Pizza

Fear. Horror. Disgust. Whenever, among diabetics, pizza is mentioned, these are the reactions. This food is often considered to be one of the most complicate to oversee in terms of BG. In fact, it requires quite a lot of attention, but the idea of it being something of unmanageable is simply false. For what concerns my personal experience, after trial and error this Italian delicacy is now part and parcel of my diet, since, on average, I've been eating it once a week for the last few years with good results in terms of BG management. 

But firstly, why is pizza so influential on blood glucose level? Well, first of all, an average pizza with normal toppings goes around 1000 kcal, and, if we consider that it is usaully consumed alongside with a drink, and maybe also a dessert, it composes a repast which implies a calorific load which not everyone is used to handle in a single meal. Furthermore, carbs outnumber other macronutrients by far, and this implies a first huge glycaemic spike, usually followed by a rebound, since fats and proteins are, in any case, present in a not negligible quantity. Fun fact: Neapolitan-style pizza tends to produce reduced glycaemic spikes thanks to longer leavening. It sucks that I prefer the normal one, duh. 

But let's come to facts: how am I used to behave in terms of diabetes management when I eat my weekly pizza? Of course following, even this time, the splitted bolus technique, adjusting it a bit to match the situation. I usually perform only 2 early boluses instead of 3, given the huge amount of carbs: a first one 15 mins before my meal (on average, of course the time can vary depending by the starting BG) covering 70% of the total dose, and a second one right before I start eating covering the remaining 30%. It's better not to exaggerate with this early boluses: a brief walk right after your dinner is more effective and less risky in terms of early hypos than a greater amount of insulin. Then, around 2 hours after the meal, fats and proteins will start to convert to sugar, and I would perform one or two small injections to cover their late effects. After, let's say, 4 hours, pizza should be definely tamed. 

But that way it would be too easy, wouldn't it? Oh yes. In fact, did you ask yourself why I talked about "total dose" and not, as usual, about the total carbs? Well, the answer is simple: nobody seems to know why, but pizza simply doesn't work with the usual rules of carbs counting, so your insulin dose, to finally be effective, should simply be evaluated by trial and error. First, I suggest trying to eat pizza on its own for a few times: this will help you establish the bolus you need to digest this "enemy" alone. After that, if you find yourself in a situation where you're bound to eat pizza alongside with anything else, you can simply add the carbs of the side dishes or drinks with your usual carb counting: this time it will work :)

And with that, my guide to defeat this "monstrous" but delicious food comes to an end. I hope it will help you depict my beloved national dish less "monstrous" every time you eat it. And remember, comfort foods, as pizza is, should truly be regarded as treats even for us diabetics: allow yourself a bit more of patience when learning how to manage them!