The Great Diabetes and Pizza Controversy

PizzaDiabetes and pizza.  Hmmmm?  If you have diabetes, and you love pizza, you’ve probably experienced the blood sugar roller coaster that occurs after you’ve filled your tummy with as much as it can stand without exploding.  (Everybody’s done it!)  Over the last week or so, for some reason, pizza has come up in conversation with many of my diabetes peeps. Then today I read this neat story at about pizza, and I figure this is the universe telling me to blog about it.

I love pizza, but I don’t eat it, partly because I don’t have the math skills to figure out the bolus required for eating pizza.  Here’s what typically happens to diabetics that don’t yet understand pizza and diabetes.  Let’s say you eat 4 slices of pizza, and you start with a normal blood sugar of about 100 mg/dl.  4 slices is approximately 100g of carbs.  Notice I said approximately.  You never really know how many carbs are in each piece for a bazillion reasons.  (It’s a word.  It’s MY word.)  So you bolus for 100g carbs.  Between 1 and 2 hours later, you crash hard.  Your blood sugar is like, . . . in the 50’s.  So you eat what you’re suppose to, exactly 12 carbs, and you check, and your blood sugar is around 80 mg/dl.  Then 2 hours later it’s 270!  WTH?!

Here’s what probably happened.  The high saturated fat content in the cheese caused temporary insulin resistance, slowing down the initial blood sugar spike, AND hours later it causes your remaining bolus and your basal to be less effective  So you bolused for 100g, and since the fat slowed down the carbs, your blood sugar didn’t rise as quickly as it would otherwise, but your insulin still did it’s job, so you crashed.  Then you corrected at about the same time that the fat is causing insulin resistance, so you’re rising from your correction, AND you’re rising from the insulin resistance.  This can last for hours.

Now if you didn’t know this, don’t feel bad.  I only learned about saturated fat’s effect on my blood sugar last year.  I have my CDE (Certified Diabetes Educator) to thank for educating me on this.  Have I mentioned that she’s amazing?  Now that I understand this, I have a lot less “unexplained high blood sugars”.  Below is how I deal with high saturated fat meals.

First, don’t just try this without first consulting your endo or CDE, because saturated fat doesn’t effect every diabetic the same way.  I’m just sharing what I do.  So here goes.  This first bit is VERY IMPORTANT.  When my meal has more than 25g of saturated fat, then I increase my total bolus amount by around 25%, BUT I  DON’T TAKE IT ALL AT ONCE.  I take 40-60% of it with my meal, and then I take the rest of it in a dual-wave bolus set for 4 hours.  That usually works for me, but you have to fine tune it every time depending on how much carbs, and how much saturated fat you eat in a meal.  When you’re meal has less than 25g of saturated fat, it’s less likely to affect you this way, so if you only eat 2 pieces of pizza, you don’t usually have to bother with this, but again, it’s different for everybody.  (I know, to many commas.  I don’t care. It’s my blog! *grin*)

I actually don’t eat pizza anymore because I try to follow the paleo lifestyle most of the time.  However I do eat large amounts of saturated fat every once in a while, so I still have to deal with this.  It’s been so long since I ate pizza, that I honestly can’t even remember the last time I had it?  Some diabetics will say pizza is horrible and you shouldn’t eat it, some will say anything is ok in moderation, and others don’t limit themselves and enjoy what they like.  Whatever you choose, I hope this blog helps you understand pizza’s effect on your blood sugar.

If you found this blog helpful, please share or comment, or both.  Thanks!

11 thoughts on “The Great Diabetes and Pizza Controversy

  1. I seem to do OK if I do a 45/55 split combo bolus, 3 hours later. And, you know, make sure I don’t eat 900 slices of pizza!

  2. “Let’s say you eat 4 slices of pizza…” OK, stop right there. No way am I eating four slices! I’ll eat two, and usually skip the crust (or some of it, anyway).

    I’m never consistent with the dual-wave bolus, though I always use one. If there’s a correction involved (positive or negative), that tends to complicate things even more.

  3. I’m still experimenting with my specifics with pizza. I’ll get it right…one of these days.

    • I think the challenge with pizza, is that it’s never the same. :) When you get it figured out, please share!!! 😉

  4. I’ve found that there’s no “magic insulin bullet” that works for every PWD, but I’m glad you found a system that works for you!!

    • “Magic Insulin Bullet”. That sounds like a great title for a blog! You’re right though Kerri, there’s no magic bullet that works the same for everybody.

  5. Pizza leaves me crashing (after a good and proper high) and feeling horrible later. I don’t know why I still eat it but I do!

  6. That is a really good picture of a pizza you must view it at full resolution.

  7. I don’t think saturated fat is the culprit because a cheeseburger does not elict the same effect despite having fat and carbs. A very simple solution is to use “regular insulin” since it lasts longer and doesn’t peak as rapid as the analogs.

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