So far I have the same terrible experience many have had with Pizza. My solution is that i have found McCain Thin Crust pizza (here in Canada) is a frozen variety that tastes amazing, but the entire pizza (about 10" dia.) is 60g carbs, and they don't pack the cheese on so I have found that it acts more like a regular meal then other pizza's. I stick to take and just take my insulin as per usual and don't have any issues.
For take out pizza, i always get thin crust, and have them go light on the cheese to lower the fat contant, and usually it doesn't do the normal 'pizza thing' discussed here.. Sadly, i find it helps to get it from a well known chain that publishes their nutritional information online, that way i can bolus correctly, small mom and pop shops tend to have better pizza, but things can go so wrong with those places, so i avoid them...
McDonalds is a place i haven't eaten at in over a decade.. :/ but other fast food places i just bolus whatever I normally do for that meal and ignore the fat content and its been working out fine so far, but that's for veggie burgers and fries, not sure what the meat will do lol