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How do you bolus for pizza? If you typically use multiple strategies, please select all that apply.
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Dual wave, baby, only way to go for that stuff. I think I’ve finally figured it out to where I no longer avoid one of my favorite foods.
I use a dual-wave bolus, giving 2 thirds of the dose immediately, followed with the remaining third over a period of 1.5 hours.
Traditional pizza is too challenging for me. My husband and I make our own with very thin crust, a small bit of pesto and a small bit of hummus, peppers, onions, fresh tomatoes, kalamata olives, and a dusting of shredded Parmesan. I bolus for the carbs before I eat. This works for me and it’s healthier.
Extended bolus 60/40 the 2nd half over 1 hr for high fat pizza 70/30 the 2nd half over 1 hr. for less fat and protein
The local pizza place makes my pizza thin. I wat one slice when mu bloos sugar is below 100. Then I exercise. No problem. I can do that again later in the day. No more than two slices per day. There are 8 slices in a large pizza. I have to watch my wife. She will eat four slices in one day, then she may eat some of my slices if I don’t watch her. lol
If I were to ever eat a piece of a regular pizza, I would use an extended bolus. I will make regular pizza for my husband but for myself, I put the sauce, toppings and cheese on a low-carb crust alternative like low-carb pita or low-carb wrap to seriously curtail the total carbohydrates.
This is a big drawback for using CGM with my pump. It does not allow dual or square boluses when Auto mode is on so I have to bolus for the carbs, then monitor my pump and bolus again when my bg starts to rise.
I’m having this same issue. I had pizza last night actually — my only high all day. I’m trying to refigure out how to bolus for it, when I had mastered the extended bolus
If you are using a Tandem X2, when you are ready to start the Bolus, there is a selection to use Extended mode even if you are using Control IQ. Hope this helps.
A Real New York slice of Pizza is equal to approx. 60-80 Carbs. I usually put 40% up front and 60% over a three-five (3-5) hour time span. Sometimes it works and of course sometimes it doesn’t?? Subject to change depending on is I eat more than one (1) slice.
Extended bolus, but also turn off control IQ and run a temp basal of above 150% for around 8 hours after the meal. I’ll monitor my glucose and turn back on control IQ if it’s running on the lower end.
Of about 150%…*
That is one thing I don’t like about temp basals. I would love for the control IQ to be able to be used with the temp basals. Hopefully one day in the not too distant future.
Pizza falls into the category of “”I can eat whatever I want as long as I willing to pay the price for it.” I dose for the approximental carb load, then spend the next 18 hours adjusting doses to compensate for the sauce, meats and white flour. Same way as with Chinese chow mmmm – maybe go for Panda Express later.
Since I’m not on a pump, I must do the same with multiple injections of Humalog (lispro). I take an increased dose before eating, then additional doses as needed, preferably 4 hours apart. Sometimes a one unit dose, if rapidly rising, but to avoid piling on insulin, I wait at least 2 hours before adding a half unit or 1 unit. I must frequently check blood glucose readings. But I don’t eat pizza that much anymore, since cutting back on carbs and using Dexcom. I tried Panda Express only once, but found it way too greasy and way too sweet. I avoid Thai because I’ve read it’s very sugary also. But authentic Vietnamese, Chinese, Japanese with lots of veggies is safer. I just avoid the rice and sometimes ask the waiter for help. Unfortunately, many ethnic restaurants cater to American tastes for sugar, grease, salt. BTW 1 tablespoon of soy sauce has 50% of the minimum daily requirement for sodium.
I usually don’t do pizza – can’t afford the calories (you’ve read my rants about my Endo’s weight goals for me – rail thin!) Wen I do I use a broccoli or cauliflower crust and an extended bolus. In terms of restaurant pizza’s, I go to the salad bar!
When had kids at home, and before my celiac diagnosis, I chose pizza restaurants with salad bars and thin crusts and ate mostly salad, was kind of a treat for me with anchovy. That was in 1970s and 80s, so no pump or cgm, but learned to give an extra bolus eventually. Gluten-free crusts I’ve tried just haven’t been worth the bother.
I will normally give myself a smaller dose of insulin for anything contained on the pizza that might be considered more simple sugar but wait about an hour or so to take more for the starch and other ingredients that take longer to digest and affect the sugar. I found if I took all insulin at the beginning covering the carbs of the pizza that I would go low and then go high before the starchier more complex carbs took effect.
I haven’t eaten pizza in a while. My hubby is dairy free and the low carb pizza I made was full of dairy. I don’t want all the fat anyways!
Pizza is off my diet for gastroparesis.
Order thin crust and use extended bolus for a 2 hour total. I often will need to add a correction bolus 2 – 3 hours later, depending on the pizza ingredients.
If it’s a thick crust order at night:
Increase basal 20% as soon as we know we’re having pizza, or an hour before (whichever is shorter).
Bolus 60/40 for 2hrs.
After 2 hrs, if needed bolus fat & protein 50/50 for 2hrs.
Keep basal higher until morning.
Used to eat the toppings and throw the crust away. Now I make a low carb crust with almond flour, oat fiber, and mozarella cheese with egg white and xanthan gum as the binder. Dose R insulin for the protein and a little Humalog to cover the tomato sauce.
With Inhaled insulin I find I take 1/3 my dose at meal time. W/in the next 90-120 minutes, I inhale the other 2/3’s and I’m Sittin’ pretty!
We make our own thin crust using flat outs coated with olive oil, baked at 300-350 for a few minutes (browned slightly), then some sauce and a little cheese, then pepperoni and onion, some more cheese and back to the oven to melt. Makes four slices. Dosing is reduced but cheese forces extended.
I’m onn a Tandem x2 w/ G6 pump, so typically will guestimate 30-40 carbs a slice; example DIgiorno Supreme frozen is 38 per serving x 6 servings per container, works out to 228 carbs…I’ll add 12 to make it easier on calculations as 240 is much easier when computing in your head. So take 240 carbs and devide by actual number of pieces cut from the pie…usually 8 so it’s 30 carbs a slice. Typically deliver at the beginning of the meal and use a 50/50 extended bolus over 1-2 hours.
Based on experience…it usually works out fairly accurate most pizzas I’ve found are between 30-40 carbs a slice. Course also depends on thick vs thin etc etc.
I now only eat pizza at a restaurant named AZZIP pizza. I get the kids meal and it is a very thin crust 6” pizza. Because of this I can give a regular 20 carb bolus. Any other pizza I would give an extended bolus and follow up with additional bonuses.
I only eat Quest pizza and it does not spike my BG. So I am able to bolus for the carb count and stay pretty level.
Combo bolus- correction + 65-70% upfront as Normal bolus and 35-30% as Extended bolus over 1.5-2 hours. All depends on type of pizza.
Pre bolus for sure to handle the white flour spike…
It depends on what my blood sugar is at the time. If I’m low, I’ll eat a few bites first. If I’m in range it’s an extended bolus. If im out of range it’s an extended bolus, waiting 15 minutes at least to begin eating.
Pizza has the same irregular effect on me. I handle it the same way except I’m doing MDI.
Because of Celiac disease, I have not eaten “real” pizza in over 15 years. The only pizza I eat is home made gluten free. I use low fat Kraft Parmesean cheese and lots of vegetables. However, there have been times were I have used the Extended bolus, some of the insulin delayed for 2 hours.
I first use an extended bbolus with some insulin now and some delivered over a few hours. Many times after that type of bolus, I may use another extended bolus or another regular bolus depending on how my sugar is doing. I just tried cauliflour crust pizza a few days ago for the first time. OMG was it good. It tasted like regular pizza dough but was just like a thin0crust pizza, not a regular crust. A friend took a piece just to try it and he said he would not have known it was made of cauliflour if I had not told him. I did an extended bolus for that pizza because of the fat in the cheese but did not have to extend it
I avoid pizza as much as possible, which is really sad to say. I love pizza, but as a T1D AND celiac, I’m left with either rice flour crusts (or cauliflower crust if I’m lucky), and they make my blood sugar levels skyrocket for an extended period of time. If I eat pizza, it doesn’t seem to matter what bolus strategy I use to cover the carbs, I usually end up high-sugar for the following 2-6 hour period. It’s just not worth it to me anymore.
Extended (aka Dual Wave for those Medtronic users) works best for me for pizza. 50% immediately for the sugar in the tomato sauce and 50% over 30 minutes for the carbs in the dough. NOTE on your choice of questions: Extended Bolus can also be equivalent to a Square Wave bolus on TSlim (0% now, 100% over time). I have not found Square Wave useful for pizza unless there is very little sauce or a veggie pizza. Lots of sugary sauce more up front, thinner crust or cauliflower crust then fewer units extended over time.
Depends on the style of crust but I generally add at least a unit above the carb count.