Pizza

Mum of type 1 said:

Hi! I was just wondering if anyone can tell me what is the deal with pizza??? My DD has had it three times at night around 8 for dinner. Her levels go down and then sky high steadily at 02.00 nightime. This is homemade white and wholemeal dough. Is it the fat in the cheese and bacon that releases the sugar slowly and later on? But if so, why doesnt a piece of bread with cheese and and some bacon do the same during the day?
Thanks!

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You don't mention the timing and the amount of insulin which will have a bearing on this reaction...?

Pizza is renown to be a challenge to dose for - it is the high carbs and high fat. Unlike bread, pizza dough contains fat so the fat content is higher.
If your daughter feels pizza is worth the effort (and I believe it is), a bit of trial and error with split dosing will help with the late peak.
I find I need a little more insulin than I think due to car counting, take half just before eating the pizza and the other half an hour or so later (this is easier with an insulin pump). We are all different so it will require some trial and error ... which is a great excuse to eat pizza more often

Mum of type 1 said:

There is a 100gr pizza= 30 gr carbs. So she takes 1/18 ratio= so she takes 1.5 doses of humalog pen pre meal. So we cant split the dose. If she takes more insulin she will go too low in half an hour, if she takes 1.5 she goes low but ok and then high after 5-6 hours. The way i see it is a real low dose for the meal but she will need corrections later on. Or having it for breakfast? Where she will be mor active during the day?

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I would be tempted to delay all insulin if her dose is so low. Maybe take it an hour after eating.
As I said earlier, it is trial and error because, like pizzas, we are all different.

I would say that eating it so late is a no no. If I embark on pizza it has to be during the day so I can knock it into submission before bedtime. It is definitely a trial and error thing. Your daughters low doses make splitting harder but it could be she also needs slightly more over a longer period. (I now do 3 injections, each an hour apart). Working it out definitely needs to be done during the day.

Hi,

The only time classic pizza works for me. (On the odd occasion.) Is after a gig at 1am with a v late basal shot, an upfront bolus. & acompanied by a few shots of vodka & diet coke.

I kid you not..

Pizza and pasta I love them both but it’s taken me ages to be able to eat them without having the same results as you, I now take my insulin two hours after I’ve eaten them it certainly stops the big spike hours after eating , it’s definitely trial and error but so worth it when u get there

@Mum of type 1

I love a slice or 2 of pizza, but I wouldn't eat it so late, because i'd want to correct before bed to save myself rising into high numbers, it's best eaten 3-4 hours before bed so you can see exactly what the insulin reaction is and then correct before bed so you can wake in range.

Pizza is well known for giving us type 1's hell, the fat delays the carb absorption which is why we feel the pain 3-4+ hours later, however I can manage pizza fine if I only have a couple of slices and split my bolus, however with your daughter i'd approach it with caution, I have had pizza before then gone hypo after eating it and then hyper hours later which is why 2 slices is my limit, it's not worth the hassle testing the split bolus system on more than that unless you're competent with insulin and comfortable in testing the boundaries of insulin management, particularly with a little one.

Mum of type 1 said:

Thank you for your reply and for explaining what happens. I read its called the pizza effect. She has only 2 slices with alot of salad and like you said she has gone pretty low and was high while asleep after 5 hours of consumption. Like you said, a small amount and lunchtime maybe. I havent been advised to split the bolus though..

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Hi,

I feel my advice above which seems to work for me fits well with the odd night of "rock & roll" lifestyle. (I also seem to be more insulin sensitive in the latter part of the day, even when my basal should have been sloping off?)
I like to be at optimum BG levels when performing as a singer in a live band.

So the the simplest explanation I can give with what seems to work for me, is bolus up front for the pizza would be covering the late basal long after the previous tail off. Then by the time the late basal shot kicks in the Novorapid is also not quite done..
The alcohol?? Retards morning liver dump.

A later bolus could well help your DD. Though testing & keeping a close eye on BGs is key.
Or you could ask your HCP regarding split bolusing..

Does your kid use a sensor?

Mum of type 1 said:

What we do here?( Other European country)...

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It would help if you name the "European" country as it will be a guessing game as there are a shed load of countries there.