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NutritionWORKSHEET FOR CARBOHYDRATE COUNTINGWORKSHEET FOR CARBOHYDRATE COUNTING
AM MEAL
Food Amount Carb Grams ____________________ _______________ ___________ ____________________ _______________ ___________ ____________________ _______________ ___________ ____________________ _______________ ___________ ____________________ _______________ ___________
BG ___ NL/HL Insulin:_______ for Food Factor____ ___________Total grams + ______ for BG Correction Factor___ = ______total insulin SNACK
NOON MEAL
Food Amount Carb Grams ____________________ _______________ ___________ ____________________ _______________ ___________ ____________________ _______________ ___________ ____________________ _______________ ___________ ____________________ _______________ ___________ ____________________ _______________ ___________
BG ___ NL/HL Insulin:_______ for Food Factor____ ___________Total grams + ________for BG Correction Factor___ = ______ total insulin SNACK
PM MEAL
Food Amount Carb Carb Grams ____________________ _______________ ___________ ____________________ _______________ ___________ ____________________ _______________ ___________ ____________________ _______________ ___________ ____________________ _______________ ___________ ____________________ _______________ ___________
BG ___ NL/HL Insulin:_______ for Food Factor___ ___________Total grams + ________ for BG Correction Factor___ = ________ total insulin BEDTIME BG___
SNACK
This is your Correction Factor or 1 unit of NL/HL will lower your BG ____points
ã 1998-2003 Eastern Virginia Medical School/The Strelitz Diabetes Institutes. All Rights Reserved.
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