Diabetes
  

Diabetes Self Management Tools

Disease Self Management Card                                                                                      Side 1    
  
 Green Zone  Yellow Zone  Red Zone
Your diabetes is well controlled. Your blood sugars are not well controlled. Caution is
required.		 Your blood sugar is outside
the safe range your physician
has given you.
  • Fasting blood sugar 80-120
  • 2 hrs. after eating <160
  • Bedtime blood sugar 100-140
  • AIC < 7
  • Blood pressure
    < 130/85

Continue to follow your management plan.


Talk to your health care
team about the best ways to control your blood sugars.


Call your primary healthcare
provider for an appointment
and follow the plan your health care team has developed with you.

Physicians Name:
Telephone:

                               Side 2   

My Current Medications
Medication
Name

Reason for
Taking it

 Dosage

When to
Take it 

 How to
Take it 		 Started    Stopped
             
             
             
             
             
             
             
             

 Source: DoD/VA Clinical Practice Guidelines
American Diabetes Association
National Institues of Health
Created: April 18, 2007