Instructions:
Please print this page and return to Medicines for People with Diabetes. If you are unable to print this page, or if you would rather use a hard-copy booklet, please contact the NDIC Information Clearinghouse at ndic@info.niddk.nih.gov and request a copy of Medicines for People with Diabetes.
Questions To Ask About Your Diabetes Medicines
Ask these questions when your doctor prescribes a medicine. Write the answers in pencil so that you can make changes if your doctor changes your medicines.
- When do I take the medicine--before a meal, with
a meal, or after a meal?
____________________________________________ - How often should I take the medicine?
____________________________________________ - Should I take the medicine at the same time every
day?
____________________________________________ - What should I do if I forget to take my medicine?
____________________________________________ - What side effects may happen?
____________________________________________ - What should I do if I get side effects?
____________________________________________
My Diabetes Medicines
Fill in this record about your diabetes medicines with the help of your doctor or diabetes teacher. Write this in pencil so you can make changes when your doctor makes changes in your diabetes medicines.
- The names of the diabetes medicines (insulin or
pills) I take are
Name(s) of diabetes medicine:____________________________________________
____________________________________________ - I take _________________ (name of diabetes medicine)
_____ times a day.
At (time)__________ I take (amount)_______________.
At (time)__________ I take (amount)_______________.
At (time)__________ I take (amount)_______________. - I take _________________ (name of diabetes medicine)
_____ times a day.
At (time)__________ I take (amount)_______________.
At (time)__________ I take (amount)_______________.
At (time)__________ I take (amount)_______________. - I take _________________ (name of diabetes medicine)
_____ times a day.
At (time)__________ I take (amount)_______________.
At (time)__________ I take (amount)_______________.
At (time)__________ I take (amount)_______________. - I should call my doctor or diabetes teacher if
I have these problems with my diabetes medicines:
____________________________________________
____________________________________________ - I should call my doctor or diabetes teacher if
my blood sugar is too low or too high for several days.
Too low is _______ mg/dl for _______ days.
Too high is _______ mg/dl for _______ days. - My blood sugar should be between _________mg/dl
and _________mg/dl before my first meal of the
day.
- My blood sugar should be between _________mg/dl
and _________mg/dl 1 to 2 hours after a meal.
- My blood sugar is too low at ________________________mg/dl.
- My blood sugar is too high at ________________________mg/dl.
- My hemoglobin A1c should be ________________________%.
This material may be freely copied and distributed
without restriction.
From NIH Publication No. 98-4222
November 1997
Doctors Corner INternet Group, Inc. 1997-2004