So, I know it's different for everyone, but nothing seems to consistantly work for me, so I'm hoping I can get some advice.
I work 9.3 miles from my house, and bike to work. I ususally work at 9, so I start biking at 7:50, and get there around 8:45. It seems like no matter what I eat before I leave, and what my fasting BS is, I end up at 150 or so by the time I get to work. Then, without correcting, I usually come down about ten points an hour over the next four/five hours. Then, I leave work, and regardless of whether I eat, I end up low - sometimes on the ride, sometimes when I get home, and sometimes hours later. To make matters worse, I work at a rock climbing gym, which means while i'm at work, I'm dealing with a roller coaster of adrenaline and exercise...
I'm frustrated with how impossible it is to get perfect blood sugars, and I'm frustrated with how lethargic I feel when I'm above 150, and how much of a wreck I am when I'm low, and how even though I'm doing this bike ride 4-5 days a week, it isn't getting any easier.
I'm the same way when I exercise, always unpredictable as to how my sugars are with exercise, but 9 out of 10 times I end up going low but not until a few hours later. You said you drop 10 points an hour at work..are you testing every hour or do you test 5 hours later and do the math? Also, are you eating while at work? If you are, is it a little bit every so often or just once for lunch then again before going home? Sorry for all the questions I just wanted to get all the details so I can get a feel for whats going on.
In the meantime I would say to eat continuously throughout your shift, and eat foods high in protein to help keep your sugars stable. Try to eat something on your ride home as well. If you need to eat before your trip do that too but it seems like you need a little something extra to keep you going and prevent the lows after you get home.
How long have you been working at this job and riding your bike there? If it's only been a short time and you've been having this problem since the beginning, then I might have a suspicion, especially if what you were doing before was not quite as strenuous.
I get the feeling that your daytime basal rate, whether it's taken by long acting injection or by pump, is way too much for the kind of strenuous activity you're doing now. Basically what you're describing is a situation where your blood sugar drops all day except for the 150 when you arrive at work. The 150 is very likely a result of a "dawn" effect where your blood sugar rises upon awakening in the morning.
To cover the dawn effect, you may try to increase your basal rate between 6 and 8 (or 9). Then drop it considerably for the rest of the day... perhaps for the next 12 to 14 hours, so that your blood sugar doesn't fall all day long. You would need at least three very different basal rates. One for the overnight from say 10PM to 6AM, one to cover the dawn effect from 6AM to 8AM, and one for the rest of your work day day from 8AM to 10PM. This could probably be done with injections as well, but I was thinking along the lines of a pump.
Also, except for your meals, try covering your lows with something like glucose tablets or liquid, where you know exactly how much one tablet will drop your blood sugar. I don't think you'll need too many if you get the basal rate corrected however.
Actually, I have heard a lot of people go higher with exercise because of adrenaline and stress. Some people that I know who are on pumps have to turn their basals up a bit during exercise and then put a temp basal for a couple of hours later.
There are no perfect blood sugars so don't beat yourself up. You can do all of the right things and actually, you can do the same exact thing everyday but, your numbers will never be the same. You should try contacting your doctor because it sounds to me like you may need some sort of adjustment.
I'm testing every hour, at least roughly. I usually don't eat while I'm at work. Sometimes I will eat a peanut butter granola bar, which is protein-y, but usually I don't have anything until just before I leave.
I've been working this job about a month, and the increased activity has definitely changed my insulin sensitivity. I went from needing 23u of Lantus to needing roughly 19, and my carb ratio has gone from 1:8 to roughly 1:10. I'm on MDI until september, so I can't do different rates at different times of day. I usually cover lows with fruit snacks, but they seem to raise my blood sugar different amounts every time I use them. I'll start paying more attention so I get a better feel for how much they'll raise it.
I'm also thinking that the high when I get to work might be caffeine related, so I'm going to start comparing days with coffee to days without.
Thanks for your thoughts about what might be going on!
you should eat constantly throughout the day and a bigger meal before you leave. and it should be without bolus to prevent lows. my blood sugar is unpredictable because my excercise is varies day to day. i figure skate so some days i work on stroking(heavier) and other days i spin(lighteer work) but i always take my pump off because if i fall, it will break. some days, if i work on stroking, i will go high or low and its unpredctable. swimming is very preditable though, it always goes down from the high i have in the mornning to just above my target, and it comes down to normal quickly without lows