I can pretty well say no to certain foods and even stick to limited quantities, except for one. And that one presented itself last night. Round Table Pizza. There is something about that sauce. Anyway, I checked my BG a few hours after inhaling far too much pizza and, shockingly, it had spiked to 208. 
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Are you looking to the community to help you solve this pizza situation or just solidarity with the idea that pizza is agonizingly appetizing and drives spiking highs?
Iāve read accounts of people who have devised sophisticated insulin dosing techniques to enable them to enjoy pizza without the almost inevitable BG spike. But what do you use to manage your T2D? Diet and exercise, pills, insulin?
I was mainly admitting my weakness. Diet, exercise and pills. No insulin here.
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I think managing diabetes and attempting to eat pizza with only diet, exercise, and pills is an incredibly difficult task. Doing well with diabetes requires making some kind of peace with your style of eating. If you donāt want to or canāt limit carbs, especially high carbs combined with high fat found in pizza, then you must accept the inevitable spike.
Have you ever looked into Fat Head Pizza? Itās a low-carb version thatās received rave reviews. Maybe you could satisfy your pizza cravings and still honor your diabetes health.
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When my family gets pizza, Iāll allow myself to eat the cheese and toppings layer (thatās the good stuff anyway, right?). And maybe a little bite or two of crust if I need to. I try not to have too much sauce (because thereās probably sugar in it).
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I feel your pain Brotherā¦I feel your pain. Like Terry said there are insulin dosing schemes to help with the carbs plus fat in pizza but they are hit and miss. Thought I had it figured out once, I still feel your pain.
As. T2 well controlled on diet and exercise only, I dislike the word weakness.
It sounds like an excuse. I make decisions, some good some not so good, but I am the one who decided and I am the one who might pay the consequences.
My thoughts
I too am weak willed around food, I find it helps to think of the exercise I will have to do to work off my āindiscretionsā and how easy it then becomes to refuse all but a small portion of my desired food.
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So firstly, donāt beat yourself up over this. We all know how tempting our favorite pizza can be, and willpower is often powerless against a strong craving. Spiking to 208 is not necessarily a bad thing as long as you donāt do it a lot, and if you have the endogenous ability to normalize your glucose levels in less than two hours. If thatās the case, treat yourself every once in a while so it doesnāt become a taboo food and jettison the guilt.
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hereās a couple of pizza ideas
I respectfully disagree that āspiking to 200 even in moderation is doable.
Just a few points.
It was stated that the person took his BG several hours after eating to obtain the 208. So no matter how much insulin his was producing his BG had not normalized in that time.
There is a bit in information missing, in that was the 208 a random BG reading, or was there a continuous glucose monitor use. If. A. CGM was not used that 208 could be the top of the spike, or the end or the beginning of a spike. unless you use a CGM a random number is just that just information at a point of time. Especially with pizza which can peak much later than other foods.
INsulin production in T2ās tends to start slowly and then moves into high gear and over produce insulin. Sometimes this over production creates a reactive low, where more insulinis produced than is needed and one could go too low.
My point is there a lot of things going on and Pizza is a difficult food to manage as a diabetic.
I do agree with Bernstein and his rule of small numbers. Small amounts and lower
glycemic wont effect your BG as much.
Unfortunately when I was first starting this trip (10 years ago) I experienced all this.
My personal opinion is that eating carbohydrates is addictive and creates a craving for more.
DX A1c of 12, 6.0 or under for the last 9 years. Diet and Exercise only, no medications
30 to 50 carbs a day.
Thanks
T2Tom
Hey Tom:
Very good points. Youāre right in your observation that this reading was after a āfew hours.ā So yes, if he has the inability to normalize after two hours 208 is not a good number at all. āIt had spikedā implied to me that this was the peak, but maybe it wasnāt, which if it were the case, would also not be good.
Indeed, reactive hypoglycemia is a common initial symptom of T2 because of an impaired or non-existent first phase insulin response. Itās important to be aware of this in making food choices.
I was a patient of Bernstein for many years and I credit him for teaching me how to keep my A1cās in the low 5ās since my diagnosis, so I couldnāt agree more regarding the ālaw of small numbers.ā But hereās the thing I also learned, there is a diminishing return of results related to tighter and tighter control, at the expense of your own piece of mind and sanity. Managing diabetes can pose a significant mental burden, and always striving for perfection only sets you up for failure. Thereās a reason that people with diabetes have a higher instance of mental health issues than the general population.
My point is to enjoy the occasional indulgence, and if it results in a rare spike to 200 that you can bring down to normal within a short amount of time with endogenous or exogenous insulin, itās not the end of the world, nor should you feel guilty about it.
Strict diet orthodoxy can have the risk of creating taboo foods that will only make cravings stronger. Yes, pizza is a disaster for people with diabetes, but it tastes great. I indulge maybe once or twice a year, and by doing so, Iām reminded that Iām not missing out because despite the great initial taste, that feeling in my gut afterwards like Iāve just ingested Elmers glue keeps me from going back.
Yes, eating fast-acting carbs can be very addictive, and every person is different. If eating even the smallest amounts of fast-acting carbs can risk a full blown relapse, itās probably best to avoid them altogether. My occasional carb indulgences fortunately do not result in me seeking out more. Maybe itās because I feel so much better on LCHF, but the rare āoff-planā food definitely mitigates me dwelling on something I ācanāt haveā and causes me to appreciate LCHF even more.
Christopher
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You were very fortunate to work with Bernstein.
I was diagnosed 10 years ago with FBG 325 and an A1c of 12.0.
I found an education program that preached limiting carbs and eating to your meter. I did not read Bernsteinās book until about 4 years ago and by that time I had formed a low carb diet program that had my A1c down to 6.0 without meds.
I did learn a lot from the book, mainly about attitude,and dealing with diabetes.
I also learned for me, that his way of eating was too strict for me. I was very comfortable with my 30 to 50 carb a day program, and felt deprived if I went lower.
I did get my numbers down to 5.6 (where I have stayed) but lower than that was too much of stretch. I was not interested in insulin until it was necessary.
I eat real food, just low carb, I donāt use any sugar or sugar substitutes or eat faux rice. (I really did not use sugar much before) other than my Diet Coke addition.
One point I do consistently make when someone asks me if their BG is too high.
My answer if you are asking me your not comfortable with it, so most likely it could/should be lower.
I am glad to hear you are well controlled.
T2Tom
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Thank all of you for your comments. Thankfully Iāve been back down to between 92-124 since my pizza binging.