Pizza

[onlytwintip]

Hi,

I've been a type 1 for about 8 years and on a pump for 7 of those. I tend to manage my diabetes quite well (last hbac1 was 5.8 ) and also don't really limit myself on what I can eat (as long as i put the insulin in to balance out). There is one food though that I have never been able to balance out very well at all - Pizza. I've tried various different things, like a squared bolus (for pumpers) and then increasing my basal rate post-meal but truth is my BG will sontinue increasing for about 5 hours post-meal and I will always end up pretty high!
Have any of you managed to tackle the Pizza phenomenon? If so, could you share your skills?

Cheers,

Harry

 

[Fallenstar]

Hi Harry
Pizza is a total no no for me, as it does with you, it just keeps on raising my BG for hours afterwards. well into thew late 20's. I used to love pizza it was my favorite meal out previous to Diabetes and in the early days of Diagnosis.
To be honest I just never eat it because even the thought of it makes me feel ill now because I know how I will feel a couple of hours after having it....
This is with dose adjustment too...I need to be on an insulin drip after eating a whole one.
Good luck I hope you find a way to eat it

 

[wsmum]

This is a very timely subject ... my 14 year-old son (T1 on MDI), has just started weekly boarding. His control has been really good for the 3 weeks he's been at school, until this morning when he woke up at 18. The school rang me to discuss, and it turns out he and his friends sent out for a late night pizza ... In the past, he has injected 50% of the bolus before his pizza, and 50% about 1.5 hours later which has kept numbers reasonably under control. Last night he just did the whole bolus at the beginning and went to bed. So I think, unless he can do a split dose, pizza is off the menu :-(
However, as you're on a pump, you're already effectively doing a split dose ... Not sure if this might help, but a tip he got from another T1 was that you might need more insulin (ie. more than your usual ratio) for very carby meals. The formula suggested was: use your usual ratio for carbs (per meal) up to the number of kilos you weigh. If you go above that, you need to add a third as much again. So, if you weigh 60 kilos your usual dose should handle up to 60 carbs, but for anything above that, use your usual dose plus a third. William has tried this with some success so it might be worth a go ... but with the usual caveat that with diabetes, no two individuals are the same!

 

[wsmum]

Just found this thread on the insulin pump forum which gives lots of advice
viewtopic.php?f=14&t=19874

 

[moonstone]

And please note when you go to Italy and have actual, real pizza, it's made with a much thinner base and contains probably only about half the carbs you're expecting. As I recently discovered. Twice........! Just to be sure.

 

[onlytwintip]

Thanks for the advice and I will definitely give that 1/3 extra thing you suggest wsmum. I guess I'll keep attempting to tackle this pizza obstacle.

And moonstone - Completely agree, went to Italy for a week's holiday this summer and the pizza's there were much thinner and easier to handle insulin-wise.

Cheers,

Harry

 

[dot]

My son finds pizza difficult too, but still eats it!

It seems to be very slow for the carbs to cross over to his BS so if he does his injection with his dinner, he will often go low within an hour or so - guessing that the high fat content is delaying the sugar uptake. If he then takes some glucose to counteract that, and then the pizza kicks in, he will be sky high in the morning.

Not an easy one.

 

[andyjc]

Pizza is the ONLY food i ever use the multiwave setting on my pump for , and stertch it out for about 4 hours .
While i'm on here , does anyone else find that the if you add up your carbs using carbs and cals book , you end up being hypo ?, which really makes it difficult to accurately asses what you're having .

 

[quicktony]

I'm on and Animas pump and pizza is always a hard one. My pump rep has developed an thing he called "Pizza bolus" which splits the bolus dose 50/50 and then retest 2 hours later and correct with the easyBG option. you may go high for a short time but sometimes its ok. I use the same plan for indian food which is hard to count aswell, (there is always a lot of sugar in a curry, even the hot ones)

 

[Ausra]

I haven't had pizza since I was diagnosed..I just think about pizza and something doesn't feel right...but it does taste very right!

 

[phoenix]

Pizza is the ONLY food i ever use the multiwave setting on my pump for , and stertch it out for about 4 hours .
While i'm on here , does anyone else find that the if you add up your carbs using carbs and cals book , you end up being hypo ?, which really makes it difficult to accurately asses what you're having .

Pizzas do vary a lot , very thin ones are not as high a you might expect. You might be able to find the carb count of the one you're eating online. I don't eat them out (didn't eat them much before diagnosis) but occasionally have half of one at home with a salad. (Usually add a few extra mushrooms, tomato and a bit more cheese) The ones we buy, having scoured the labels, rejecting all the ones that are very high, have about 42g carb in half so not too bad for a lunch.

 

[AndyS]

Oh yes I know the Pizza effect very well.
As with many I also more or less avoid it but when I do have it I tend to go for a split dose for 2 reasons.
First off most pizza tends to be pretty heavy with the carbs, except proper italian pizza.
Second the cheese etc seems (to me at least) to really slow down the absoption.

When I have just done a single bolus I have noticed that sometimes by BG will actually dip and then bounce back later and go high. The 50/50 split, usually waiting around 30 minutes after the meal, seems to take that peak off for me but doesn't get rid of the post pizza highs completely.

/A

 

[Grazer]

I'm not on insulin so can't comment on that, BUT, i did have a big pizza issue. Any type of pizza, even thin home made with rye flour, sent me through the roof with BG. Now, I've discovered Carbalose low-carb flour (sorry if that sounded like an advert!) So I make my own pizzas with it, and instead of BG's of 12 or so, I stay at about 6. In other words, doesn't really affect me at all. Not as good as the real thing, but not bad. Have to use a slightly lower temp. in the oven, and cook a little longer, but at least I can eat pizza (of sorts!) with impunity, whenever I want. By the way, it makes great suet pastry for pies, (better than the pizza base in fact!) and again no BG rise at all for me.

 

[Beav]

Just have it as a one of treat. Say 1 / 2 times a week. Pizza is not good for you diabetic or not diabetic

 

[the_exile]

Never had a problem with Pizza at all, although I don't have cheese on mine as I hate the stuff, maybe that's something to do with it?

 

[Cheryl]

I multiwave bolus for pizza & also for pasta if I have a pesto type sauce on it.

However, I also find that I have to increase my insulin to carb ratio for pizza.

Example:
1/2 Dr Oetker frozen pizza is 44 grammes of carb. I will also have a yoghurt at 17 grammes of carb.

Normally, I apply 1u insulin to 12 grc so for the 61 grammes in the meal would have 5 units of insulin.

BUT for pizza I then add another 1 unit of insulin over 90 minutes with the multiwave bolus. I guess that it's similar to doing a temp basal of 200% for 2 hours with a standard bolus (at my basal rate), but I find that I need about 20% extra insulin for the carb content than usual, delivered over a period of time.

Works for me

 

[Debloubed]

I am the same as most of the posters, have tried multiwave bolus and extended bolus on my pump and I just can't get it right! I actually don't eat a lot of shop bought pizza for this very reason and can't remember the last time I had a pizza delivered as the lack of BG control annoys me too much, lol! I tend to make my own and use a really thin pizza base (there is a new Warburtons Thin on the market which is thin and tasty when baked, FYI!) and then less cheese and less oil, etc. But that is my preference. Top recipe tip whilst on the subject, cream cheese in place of grated, tinned toms, red onion, red peppers and mushrooms on the Thin base then bake for 10-15 mins - yum!