Download Blood Test Date Targets Check Any That Apply DAILY BLOOD

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Debbie Pepper-Dougherty, RD, LD
DPD Nutrition Consultants, Inc.
361 US Route 1, Falmouth, ME 04105
Call: 207-781-4922 or Fax: 207-781-4925
DAILY FOOD RECORD
Write down everything you ate, drank, chewed, or swallowed for the three days
of blood testing. Tell us the amounts, grams of carbs and how you cooked the
foods.
Time
DAILY BLOOD GLUCOSE
Blood Test Date
Breakfast
Targets
Fasting
Snack
2 Hr After Breakfast
Before Lunch
2 Hr After Lunch
Lunch
Before Dinner
2 Hr After Dinner
Snack
9:10pm/Bedtime
Option 2am
Check Any That Apply
Dinner
Stress/Illness/Ketones
Overeating/Skipped
Meals
Exercise
(walking, etc.)
Date______
Snack
g Carbs
Time
Date_______
g Carbs
Time
Date_______
g Carbs
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