I know that we already have a pizza thread, but when on it, we have veered is many different directions, so the info that i have been looking for i have not found. so here goes:
i would like to eat 2 slices of regular cheese pizza. NYC style. not the stuff you make at home. not the thin crusted pies. just the kind you find in a pizza joint from a hot oven. not a brick oven style. just a regular, old fashioned pizza pie.
with that said, i have been experimenting for several years now and have been unable to figure out how to bolus for 2 slices and have something resembling a flatline. in the past, and i am on a pump, i have always used a dual bolus, but it has been dificult to figure how much insulin to give up front, and how to bolus for the extended period. also, how many hours should i be bolusing for. tomorrow, my husband and i are going to our most cherished pizza joint in Brooklyn NY, called Fascoti’s. (if you are ever our way, this is the place to go.)
i am going to try a 40/60% split over 2.5 hours, bolusing for coverage of 80 grms of carbs for 2 large slices. i dont use a dexcom, so i will have to do multiple finger sticks.
for all of you out there who love to enjoy pizza, please open up your mouths (LOL) and chime in. i think that pizza is an all time classic meal that gives many of us at FUD challenges. lets share our experiences here.
all the best, and i look forward to hearing back from you. thanks, DM
Assuming 1 slice = 35 grams (he usually eats only 1 slice, but sometimes 2), we use the Extended Bolus feature. 25% up front and the other 75% over the next hour. In addition to this, we have a Temp Basal created that gives him 95% more basal over the next 3 - 4 hours.
The extended bolus + the Temp basal for slow acting foods such as Pasta work best for us because these methods provide flexibility to suspend either of them in the event his body decides it wants to be someone else’s body for the day and totally not act like it typically does with this food.
YDMV and there are probably a million ways of bolusing for slow-acting foods, but this is what works for us (right now.)
i dont know which pump you use. i have the Medtronic Paradgm. when i do a TB, if i wanted to raise my basal rate by ten percent, it would give me a TB of 110%. if i were to give myself 195% i would crash six feet under. am i understanding you correctly? 195% seems very dramatic. do you mean you add 5% extra as a temp Basal rate?
wow. thats a large increase. how did you come up with your formula? how long did it take to figure this out? i know its all trial and error, and that YDMV, but i am very curious.
A million and one, because here’s mine: Assuming 1 medium slice (thinnish crust, sorry!) = 30 g, and usually eating 2 slices but sometimes 3, 60/40 over 3 hours.
When I have a leftover slice for breakfast, I don’t need an extended bolus.
Many many months of failed tests and experimenting with lots of different methods. This is how we came to this formula working best for us.
Pizza is a SEVERE SPIKE so although doubling the basal may sound like a lot, it’s not so much if you consider the havoc pizza wreaks on the BGs - at least in Liam’s case.
At this stage in Liam’s life we would NEVER consider eating pizza for breakfast. This is the time of the day where he spikes the worse so pizza, for him, would result in an over 400 BG.
i am assuming the same carb count, but i plan on doing eric’s measuring of the double bolus trick. i plan on eating 2 slices and bolusing for 80 - 85 gms of carbs. i can always suspend the extended bolus if i have too much IOB.
Bottom line is…I think universally, some foods just require a lot of experimentation, failing and continuing to experiment until you find the right equation for you and your body. This is for most foods, but slow-acting foods especially (at least for Liam).
It’s either that or just don’t eat some foods (which is also an option)…low/no carb.
Ours is a little one, so it may not be as relevant to you. But we basically bolus for something like 40%-50% of the carbs up front, then wait another hour and and a half or until he’s gone up and down and is starting to plateau, then give the remainder. He usually eats around 30 grams of carbs worth of pizza, so that’s about 0.6 units (enough for 15 grams or so) up front, then wait an hour or two, another 0.6 units, then wait another hour or so, and another 0.6 units. It takes more insulin total than the carb count alone would predict.
The other thing we do if it’s over night is we log “fake” carbs throughout the night, so that the openAPS system can give high temp basals. But if we didn’t have this my guess is we’d just set a temp basal for four to six hours equal to twice his normal rate.
for us pizza doesn’t cause a severe spike so much as HOURS and HOURS hovering in the low 200s unless we log fake carbs and bolus more than you’d think necessary.
I wore a CGM for a week and noticed that pizza caused my BG to be elevated all night long too. So I think this is just a feature of pizza.
although not on every time, this has happened to me too. what is it about pizza that creates such havoc in our BGs? is there some secret ingredient that we do not know about?
my theory is that it’s some combination of the high fat+ high carbs. The carbs cause the spikes but the fat makes absorption extra extra slow. Just my thoughts though, I have no idea if that’s correct. Either way, pizza is delicious. Knowing that it causes a BG elevation has made me eat it more sparingly, but I could never give it up altogether.
i want my cake and eat it too!!! 
