So I thought my I:C ratio was 1:20. I ate 1 medium-sized piece of vegetable pizza and a medium apple for lunch. Because pizza makes my BG rise slowly, I split the bolus-2 units of Novolog 15 minutes before lunch and 3 units after. I feel that was too much insulin for the amount of carbs, but for the past 3 hours, I’ve been above 190. The 1:20 ratio seems to work for other meal types. Any words of wisdom?
For me there is no amount of insulin that counters pizza. I’m about to the point of needed to stop eating it, not the best option in my opinion.
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An average meal for me takes 4 units of insulin; pizza takes 12 with 40% extended over 4 hours. And that seldom takes care of the spike. I avoid pizza like the plague.
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Depending on what was on the pizza … in particular how much cheese because you said it was a veggie pizza …it sounds like the fat and protein have combined forces to give you the prolonged period of high. I don’t have a magic recipe, but adding both more dose and more duration to the extended bolus seems to help … or maybe a second extended bolus.
A very tricky food … but I don’t have the discipline to give it up.
Stay safe.
John
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My average meal is 4 units
My average for 2 slices of pizza is 15 units.
It’s pretty much a no go
The problems are why I only eat pizza once a year on Super Bowl Sunday.
Many people need to dose for more than just carbs if you are eating foods very high in protein and/or fat. You don’t need to dose nearly as much for as carbs, but they can rise some folks blood sugars too, in enough quantity, and/or increase insulin resistance (in the case of fat).
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There is no pattern because there are a trillion variables you can’t control, such as how fast the pizza digests, how much insulin was absorbed at the injection site and how quickly, your activity level generally and at the moment, your stress level, your quality of sleep and other things I’m forgetting. An I:C ratio is just a starting point. It will not be consistent from moment to moment, day to day or across different types of foods.
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Absolutely!!!
The best benefit of cgms is being able to see impact of those variables, and respond. (Or have pump that responds automatically).
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I gave up on finding an insulin-dosing “solution” for pizza many years ago. I’ve since stopped eating any grains often used for pizza crust. I’ve read many accounts of people who gave up pizza since it is tricky to dose for and even if you find a solution to work one time, it may not be reproducible. On the other hand, I have read a few a stories of people who claim to have perfected the pizza dose.
A CGM would be a great source of data to inform subsequent pizza trials. If it were me, I’d look for recipes that reduce the carbohydrate content to a minimum. Then you’d only have to consider the protein and fat absorption, the less volatile macronutrients. Alternately, you could just eat the top layer off of any traditional pizza and see what happens.
I used to be very fond of pizza but since I haven’t eaten it for many years, I do not feel any addictive longing for it. As far as breaking habits goes, I had a much harder time quitting cigarettes. Good luck finding your way!
I put pizza on the menu twice a month, and my formula is “crap ton of insulin up front, 25% delayed”. Mine is homemade, though, so I know exactly what’s in it. I think that simplifies things.
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I’m American, we don’t do metric 
So that’s a full imperial crap ton of insulin up front, and 25% extended.
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Thanks for the responses! I guess pizza’s a rare treat from now on.
I am hoping you don’t think I have perfected my pizza bolus but I will say, I will never give up pizza. Growing up in Chicago, I live for pizza and Italian beefs! And than for many years worked in the Costco pizza kitchen. So I eat pizza.
As far as perfect dosing, no such thing. But I have after many months of pizza once a week from Costco, I have it as close as I can get it. Some weeks, blood sugars are right on target and some weeks I am chasing some during the night. And of course where I am starting plays a big part. But I have good success with 25% up front and 75% later over 5 hours. (A Costco cheese pizza has almost 2# of cheese!!!)
My feeling if it’s something you love, you can figure it out. It took a couple of months of pizza once a week, fine tuning until I got close enough. My other favorite is clam chowder that in the past was brutal but now with CGM knowledge, I think I will take it on as my next experiment. Getting cold and soup will be back on the menu.
Everyday is just another science experiment and all experiments have to be repeated over and over again to prove it’s worth! And we live these experiments everyday!
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I gave up pizza some 40 yrs ago. It is extremely hard to figure out a dose to account for the sugar in the crust (to hide the burnt taste) and sauce. Then there is the fat, which delays absorption; it can extend, as already mentioned by several people, the meal 4-5 hrs. I stuck out like a sore thumb at meetings and gatherings with friends, but could always get by with a salad. For the same reason I avoid pasta - too many carbs.
Recently my wife and I have been making our own pizza using cauliflower crust (frozen) and fresh ingredients. My BG has been normal with this type of crust It is also good by itself as a snack when baked, adding some garlic and Ms Dash.
Mike
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Flatbread works too. You still have carb but it’s not so damn unpredictable.
My I:C ratio seems to vary. I eat the same things most days, buy my glucose levels (via CGM) may go up or down. I also use ‘insulin sensitivity factor’ to calculate what my I:C WAS after eating a known quantity of carbs and taking insulin (Novolog™). I aim for a target level (usually 120). If my level is above the target, then I (1) calculate how much extra insulin would be needed to get from where I am (say 180) to 120, and change of 60 mg/dL. If my insulin sensitivity factor was 60, that means I’d need 1 more unit of Novolog. So my new I:C is (old insulin dose + 1 unit):grams_of_carbs.
Yeah, the I:C wanders around, but it helps me through changes, like when I had to take prednisone for 6 days.
I have my Amy’s vegan roasted veggie pizza figured out pretty good. But it is without cheese, it still has fat, just not nearly as much. I take a third when I eat, a third a half hour after and another third an hour later.
But a pizza place is now making a veggie pizza loaded with vegan cheese and a sofrito sauce instead of traditional tomato sauce. Amazing!!! I’ve eaten it about 5 times now and still haven’t figured it out. Getting better, but it loves to make me spike hours and hours later. I’m sure that’s the high fat in it doing it.
But I am a firm believer in eating what I want to, and pizza is a treat not to be ignored lol…so I will keep trying until I figure it out, no matter how many times of trying it takes!!! 
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