The Peanut Butter and Chocolate Punishment

loooooove peanut butter (frequent visitors of this blog are very aware of this fact) and chocolate. It’s the perfect combination of salty and sweet. And Reese’s cups of all shapes and sizes are definitely the most delicious snack in the entire world – though I have a special affinity for Reese’s pumpkins for having the ideal chocolate-to-peanut butter ratio.

Despite my unwavering adoration for peanut butter and chocolate, the dynamic duo doesn’t always love me – or my blood sugars – back…especially when I neglect to bolus accordingly.

It was a lazy Sunday afternoon. I’d just woken up from a brief cat nap on the sofa and felt hunger pangs. I checked my CGM and noticed that my blood sugar was going a little low, so I yawned, stretched, and ambled into the kitchen for a snack.

That’s when I remembered I had a tasty treat in the fridge – crunchy peanut butter chocolate squares I’d whipped up the night before to bring to a friend’s apartment. They were made from, obviously, crunchy peanut butter, but also crushed graham crackers, butter, confectioner’s sugar, and a silky, smooth layer of melted dark chocolate. The squares were chock-full of carbs, but cut small enough and on the thin side…so I naively assumed I could eat a couple without doing any real damage to my blood sugar levels.

The Peanut Butter and Chocolate Punishment.png
The crime? The existence of these peanut butter and chocolate squares. The punishment? High blood sugar for unknown length of time. Cruel.

So I dove in, helping myself to some additional crumbs at the bottom of the bag that had broken off from roughly cut squares. After a couple of minutes of totally pigging out, I made myself stop because I could practically feel my blood sugar begin to rise. I even took a couple of units of insulin (not at all calculated, just two off-the-cuff units) to offset any high blood sugar.

Unfortunately, two units wasn’t exactly enough. Within an hour, I saw my blood sugar go from the 80s to somewhere in the 280s. Not at all what I wanted! I began bolusing and stacking my doses like crazy while I fixed dinner and fretted over how long it might take for my blood sugar levels to come back down so I could eat a real meal. By the time dinner was ready, though, I was still high but confident that the insulin on board would do its job. But it took nearly five hours for everything to stabilize, from when I first gave into the peanut butter and chocolate squares to a couple hours after dinner.

Not my finest moment in life with diabetes since everything could’ve been prevented from the beginning. But maybe it goes to show one of the reasons why people start out each new year with the hopes of eating clean and cutting out sweets – junk food tastes so wonderful when it’s being consumed, but the long-term effects are too much of a punishment to make it worth it.

Now, if you’ll excuse me, time to evacuate the apartment of all carb-y confections…

Is it Possible to Eat Pizza Without Encountering Blood Sugar Problems?

My short answer to that question is YES. Yes, it’s absolutely possible to eat pizza – and just about any food, in my opinion – without experiencing turbulent blood sugars.

It all just comes down to serving size, timing, and method of insulin delivery. Piece of cake, right? (Or should I say, piece of pizza?)

Have a slice!

Well, it really isn’t THAT simple. Other factors include the exact type of pizza (Is it gluten-free? Are there toppings? Is the crust thick or thin?), whether or not other food/drink is being consumed with it, whether exercise or inaction will follow in the hours after eating it…truly, there’s all that (and more) that people with diabetes need to think about when eating any type of food.

But what’s different about pizza is that it has a particular combination of fat and carbohydrates that can make it a tricky food for people with diabetes to figure out how much insulin to take and when to take it. It’s a little easier for those of us who have insulin pumps, because we can utilize the extended bolus (or square wave) feature that allows us to give a certain percentage of a mealtime bolus at once, and select a time later on to receive the rest of the bolus.

If that last sentence didn’t make any sense, here’s an example of what I mean:

It’s dinnertime – 5:30 P.M. I have two slices of pizza that I plan on eating. One’s plain, the other has BBQ chicken on it. I figure that there’s 50 grams total of carbohydrates in the two slices of pizza. My blood sugar before eating the pizza is 130 mg/dL. I put that number into my pump, and also input 50 grams of carbs. My pump wants me to take 8 units of insulin to cover the pizza. Instead of administering the full 8 units at once, I hit the “extend” option and opt to take 75% of the dose now, and the remaining 25% an hour and a half from now. So I get 6 units of insulin at 5:30, and 2 units at 7:00. This extended bolus typically has the power to prevent my blood sugar from crashing and spiking hours after eating said pizza, and in turns, saves me from dealing with a massive headache and questioning why I ever ate pizza in the first place.

Granted, an extended bolus isn’t the end-all, be-all. It relies heavily on me and my ability to count carbs correctly and time my boluses perfectly. But I have had fantastic success using it, particularly in a recent situation in which I ate two large slices of whole wheat pizza, a side salad, and a bit of pita bread without spiking beyond 160. I can’t say whether it was the whole wheat crust that helped me out (maybe it has a lower carb count compared to regular crust?), or if it was just supremely accurate calculations on my end, but it really doesn’t matter to me in the end…because I know that I can eat and enjoy pizza – and again, virtually any food – without my diabetes ruining it for me.