A diabetes flow sheet is the running record a primary care team keeps for each person with diabetes: the targets, a line of results for every visit, and the checks that are due. Copy the free template, see a type 2 example over a year and a type 1 example on a pump, and check what goes in each part.
Blank diabetes flow sheet template
FreeDIABETES FLOW SHEET Patient: [Name, date of birth] Care team: [Lead clinician, nurse or diabetes educator, pharmacist, dietitian, specialists] DIAGNOSIS AND TARGETS Diabetes type: [Type 1, type 2, or another type, and what the diagnosis rests on] Diagnosed: [Month and year] Other conditions: [Hypertension, kidney disease, heart disease, heart failure, retinopathy, neuropathy, or none] Allergies: [Drug and reaction, or none known] A1c target: [Such as 7.0% or below, or another target and the reason for it] Blood pressure target: [Such as below 130/80] LDL target: [Value in mmol/L or mg/dL, or a percentage drop] Glucose target: [Fasting range, or CGM time in range] Targets agreed: [Date, and with whom] VISIT TABLE One line per visit, oldest first. Put a dash where a test wasn't done. Units: LDL in [mmol/L or mg/dL], urine ACR in [mg/mmol or mg/g], weight in [kg or lb] Date · A1c % · BP · Weight, BMI · LDL · eGFR · Urine ACR [Date] · [A1c] · [BP] · [Weight, BMI] · [LDL] · [eGFR] · [ACR] [Date] · [A1c] · [BP] · [Weight, BMI] · [LDL] · [eGFR] · [ACR] [Date] · [A1c] · [BP] · [Weight, BMI] · [LDL] · [eGFR] · [ACR] [Date] · [A1c] · [BP] · [Weight, BMI] · [LDL] · [eGFR] · [ACR] GLUCOSE DATA Monitoring: [Meter, CGM, or none; the device, and how often] CGM, the 14 days before each visit, time in range 3.9 to 10.0 mmol/L or 70 to 180 mg/dL: [Date] · [In range %] · [Below range %] · [Wear time %] · [GMI or average glucose] [Date] · [In range %] · [Below range %] · [Wear time %] · [GMI or average glucose] Meter readings: [Usual fasting and after-meal ranges, and how many readings] CHECKS DUE Eye exam: [Date last done, result, next due] Foot exam: [Date, monofilament, pulses, skin, risk level, next due] Kidney: [eGFR and urine ACR, date last done, next due] Lipids: [Date last done, next due] Dental: [Date of last visit, next due] Other tests: [B12 on metformin, thyroid in type 1, or others, with dates] HYPOGLYCEMIA AND DRIVING Lows since last visit: [Number, lowest reading, time of day, likely cause] Severe lows: [Episodes that needed another person's help, with date and treatment] Awareness: [Feels lows coming on, or reduced awareness, and a score if used] Glucagon: [Prescribed, date, and who at home can give it] Driving: [Drives or not; glucose check before driving; what to do if low at the wheel; licensing rules and any report made] MEDICATIONS AND PROTECTION Diabetes medicines: [Each drug and dose, or the pump and its mode] Changes by date: [Date, drug, change, and reason] Statin: [Drug and dose, not indicated, or declined] ACE inhibitor or ARB: [Drug, dose, and indication, or not indicated] SGLT2 inhibitor or GLP-1 receptor agonist: [Drug, dose, and indication such as kidney disease, heart disease, or heart failure, or not indicated] Aspirin: [For established heart disease, or not indicated] Pregnancy planning: [Contraception and plans where relevant, and drugs to stop before pregnancy] Side effects: [Reported, and what was done] VACCINES, SMOKING, AND MENTAL HEALTH Influenza: [Date of this season's dose] Pneumococcal: [Vaccine and date] Other vaccines: [COVID-19, hepatitis B, zoster, or others due by age and current guidance, with dates] Smoking and vaping: [Never, former, or current; quit support offered] Mood and distress: [Tool, score, and date, such as PHQ-2, PHQ-9, or a diabetes distress scale] Support offered: [Counseling, peer support, referral, or none needed] SELF-MANAGEMENT AND SICK DAYS Patient's goals: [In the patient's words, with progress at each visit] Education and programs: [Topics and dates: lows, foot care, eating plan, carbohydrate counting, injection or pump skills; diabetes education, dietitian, or peer programs] Sick-day guidance: [Medicines to pause, glucose and ketone checks, when to restart, when to get help, date given] NEXT STEPS Due before the next visit: [Tests and referrals, and who arranges them] Next visit: [Date and type] Updated by: [Name, credentials, date]
Use it for
Each one follows the template. Use them to judge how much detail every part needs.
Family practice, updated at the October 2026 visit
58-year-old man, sales manager, drives for work. Type 2 diabetes, diagnosed March 2019 with an A1c of 7.2% and a fasting glucose of 8.1 mmol/L (146 mg/dL). Other conditions: hypertension since 2017; moderately raised urine albumin found in August 2025 and confirmed in November. No heart disease. Allergies: none known. Targets agreed with him on November 12, 2025: A1c 7.0% or below; blood pressure below 130/80; LDL below 1.8 mmol/L (70 mg/dL); fasting glucose 4.0 to 7.0 mmol/L (72 to 126 mg/dL).
Units: LDL in mmol/L with mg/dL after it; urine ACR in mg/mmol with mg/g after it. Nov 12, 2025: A1c 8.6% · BP 142/86 · 98 kg (216 lb), BMI 31.0 · LDL 3.4 (131) · eGFR 71 · ACR 4.8 (42). Feb 18, 2026: A1c 7.9% · BP 135/82 · 96 kg (212 lb), BMI 30.4 · LDL 1.7 (66) · eGFR 66 · ACR —. May 20, 2026: A1c 7.4% · BP 130/78 · 94 kg (207 lb), BMI 29.7 · LDL — · eGFR 68 · ACR 3.4 (30). Oct 28, 2026: A1c 7.1% · BP 127/76 · 93 kg (205 lb), BMI 29.4 · LDL 1.6 (62) · eGFR 69 · ACR 2.6 (23).
Meter, fasting, 3 mornings a week; no CGM. November 2025: fasting 8 to 11 mmol/L (144 to 198 mg/dL). February 2026: 7 to 9 mmol/L (126 to 162 mg/dL). October 2026: 5.5 to 7.5 mmol/L (99 to 135 mg/dL), from 36 readings.
Eye exam: last done March 2023, more than a year overdue when the sheet was reviewed on May 20, 2026. Referred that day; retinal photos on June 9 showed mild nonproliferative retinopathy in both eyes, no macular edema. Next due June 2027, then yearly. Foot exam: October 28, 2026; monofilament felt at every site on both feet, pedal pulses present, skin intact, no calluses; low risk; next due October 2027. Kidney: eGFR and urine ACR October 2026; next due April 2027, every 6 months while albuminuria is followed. Lipids: October 2026; next due October 2027. Dental: cleaning April 2026; next due now. B12 on metformin: November 2025, normal; next due November 2027.
Lows: none. Metformin and dapagliflozin seldom cause lows on their own, so no glucose check is needed before he drives. Revisit if insulin or a sulfonylurea is ever added.
Diabetes medicines: metformin 1000 mg twice daily; dapagliflozin 10 mg each morning. Changes by date: Nov 12, 2025, dapagliflozin 10 mg added for an A1c of 8.6% and albuminuria; same day, rosuvastatin 10 mg started, after he stopped atorvastatin in 2024 because of muscle aches. No changes since. Statin: rosuvastatin 10 mg, no aches; LDL 1.6 mmol/L (62 mg/dL), at target. ACE inhibitor: ramipril 10 mg daily since 2017, for blood pressure and now for albuminuria too. SGLT2 inhibitor: dapagliflozin, for glucose and to protect his kidneys; eGFR dipped from 71 to 66 at 3 months, as expected, and has held at 68 to 69. GLP-1 receptor agonist: offered in May for weight and as the next step if the A1c rises; he prefers to keep going with diet and walking first. Aspirin: not indicated, with no heart disease. Side effects: one genital yeast infection in January 2026, cleared with a cream from the pharmacy; hygiene advice given; none since.
Influenza: October 28, 2026. Pneumococcal: conjugate vaccine February 18, 2026. Other vaccines: COVID-19 per current guidance, October 2026; zoster, 2 doses finished in 2024. Smoking and vaping: former smoker, quit 2015; no vaping. Mood: PHQ-2 score 1 in November 2025, 0 in October 2026. Support: none needed; he says the falling numbers “make it feel worth it.”
His goal in November 2025: “Stay off insulin.” Walk 30 minutes at lunch on 5 days a week: met since March. Water in place of sugary drinks: met. Down 5 kg (11 lb) over the year. Education: dietitian visits in December 2025 and March 2026; foot care reviewed October 2026. Sick-day guidance given in writing when dapagliflozin started and reviewed in October: on a day of vomiting, diarrhea, or too little to eat or drink, hold dapagliflozin, metformin, and ramipril, and restart once he has eaten and drunk normally for a day or two. Get seen urgently for nausea, stomach pain, or fast breathing, even if his glucose is normal, as ketoacidosis can occur on dapagliflozin without high sugars. Hold dapagliflozin 3 days before any planned surgery.
A1c 7.1%, just above target, falling at every visit, with no lows: no change today. Due before the next visit: A1c in January 2027, ordered today; eGFR and urine ACR in April 2027; dental cleaning, which he will book. Next visit: January 27, 2027, in person. Updated by: family physician, October 28, 2026.
Primary care, shared care with the diabetes clinic, updated October 2026
24-year-old woman, veterinary technician, drives to early shifts. Type 1 diabetes, diagnosed at age 11 in 2013, with ketoacidosis at onset. The diabetes clinic manages her pump settings; this practice keeps the flow sheet and the yearly checks. Other conditions: none. Allergies: none known. Targets agreed on February 10, 2026: A1c 7.0% or below without frequent lows; CGM time in range above 70%, time below 3.9 mmol/L (70 mg/dL) under 4%, and below 3.0 mmol/L (54 mg/dL) under 1%; blood pressure below 130/80.
Units: LDL in mmol/L with mg/dL after it; urine ACR in mg/mmol with mg/g after it. Feb 10, 2026: A1c 8.1% · BP 116/72 · 64 kg (141 lb), BMI 23.5 · LDL 2.6 (101) · eGFR 118 · ACR 0.8 (7). Jun 2, 2026: A1c 7.6% · BP 112/70 · 64 kg (141 lb), BMI 23.5 · LDL — · eGFR — · ACR —. Oct 20, 2026: A1c 7.2% · BP 114/72 · 65 kg (143 lb), BMI 23.9 · LDL — · eGFR — · ACR —.
Insulin pump with CGM; automated mode started February 10, 2026, after years in manual mode. 14 days before each visit, range 3.9 to 10.0 mmol/L (70 to 180 mg/dL). Feb 10: in range 52% · below range 3%, with 1% below 3.0 mmol/L (54 mg/dL) · above range 45% · wear 94% · GMI 7.9%. Jun 2: in range 61% · below range 5%, with 1.5% below 3.0 · above range 34% · wear 91% · GMI 7.5%. Oct 20: in range 68% · below range 2%, with under 1% below 3.0 · above range 30% · wear 96% · GMI 7.2%.
Eye exam: September 2026, no retinopathy; next due September 2027, every 1 to 2 years while clear. Foot exam: February 2026; monofilament felt at every site, pulses present, skin intact; low risk; next due February 2027. Kidney: eGFR and urine ACR February 2026, normal; next due February 2027. Lipids: February 2026; next due February 2029. Dental: cleaning August 2026; next due February 2027. Thyroid: TSH February 2026, normal; next due February 2027.
Severe low on May 17, 2026, at 3 a.m., after a wedding where she danced for hours and had 5 drinks. At 1 a.m. she gave a manual correction of 4 units for a reading of 14.2 mmol/L (256 mg/dL), on top of what the pump was giving. Her partner woke to the CGM alarm and found her sweaty and confused at 2.4 mmol/L (43 mg/dL); she couldn’t swallow safely, so he gave nasal glucagon 3 mg. Awake and talking within 15 minutes; ate, and stayed home. Other lows: 3 or 4 a week in February and June, mostly after exercise; 1 or 2 a week by October. Awareness: Gold score 2; she feels shaky at about 3.5 mmol/L (63 mg/dL). Glucagon: replaced in May; her partner and a coworker know how to give it. Driving: the severe low was in her sleep, with a clear cause. Agreed in June: check the CGM before every drive, and don’t drive below 5.0 mmol/L (90 mg/dL) or on a falling arrow until treated; glucose tablets in the car; if low at the wheel, pull over, treat, and wait 40 minutes after recovering before driving on. The licensing authority’s rules on severe lows were checked: this episode didn’t need a report where we practice. She knows a severe low while awake would mean stopping driving until reviewed.
Diabetes medicines: insulin lispro by pump, about 36 units a day; automated mode. Changes by date: Feb 10, 2026, automated mode started with the diabetes clinic. Jun 2, 2026, after the severe low: the pump’s activity setting 1 to 2 hours before long exercise; no manual corrections after drinking; a bedtime snack on nights with alcohol. Oct 20, 2026: no change. Statin: not indicated at her age, with no eye or kidney disease; revisit at 30, or sooner if either appears. ACE inhibitor or ARB: not indicated; blood pressure and urine ACR normal. SGLT2 inhibitor or GLP-1 receptor agonist: not used. Aspirin: not indicated. Pregnancy planning: hormonal IUD since 2024; hopes to have a child in 2 to 3 years. Advised to plan it with the diabetes clinic first, aiming for an A1c below 6.5% without lows before trying, and folic acid from 3 months before. Side effects: skin irritation at infusion sites, better with site rotation.
Influenza: October 20, 2026. Pneumococcal: conjugate vaccine February 10, 2026. Other vaccines: COVID-19 per current guidance, October 2026; HPV and hepatitis B finished as a teen. Smoking and vaping: never. Mood and distress: Diabetes Distress Scale, 2-item version, 8 of 12 in June, after the severe low; she was afraid to sleep alone on nights her partner works. Referred to the diabetes clinic’s social worker; 4 sessions. Score 5 of 12 in October. PHQ-2 score 1.
Her goal: “I want to stop thinking about my sugar every hour.” Time in range above 70%: 68% in October, close. No more severe lows: none since May. Swimming twice a week with the activity setting: started in July. Education: carbohydrate counting refresher with the clinic dietitian in March 2026; alcohol and exercise plan in June. CGM sharing set up so her partner’s phone gets her urgent-low alerts when he works nights. Sick-day guidance reviewed in June: never stop insulin; check glucose and blood ketones every 2 to 4 hours; for high glucose with ketones, give the correction by pen and change the infusion set; go to the emergency department for vomiting with ketones, or blood ketones of 3.0 mmol/L or more. Ketone strips in date.
Time in range 68% and A1c 7.2%, both better, with no severe low in 5 months. No setting changes today; the diabetes clinic reviews her pump data in January. Due before the next visit: A1c, eGFR, urine ACR, and TSH in February 2027. Next visit: February 2027, in person, with the yearly foot exam. Updated by: nurse practitioner, October 20, 2026.
The diabetes type, and the agreed targets every result below is read against.
Avoid: One target for everyone. An older adult with frequent lows may need a looser A1c goal; write the reason beside it.
One line per visit, so the trend shows at a glance next to each medicine change.
Avoid: A number with no unit. An LDL of 2.4 and an LDL of 93 can be the same result in mmol/L and mg/dL.
Meter or CGM results by visit. For people on insulin, they say more than the A1c.
Avoid: Quoting time in range without wear time. If the sensor was worn for less than about 70% of the 14 days, the figures may mislead.
Each periodic check, with the date last done, the result, and the date next due.
Avoid: Writing only the last date. Add the next due date, so an overdue check stands out the next time the sheet is opened.
Lows since the last visit, awareness, glucagon, and the driving advice given, for anyone on insulin or a sulfonylurea.
Avoid: “No lows” with no question behind it. Ask about lows overnight, at work, after exercise or alcohol, and while driving.
The diabetes medicines, each change with its date and reason, and the drugs that protect the heart and kidneys.
Avoid: Listing medicines with no indication. Write why each protective drug is there, or why it isn’t.
The prevention items that slip between busy diabetes visits.
Avoid: Screening for depression and missing distress. Diabetes distress is common, shows up as burnout with self-care, and needs its own question.
The patient’s goals, the education they’ve had, and their sick-day plan.
Avoid: Sick-day advice given once and never revisited. Review it whenever a drug that needs pausing is started, such as an SGLT2 inhibitor.
A date in the past doesn’t say what is overdue. Write the next due date beside every check, so a missed eye exam shows at the next visit, not years later.
An A1c is an average. In someone on insulin it can look acceptable while lows hide underneath. Record time in range and time below range beside it.
For anyone on insulin or a sulfonylurea, ask about lows at every visit, including overnight and at the wheel, and record each severe episode and the driving advice given.
A good A1c doesn’t mean care is complete. Check the statin, the ACE inhibitor or ARB, and an SGLT2 inhibitor or GLP-1 receptor agonist against each patient’s indications.
Tests from a hospital, a specialist clinic, or another lab belong in the table too. Without them the trend has gaps, and tests get repeated.
Vero Scribe writes the flow sheet entries in your template from the visit, with the patient’s consent, or from your dictation. You review and edit every section, then copy it into your record or export it to Word or PDF. Vero works in 60+ languages.
A running record for one person with diabetes. It holds the agreed targets, a line of results for every visit, the yearly checks with their due dates, and the medicines that protect the heart and kidneys, so anyone on the team can see the trend and what is due before the visit starts.
The diabetes type, date of diagnosis, and targets; A1c, blood pressure, weight, BMI, LDL, eGFR, and urine albumin-to-creatinine ratio by visit; CGM or meter data; eye, foot, kidney, lipid, and dental checks with due dates; lows and driving; medicines and changes; heart and kidney protection; vaccines; smoking; a mood or distress screen; self-management goals; and sick-day guidance.
An A1c about every 3 months while treatment is changing or above target, and about every 6 months once stable at target. Blood pressure at every visit. An eye exam every 1 to 2 years when there is no retinopathy, and at least yearly when there is. A foot exam and kidney tests at least once a year. In adults with type 1, eye and kidney screening usually start 5 years after diagnosis. Follow current guidelines where you practice.
A follow-up note records one visit: the history, exam, and decisions. A care plan sets goals, roles, and an action plan across several conditions. The flow sheet is the running table between them: it shows each result against its target over time, and which checks are due, so the visit note can focus on what to change.
Use the 14 days before each visit. Record time in range, 3.9 to 10.0 mmol/L (70 to 180 mg/dL), with a target above 70% for most adults; time below 3.9 mmol/L (70 mg/dL), under 4%; time below 3.0 mmol/L (54 mg/dL), under 1%; wear time, ideally at least 70%; and the glucose management indicator.
Yes. Copy it, or download it as a Word or text file. No account needed.
The preventive visit: interval history, screening and vaccines due, full exam, and counseling.
The Medicare AWV, G0438 and G0439: health risk assessment, cognition, screening schedule, risk factors, and the prevention plan.
The one-time IPPE, G0402: history, depression and safety review, exam with visual acuity, end-of-life planning, and the written plan.
The standing summary at the front of the chart: problems, history, medications, allergies, immunizations, risks, and reminders, kept current.
Screening, vaccines, and counselling due at an adult periodic health review, by age and sex, with a next due date on every line.
Longitudinal context, complex visits, and specialty notes for diabetes care.
Chronic disease reviews and visit notes, drafted from the visit for you to check.
Goals, targets, and team roles for patients with two or more long-term conditions.
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