Magic Formula for Pizza?

I was wondering if anyone has a magic formula for dealing with pizza with an insulin pump. I have a 9 year old who loves pizza. We don't eat it often, but it is the birthday party food of choice... And we definitely believe in "kid first, diabetes second". For a while we had it down with a 40/60 dual wave for 6 hours, but that's not cutting it anymore. I totally understand that diabetes varies, but I'd love some tips and tricks if you have any. If you or your T1 kid eats pizza, how do you handle it?

I use square bolus or extended bolus with Animas pump.
Pizza has a ton of carbs, I just use the squarewave for 2 hours. 45 carbs er slice is what I count. That is 3 units square for 2 hours.
If you experiment with it you will find the right time frame. The dualwave never worked for me with pizza. I never need the initial bump.

I eat it a few times a year.

For me a Bagel is nearly impossible to manage, and I don't know why. It does not seem to metabolize the same way each time, so I have pretty much given up trying to eat them.
Toast is just a good !

I go for the "Home Run Inn Ultra Thin" variety. I grew up in Chicago and was sort of drifting to deep-dish like 20 years ago but in Champaign, where I lived 1986-2009, there was quite a bit of thin and crispy and I found that better. I like the HRI frozen ones about the best and like them better than @ the restaurant (about a mile from my house...) which tend a bit too much towards the greasy for my taste. They are about 28G of carbs/ serving and I don't seem to have to do any dual wave "magic" (good word choice!) for them? I've never really had good luck w/ those.

Oh pizza how I love/hate thee. For me, this is the ONLY thing that works - THIN CRUST pizza (22g carbs per slice) with a dual wave bolus (aka, the pizza bolus). I do 60% when I start eating, and then spread the remaining 40% over 2 hours. I have no more than 3 slices (66g of carbs total).

Just did it the other night and worked like a charm (highest I went was 170). If I start out within range, this usually works just fine. Granted, I also had a beer with it (which I'm assuming your 9 year-old will NOT be having) and even a small amount of alcohol has a lowering effect for me. BUT, it worked.

One trick for me is that I have to start out in range. If I am already a wee high I will go higher than a freaking kite.

I only have pizza about 3-4 times a year, but darn is it good. Pizza is one of those things that make my pump totally worthwhile. I could never eat pizza on MDI without ending up somewhere in the 300s and then crashing in the middle of the night. But with my pump, it is much easier.

I know that some folks have also had success with doing an initial bolus and then increasing their basal rate for several hours. Bottom line is it's a bit of trial and error. But it is possible.

Pizza is an eat and test a lot experience. The obvious thing to do that I have trouble with is to limit the amount you eat to lessen the unexpected results. I think a dual wave bolus and crossing your fingers are the best advice. The other big piece of advice I can share is that if you stick with the same pizza company (and possibly type) you are limiting your variables. Through trial and error you will eventually figure out a pretty effective way to bolus for that specific pizza.

I do thin crust pizza myself, and I allow 30g per slice, then I dual wave it 50/50 over a period of 4 hours. Works for me, but everyone's mileage varies.


It varies for my son depending on the kind of pizza, how much he eats and the time of day. In general, we do a 60/40 combo bolus with the 40% spread over 2 hours. If he eats a large quantity, it seems to hit later, so we would do more like a 50/50 or 60/40 over 4 hours. If pizza is served at lunch, he tends to be active enough that his bg doesn’t get too high and the 2 hour combo works; dinner pizza hits later & he needs the longer combo time. We also tend to bolus for pizza after he eats rather than before. That further delays the front end part of his bolus.

Pizza is definitely trial & error and lately a food my son chooses not to eat much. Unfortunately, it seems to be served at every school function, party, etc. he goes to. He probably has the opportunity to eat pizza at least 3 times a week if he wanted to. Fortunately, he’s recently decided that he would rather limit how frequently he eats pizza rather than risk the high blood sugar that sometimes comes with it.

I wish foods came with appropriate amounts on insulin built in :)

Thanks for your suggestions. Pizza just seems to hit him so late... I've tested him every hour after pizza and he's nicely in range until somewhere between the 5th and 6th hour. Then he's practically 300! Maybe he just needs to run a few miles 4 hours after pizza. ;-) Maybe a temp basal would do the trick. I'll have to experiment with different dual waves. I will try the square bolus (haven't used that yet.) But maybe he just shouldn't eat pizza! Really I would rather he eat chocolate cake sometimes!

I'm sure once I figure it out, he'll have a growth spurt or something and then all bets are off.

Too many variables!!

Keep those suggestions coming. I appreciate the feedback.

most pizza i have no problem with about 45 carbs per slice. but some of the high gluten pizza dough's make it really hard as the BG stay high for over 4 hrs then drops like a rock. i have to be careful when i eat at my Favorite pizza place and cut the final bolus to 1/2 if its close to 4 hrs and it wants me to bolus again