Any type of pizza, plus diabetes, usually equals one giant headache in terms of nailing a correct insulin dosage.
Nine times out of ten, my blood sugar ends up high in the hours following a pizza meal. This is a fairly common phenomenon for people with diabetes, because even though pizza contains high amounts of carbohydrates, it also contains a large amount of fat that ends up delaying the digestion of pizza – resulting in a belated blood sugar spike. My go-to workaround for this is to do an extended insulin bolus, meaning that I take part of my insulin dose at mealtime and my pump will deliver the remaining dose later on, but it can be tricky to nail the timing of it.
So imagine my surprise when, after enjoying an evening out with my boyfriend in which we split a very tasty flatbread pizza (half buffalo chicken, half brussels sprouts and bacon), my blood sugar didn’t spike even a little bit post-meal. In fact, it actually ended up tanking – so much so that over the course of 2 hours, I had to eat 3 packs of fruit snacks and a handful of leftover Easter candies in order to keep it from dropping too much.

My mind was blown. I had actually eaten more flatbread slices than I normally do during this meal – the two of us nearly demolished a large-size flatbread, which is quite a feat – and so I bolused for 60 grams of carbs, using the manual mode on my Omnipod 5 PDM to enable an extended bolus in which I gave myself half my insulin dose upfront with the remaining half to follow 1 hour later. I actually thought I was underestimating the total carbs I’d consumed, especially considering I had two cocktails with my meal. But nope, I had completely missed the mark on this one and paid the price as I did whatever I could to keep my blood sugar up in the hours before I planned to go to bed. You can see from my CGM graph below that this was a bit of a prolonged struggle, one that kept me up much later than I would’ve liked.
But, oh well. That’s just how it is with diabetes sometimes, and I remain optimistic that I can nail the pizza bolus next time. After all, I’ve done it before, so I can do it again. And this is the kind of bolus experiment that’s kind of enjoyable – any excuse to have some delicious pizza.

