Pizza, which I absolutely love (Try a thin-crust chicken garlic – MMMM!), is also one of the toughest foods to control. I tried a different sort of bolus the last two times I had pizza, and it worked pretty well on a COSTCO slice, no less!
Basically, bolused for 120g and initially set it up to do the entire bolus extended over 3 hours. That way, if I forget the rest of the process, things don’t go completely out of the ballpark.
Then, keep an eye on the CGM (actually, I use xdrip+ to set a temporary glucose level alert at 110), then when I hit my threshold on the rise, modify the bolus as follows: See how much is remaining from the original extended bolus, and cancel it; start a new bolus for the remaining amount, and deliver a portion immediately, the amount of the remaining bolus based on DVM*, the rest set to deliver over 2-3 hours.
With this I’m able to spike over 120 for only 30-60 minutes, peaking no higher than 135-140 or so. And i don’t get any nasty surprise at 4-5 hours with a mysterious climb in BG.
Maybe this will work for someone else!
*DVM: Diabetes Voodoo Magic… Basically, taking the time from eating until you start to seriously rise, the nature of what you ate, etc. – basically experience mojo – to make a treatment decision. For example, pepperoni pizza on regular crust will start to rise later, and last longer, so smaller immediate bolus when the rise starts, leave more of it in the trailing extended. Opposite situation with the chicken garlic with creamy garlic sauce.
Remind me in near future and I’ll post a picture of my dexcom sugar surfing a pizza beinge with my diabetes whistle. No advanced plan will be necessary and I’ll eat right up to the point of just-shy of vomiting. Then every time the dexcom beeps at 120 upward bound I’ll give it a toot toot. It’ll be fun for everyone.
BTW, I still plan to try it, and the good news is now that this GI C. diff thing seems to be resolving (yes, I’m finally starting to really truly feel better, but not quite 100% so cautious), I can get going on Afrezza again.
I have also found pizza relatively straightforward to do using an extended bolus. Half a 16" thin crust, I usually count as 115g carbs (do you really count one slice of Costco pizza as 120g - seems an awful lot). Using a combo bolus with 40% upfront and the remaining 60% over 2 hours, my sensor BG will barely rise (8 or 8.5 max) typically without any subsequent correction. TBH, I find any low GI carbs can be dealt with using an extended bolus - although I actually find pasta more difficult than pizza. The hIgh GI stuff is more of a problem.
OMG, to an individual on MDI who has spiked to nearly 250 from one piece of pizza and a beer with starting at BG 89 before eating and ending at 72 five hours later from a single pre-meal bolus - your approach sounds like pure magic! (But I’ll still never get a pump or CGM.)
