Diabetic Record
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999 Hospital NHS Trust ADULT DIABETES RECORD Current values as of (date): ………… Year diagnosed: ………… Height: ……… cm Pre-admission diabetes therapy: Weight: ……… kg SURNAME Hospital Number First name(s) Date of birth Sex Consultant Ward –2 BMI: ……… kg m HbA1c: ……… Creatinine: ……… mM (mmol l–1) Capillary blood glucose reading (mM) DATE READINGS Time Glucose Time Glucose Time Glucose Time Glucose Time Glucose Time Glucose Time Glucose Time Glucose Time Glucose Time Glucose Time Glucose Time Glucose Time Glucose Please record across the page COMMENTS (e.g..
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