Keeping a diabetes diary

Christine Manga advocates why keeping a diabetes diary is of benefit; it assists with accountability and in achieving the best possible health outcomes.

Not all of us kept diaries as teenagers, but those who did would recall recording the happenings of each day. Looking back at these, we gain insights into ourselves: what we did, how we felt and how we reacted to situations. Perhaps the most important aspect is that journal keeping leads to accountability to ourselves, helping us take responsibility for our actions.

A diabetes diary is similar. It gives us an insight into the effects of daily food, exercise, stress, medication, menstrual cycle and mood have on our blood glucose readings.

In today’s modern world, diary keeping can be done with ease on a number of different platforms and devices. There are hundreds of specific diabetes diary apps, but we should not overlook the good old-fashioned book and pen.

There are advantages and disadvantages to both. For instance, carrying a book around is certainly not as convenient as a cell phone. Certain apps will require specific data to be captured before an entry can be created, this is certainly not the case with a manual journal. Ultimately the decision is a personal one, it should be a choice which encourages active record keeping.

What should be logged


Food logging can be really simple or extremely detailed. This helps both you and your healthcare practitioner (HCP) to learn about your habits and actions. For instance, emotional eating can be detected in this manner.

Some of the basic information you should include: the time of meals, snacks and any beverages consumed (coffee has a particularly deleterious impact on glucose levels). Some additional details which can be recorded are the type of food, quantity, calorie content and carbohydrate amounts.

Food is an integral part of our lives, and perhaps one of the most pertinent information to record is the reason for eating. For example, feeling sad or depressed, being hungry, a regular meal, pre-exercise or correcting a hypo.

With food journaling, digital options are frequently better as many apps have the functionality to add photos of your meals. This is extremely helpful when visiting your HCP. Your HCP is often better equipped to assist you with carb counting when they can see what you have eaten.

Diaries can help shed light on the reason your weight may be fluctuating. Studies have shown that people who regularly keep a food journal are far more successful in losing weight than those who don’t or do so irregularly. Food diaries increase your awareness of the food you eat and helps inculcate a culture of mindful eating.


The mere action of keeping a medication journal mitigates the chance that you may omit a dose of any of your medicines. As a basic, you should be tracking the timing and dosage of oral medications. Doing the same for injectables will improve your understanding of the efficacy of a drug on your glucose control. As each person will react differently to different medications, this can help you and your HCP reach the optimum drug regimen for you.

The recording of medication should not be restricted to diabetic-related medication. Certain medications, such as corticosteroids, have been shown to elevate blood glucose levels.

Continuous glucose monitoring systems show how important it is to administer insulin timeously.


Exercise can frequently be a double-edged sword for people living with diabetes. It’s always held to be one of the cornerstones of a good diabetes management strategy. While its benefits can’t be overstated, it often can leave you feeling frustrated by an adverse response in your glucose levels.

By journaling the time of day, intensity of your exercise and the duration of your exercise and comparing it to your glucose levels, you will, over time, be able to alter the amount of carbohydrates you need to eat before and after exercise. You will also learn how to adjust your insulin accordingly. This information will help you and your HCP to get the most benefit from exercise as part of your treatment.

Emotional state

It’s often underestimated what a significant impact mood has on blood glucose levels. When we are stressed or anxious, hormones, such as cortisol, are released causing spikes in glucose levels even in the absence of food. Excitement and elation often have similar effects.

By recording these emotional responses and comparing them to glucose readings can often explain an otherwise inexplicable glucose excursion. As noted earlier, this is also very helpful in identifying whether or not you eat in response to emotional extremes.

Menstrual cycle

Having a section in your diary to record your menstrual cycle is beneficial. By doing so you note the impact of the stage of your cycle on your blood glucose levels. For example, many women experience elevated blood glucose when pre-menstrual. If you are using insulin and are comfortable titrating your doses, you can proactively increase or decrease your dosage accordingly.


It goes without saying that anyone living with diabetes should be recording their blood glucose levels whenever they test. This will be used by your HCP for analysis and trend identification. The type of diabetes and the treatment you use will determine the frequency of testing that is required.

Typically, someone with Type 1 diabetes using multiple daily insulin injections should be testing at least four times per day: before each meal and at bedtime, and in between if feeling unwell.

On the other hand, for someone with Type 2 diabetes, using one oral medication is only required to test two or three times per week. A good exercise for these people would be to conduct a twelve-point test. This entails four tests over three days: one before each meal and at bedtime. This has the potential to expose, otherwise, hidden hyperglycaemia and allow the linking of test results to food, exercise, etc.

In conclusion

Using a diabetes diary should encourage people to set their own goals. This diary will identify what works for each individual, it also helps highlight what changes and improvements can be made.

It’s of critical importance that HCP be involved in the assessment and decoding of the diary with patients. Our guidance and professional experience help provide better healthcare outcomes, and help you become better equipped to interpret your records and to adjust your behaviour and medication accordingly.

Understandably, thorough diabetes diary keeping can be time consuming and cumbersome. If necessary, take a break from a detailed diary, but do keep a record of blood glucose readings.

A diary should be honest and kept primarily for yourself and secondly for use with your HCP. Journal keeping assists with holding yourself accountable and should be there to help you take responsibility for your actions and ultimately assist in achieving the best possible health outcomes.

Christine Manga (Post Grad Dip Diabetes and Msc Diabetes) is a professional nurse and a diabetes nurse educator. She has worked with Dr Angela Murphy at CDE Centre, Sunward Park since 2012.


Christine Manga (Post Grad Dip Diabetes and Msc Diabetes) is a professional nurse and a diabetes nurse educator. She has worked with Dr Angela Murphy at CDE Centre, Sunward Park since 2012.

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