Add 1 unit of insulin for every ___mg/dL over ___mg/dL.
Some CGM users may adjust their insulin dose using the trend arrow. Discuss whether you should do this with your diabetes care team.
