*Disclaimer: All content and information in this blog is for informational and educational purposes only.
Pizza is one of the biggest food culprits inside the diabetes community. It is widely known for being extremely difficult to dose for and causing stubborn high blood sugars for hours at a time. Instead of surrendering to pizza and accepting defeat, this blog post is going to discuss helpful strategies for helping you conquer the infamous pizza bolus.
Strategies for Dosing for Pizza
The main reason that pizza can be troublesome to dose for is because of the combination of carbs and fat. Check out our full blog post on dosing for high carb/high fat meals here. The combination of pizza crust and layers of gooey cheese will impact blood sugars differently compared to most meals.
What Happens to Your Blood Sugar After Eating Pizza
After eating pizza, you will likely see a small-moderate immediate rise in blood sugar levels due to the partial digestion of the pizza crust. At this time, most people think that they are out of the woods…until 4-6 hours after eating and they see their blood sugars slowly start to climb…and climb…and climb. The delayed secondary rise in blood sugar levels can be contributed to fat from the cheese and other pizza toppings. During this time, you will likely be experiencing a higher level of insulin resistance meaning the insulin dose that usually is enough to bring your blood sugars down into range won’t be enough. Some people with diabetes may require 30% or more insulin to account for the added insulin resistance.
How to Stay In Range When Eating Pizza
There are a number of different strategies for staying in range when eating pizza, but strategies may differ depending on:
- Number of slices you are eating
- The type of pizza crust (deep dish vs thin crust)
- Additional toppings (additional fat content)
- Eating other foods along with the pizza
In general, utilizing a split bolus for those who use multiple daily injections or an extended bolus for those who use an insulin pump can be a helpful starting point. This insulin dosing method can provide a longer period of insulin coverage than if the full dose was given upfront. When the full dose of pizza is given initially, there is a likelihood of hypoglycemia due to the delayed fat digestion.
The goal is to match insulin dosing to how the foods are digested. If the foods are being digested slowly, you will want to mimic that your dosing strategy. Typically, boluses are split into the following percentages:
The percentage that you choose to split your bolus and the duration of your extended bolus will be influenced by the type of pizza you are eating. It may take some trial and error to figure out what combination works best for you when eating different types of pizza.
Interested in learning more about dosing for pizza? Listen to Keeping it 100 Radio- Episode 63: How to Bolus for Pizza where your host Lissie Poyner sits down with Amanda Ciprich from T1D Nutritionist to discuss strategies for different types, shapes and sizes of pizza. Listen to Keeping it 100 Radio today on Apple Podcasts or Spotify.