My Action Plan to Control My Blood Sugar
Three questions about my blood sugar control to ask my health care provider:
1. What is my hemoglobin A1c goal? _______
2. What is my blood sugar goal before
meals when self-testing using
a blood glucose meter?
_______
3. What is
my blood sugar goal at bedtime when self-testing using a
blood glucose meter?
_______
Three things I will work on over the next three months to control my blood sugar:
1. ___________________________________________________
2. ___________________________________________________
3. ___________________________________________________
Note: Select things
that you really want to do. Here are two examples:
1. I will walk briskly around my neighborhood with a friend for 20 minutes
every Monday, Wednesday, and Friday at
2. I will eat the three vegetables included in my daily meal plan.
The people who can help me do these things (e.g., friend, co-worker, health care provider):
1. ___________________________________________________
2. ___________________________________________________
3. ___________________________________________________
My three main reasons to keep my blood sugar in a good range:
1. ___________________________________________________
2. ___________________________________________________
3. ___________________________________________________
Note: Your goals will change over time, so be ready to change your current plan or write out a new one at least every three months. Then place your action plan where you will see it often. Do it today!
Keep
Your Blood Sugar Under Control . . .
Tips to Maintain Blood Sugar Control
Set Goals You Can Reach
physical
activity, start by taking one 5-minute walk three times a week. Then
try walking longer or more often.
Create
a Plan to Deal With Diabetes
Manage
Setbacks