27 posts were split to a new topic: Moose, blowtorches, kitchen gadgets and us
Yeah, falling asleep while still balancing food intake really sucks, doesnāt it? It makes me want to eat dinner earlier, but eating around 8pm is a habit that is too hard for my wife and me to break.
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Same hereā¦ You would think it would be a pretty simple adjustment to make in oneās life but it certainly doesnāt seem to work that way
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We are also trying hard to move dinner times up. But we also find it difficult.
For us there is an added benefit: if we get an evening hormone peak before dinner, then dinner may be postponed by 2-3 hours, sometimes till 10 or 11pm (since we always wait until my sonās BG is in range and with dinner IOB activating)
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My parents like to eat dinner at 4:30ā¦ so I overcompensate and eat at 9-ish. Sometimes I snack and Iām sky high before I even start eating but I donāt wait til I"m in range (but thankfully I donāt have to deal with hormone peaks that would make management much more difficult). Iām a slacker 
a1c jumped from 5.5 to 5.7ā¦ Its tax season so there is a decent amount of pizza in my diet right now. A mix of the good local place and dominos.
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I try not to eat anything after 8 pm. Donāt like going to bed feeling full. And, I love waking up with a good appetite to have a hearty breakfast. I think itās my favorite meal of the day 
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Ok I have read thru all the pizza tips and am going to try working out a formula for our almost 14 yo sonā¦cause I have to say I dread pizza nights which are sort of part of the fabric of teenage social life, due to the wild and unpredictable nature of the spikes/long term elevations.
Hereās the pizza word problem for you pizza wizards: 14 yo boy will be going with his youth group to eat pizza (usual teenage boy intake of 3-4 slices before parent throws body across rest of pizza) , then go to āFrankies Fun Parkā where he will doubtless run around like a sweaty idiot for 2 hours, then off to spend the night not-sleeping with sweaty teenage boy peers. Fortunately my husband, not I will be chaperoning, eww! He has a dexcom and an omnipod.
Based on this thread maybe I will try: 40/60 split on an extended bolus of 2.5 hrs, then turn his basal up somewhat (maybe 25-30%) for around 4 hours. We can always bag the temp basal and/or eat more snacks if the exercise takes him low.
By the way, re earlier questions about high carb high fat foods, I learned a few months ago (sorry canāt recall source but it was actual medical literature not the back of a magazineā¦) that a big dose of saturated fat induces insulin resistance over a few hours after itās consumed. That totally made sense to me with pizza ā and other teenage junk food indulgences like premium ice cream ā because it seems like there are actually two things going on, the delayed and terrifyingly large spike (presumably due to the poor overwhelmed stomach breaking down the large mass of carbs after your peak of insulin action has already passed) and then the prolonged moderate elevations that donāt seem to respond to the correction doses that would normally bring them down. Delayed absorption + insulin resistance.
Suggestions? Feel free to tell me that the blood sugar of hormonal, jacked up teenagers binging on pizza followed by an amusement park and an all nighter is essentially a model of chaos theory and Iām definitely screwed 
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Your not screwed, but note that we dose 75% of the normal amount of the carb count and then add another 75% in the extended dose, so for pizza we actually use 150% of the expected dose based on the carbs only. Our experience agrees with your medical literature.
Since your son will be exercising right after, I would be a little conservative with the extended dose, and perhaps set a limit. Like he will find your husband if he is over 300.
If he wasnāt exercising I would do what @Eric and others suggest and dose 200% and then eat small amounts of carbs to keep from going low.
obviously a teenager is totally different from a little one, but our four-year-old needs a dose for about half the carbs of pizza upfront ā and then three times his basal rate or more for about 4 hours or more. There are some variations to this basic formula, depending on how much pizza and what type he eats, and what time of day (pizza during the day doesnāt need the same duration basal elevation), but thatās the general idea. I think the formula would generally be something like
1/2 carbs upfront, then to calculate total basal rate = (remaining carbs + grams of fat/carbF)*3/4
Who knows if itās perfect, but it usually keeps him hovering at around 140 for three or four hours before he drops down.
i cannot account for a hormonal teenager, but i can say for myself that different pizza joints have different formulas for me. some use unsuspecting more cheese, more sugar in the sauce, thicker carbs for the dough, etc.
i am aware of this and use the same pizza joint again and again so i have found a working formula. also, i eat late afternoon/early evening eating time so i dont have to worry about over-night spikes that require corrections while i am sleeping.
my formula for 2 large slices is this : i account for 95 gms of carbs; i do a dual bolus, spread out over 2.5 hours. 30 percent upfront, 70 % over the 2.5 hours. so far, it has worked like a charm. remember that the more cheese, the slower the digestion. i need to bolus hard for that tail end. if i bolus too much up front, i tend to crash and then spike.
i hope this helps some. and, good luck.
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@katiereeder, our experience largely agrees with @Chris: we dose 100% upfront, then, 30 minutes after eating the pizza, we add 50 to 75% on top of the original dosing over 1.5 hours: total 150% to 175% overall including all insulin before and on extended. It is possible that dosing less than 100% upfront may also work for us but we have not tried yet.
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You can always give yourself the best shot by getting the thin crust, and ask them to go light on the cheese. Many years ago when I worked at a pizza place, you could literally go 2x with the cheese and no one would know unless they weighed the pie. It is easy to see why there is so much variance.
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Yeah except that strategy involves eating thin crust pizzaā¦thank goodness itās not me who needs the insulin, Iām a deep dish fiend all the way!!
I have more options when weāre making or ordering itā¦itās the teen party pizza feeding frenzy that is more challenging when I donāt know what it will look like in advance. Heās a great estimator though in general.
Iām guessing it would NOT be cool to show up at such a party with your mom and a midsize kitchen scale, haha! But will save that plan for if he makes me really mad 
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I guess I am my kids worst nightmare. I thought everyone traveled with a scale. We donāt do it anymore, but we used toā¦
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I tried it, and it was an utter disaster. I shot up to 12 (215) and hovered there for about 6 hours, despite corrections. This was the same pizza I usually get, from the same place. Clearly I need more insulin right up front. Iāll stick with my 60/40/3h ā¦ until it no longer works.
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every pizza is not created equal. different sauce, different amount of cheese, different crust. when i found the formula that worked for me at one specific pizza joint, i stuck with it. it worked and continues to work.
if you have a formula that works for you,well, if the clock aināt broke, dont fix it! 
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I had great results last night using R and 1.5x my normal carb ratioā¦ stayed nice and flatā¦
how many slices did you have? did you have extra cheese and pepperoni? how many grams did you bolus for?
just curiousā¦