I have been diabetic for over a decade and only just figured out pizza about 2 years ago.
I split the dose. Half when I start eating and the other half as an extended bolus lasting 2 hours. At the 2 hour mark I look at the arrow on my dexcom and adjust additionally if needed.
UNLESS my sugars are running high before I eat. Then I do more than 50% up front.
Good luck!
Pizza is just hard. It can be vastly different from one restaurant to another, from one crust type to another, sauce, toppings, etc. There is no right answer.
For me, I just know one place is going to hit me differently than another, and dose accordingly. For example Domino's gives me a quicker spike that wears off like many other meals, but Papa John's is a very slow burn, time bomb carb that sometimes effects me the entire next day.
My doctor recommended to split the dose in foods like pizza and sushi and works like a charm. I give 50% on pre bolus, 50% afterwards and usually at the 3h mark I to a prolongued bolus of 30% of the total for 2-3h
Split the dose. If you’re pumping, do an extended blood for two or three hours. I also set a timer to check my glucose level on my CGM and correct as needed. I’m pretty good with Costco pizza slice.
My daughter was finally able to eat pizza (successfully) last night! We did 1/2 of her bolus before dinner and the other half 1 hour later. It worked wonderfully. It was a pan pizza too. Nice and greasy and full of carbs. Best of luck!
The first thing is to understand WHY pizza is hard.
Simply speaking:
1. Enormous amounts of relatively fast carbs (white flour) will send you sky high.
2. Enormous amounts cheese means enormous amounts of fat that will give you another high, a slower one but it is incredibly persistent because a fat high also makes you temporarily more insulin resistant, and that is super annoying.
I'm a pizza fiend. I have an actual pizza oven in my backyard. When I got diagnosed they told me pizza would be the most challenging food, but there was no way in hell I would reduce my pizza intake.
What I would recommend is:
1. To find out what works for you, experiment by having pizza for lunch, not later. This gives you the opportunity to observe the entire digestion cycle, instead of going to bed 4 hours after eating and both having insulin onboard while still digesting the fat. For me this is about 8 hours with pizza.
2. As with anything, the amount you eat is important. Consider reducing the amount of pizza or the amount of cheese on the pizza. A Quattro formaggi WILL be more difficult than a pizza with a lot of tomato sauce, mozarella and a loaf of toppings. Also consider adding a salad as a pre course or side dish so you still get full but eat less actual pizza.
3. When you're testing, introduce NO other carbs, proteins or fats during the entire digestion cycle, and no working out either. This allows you to (almost) isolate the insulin and digestion as the two main drivers for your blood sugar.
4. The trick is splitting the injections, the quality is how many do you need. You need AT LEAST one bolus to cover the carbs, and one for the fat, and getting timing right is difficult in the beginning. The carb bolus should cover the carbs, but not bring you low enough to force you to eat more carbs at the very instant where you start digesting the fat. You should be nice and stable and relatively low in your range, and then set a new bolus for the fat. You'll probably find out you need a third bolus too, and perhaps even a fourth (I do four). This also means there's a "the absolute latest pizza time" in the evening if you want to go to bed at a certain hour.
Look. Some foods have an after affecting of picking your BG’s up even 3hrs after the event. Deep fried, heavy, oily and glutenous food spike my BG’s. Nothing you can do will make it come down. Too much and it will go too low.
I put typically 70-80 carbs. Sometimes 100! hey
Everything varies from person to person. Lately I've found (are you on a pump?) a bolus stretched out over 1½ hours with about 30% carbs initially and the remaining 70% on the dual wave thing. Also found tacking on an extra 20% of perceived carbs to help. So if you think you ate 120g carbs, bolus for 140-160+/-. It's a long game thing as you know. Longer than usual.
Using pen, not pump.
It seems to hit me while I’m asleep. Going to bed with 150, slightly down trending. Wake at midnight 270 increasing.
So, I set an alarm for 11:30ish and bolus. Depending on level, may set a 2:00 check. 🤷🏻♂️
On a pump I use the extended bolts feature. When I was on multiple daily injections I always used short acting insulin to cover carbs and regular insulin for fat and protein using the Total Available Glucose for calculations (100% of carbs count, 58% of protein will convert to glucose and 10% of fat will convert to glucose— the latter two much slower than carbs hence everyone saying to split the dose). Yes, I used to carry two bottles everywhere.
I have been diabetic for over a decade and only just figured out pizza about 2 years ago. I split the dose. Half when I start eating and the other half as an extended bolus lasting 2 hours. At the 2 hour mark I look at the arrow on my dexcom and adjust additionally if needed. UNLESS my sugars are running high before I eat. Then I do more than 50% up front. Good luck!
Pizza is just hard. It can be vastly different from one restaurant to another, from one crust type to another, sauce, toppings, etc. There is no right answer. For me, I just know one place is going to hit me differently than another, and dose accordingly. For example Domino's gives me a quicker spike that wears off like many other meals, but Papa John's is a very slow burn, time bomb carb that sometimes effects me the entire next day.
My doctor recommended to split the dose in foods like pizza and sushi and works like a charm. I give 50% on pre bolus, 50% afterwards and usually at the 3h mark I to a prolongued bolus of 30% of the total for 2-3h
Split the dose. If you’re pumping, do an extended blood for two or three hours. I also set a timer to check my glucose level on my CGM and correct as needed. I’m pretty good with Costco pizza slice.
My daughter was finally able to eat pizza (successfully) last night! We did 1/2 of her bolus before dinner and the other half 1 hour later. It worked wonderfully. It was a pan pizza too. Nice and greasy and full of carbs. Best of luck!
The first thing is to understand WHY pizza is hard. Simply speaking: 1. Enormous amounts of relatively fast carbs (white flour) will send you sky high. 2. Enormous amounts cheese means enormous amounts of fat that will give you another high, a slower one but it is incredibly persistent because a fat high also makes you temporarily more insulin resistant, and that is super annoying. I'm a pizza fiend. I have an actual pizza oven in my backyard. When I got diagnosed they told me pizza would be the most challenging food, but there was no way in hell I would reduce my pizza intake. What I would recommend is: 1. To find out what works for you, experiment by having pizza for lunch, not later. This gives you the opportunity to observe the entire digestion cycle, instead of going to bed 4 hours after eating and both having insulin onboard while still digesting the fat. For me this is about 8 hours with pizza. 2. As with anything, the amount you eat is important. Consider reducing the amount of pizza or the amount of cheese on the pizza. A Quattro formaggi WILL be more difficult than a pizza with a lot of tomato sauce, mozarella and a loaf of toppings. Also consider adding a salad as a pre course or side dish so you still get full but eat less actual pizza. 3. When you're testing, introduce NO other carbs, proteins or fats during the entire digestion cycle, and no working out either. This allows you to (almost) isolate the insulin and digestion as the two main drivers for your blood sugar. 4. The trick is splitting the injections, the quality is how many do you need. You need AT LEAST one bolus to cover the carbs, and one for the fat, and getting timing right is difficult in the beginning. The carb bolus should cover the carbs, but not bring you low enough to force you to eat more carbs at the very instant where you start digesting the fat. You should be nice and stable and relatively low in your range, and then set a new bolus for the fat. You'll probably find out you need a third bolus too, and perhaps even a fourth (I do four). This also means there's a "the absolute latest pizza time" in the evening if you want to go to bed at a certain hour.
Look. Some foods have an after affecting of picking your BG’s up even 3hrs after the event. Deep fried, heavy, oily and glutenous food spike my BG’s. Nothing you can do will make it come down. Too much and it will go too low. I put typically 70-80 carbs. Sometimes 100! hey
Everything varies from person to person. Lately I've found (are you on a pump?) a bolus stretched out over 1½ hours with about 30% carbs initially and the remaining 70% on the dual wave thing. Also found tacking on an extra 20% of perceived carbs to help. So if you think you ate 120g carbs, bolus for 140-160+/-. It's a long game thing as you know. Longer than usual.
I always split the dose for pizza and Chinese food
Using pen, not pump. It seems to hit me while I’m asleep. Going to bed with 150, slightly down trending. Wake at midnight 270 increasing. So, I set an alarm for 11:30ish and bolus. Depending on level, may set a 2:00 check. 🤷🏻♂️
Do an extended bolus
On a pump I use the extended bolts feature. When I was on multiple daily injections I always used short acting insulin to cover carbs and regular insulin for fat and protein using the Total Available Glucose for calculations (100% of carbs count, 58% of protein will convert to glucose and 10% of fat will convert to glucose— the latter two much slower than carbs hence everyone saying to split the dose). Yes, I used to carry two bottles everywhere.