Whats the score with pizza?

[ruthelliot]

Our 3yr old has just discovered the delights of pizza ( he really is his mum's boy i fear!) and I'm struggling to get it right. He is on mdi and we carb count religiously. The last few times he's had pizza it's been pizza bolognaise from our local italian restaurant. We've compared to pizza we know the value of and think it's fairly accurate (my brother in law is the chef so he helps confirm things as much as poss) but each time he's gone really low 2-6hrs later. Tonight he had it with chips and a little ice cream ( i know not the healthiest but it was a treat night). I know that's quite a fatty meal and as such it would absorb slower but I did think we had dosed quite low and still he went low 2hrs later so what should i do? Should I just give him a tiny dose then check him later and give him more? if so how much later. I've had problems before when we tried splitting doses like that as at some point we always get a cumulative effect so I dont really know what to do... Avoid pizza? What life would that be!!!

 

[SacredHeart]

I'd check out the Big Night In Threads in the Food and Carbs section 🙂 You can have a look at how pizza hits different people there.

Myself, I split the dose, but I usually give myself a bit extra up front, so it's not bang on 50/50, more like 60/40.

Chips on the other hand, I can't get the hang of!

 

[Adrienne]

Hiya

Pizza is an absolute nightmare, easier on a pump of course but still not straightforward. People on MDI tend to have to split the doses. However there is a guy on another diabetes group who posted this way of dealing with pizza and how they do this in Italy. Some of the parents on the cwd email group have tried this and it does work. If you try it you will have to work out how to on MDI. This guy is on a pump. He is replying to someone going to Italy. Where he says square wave this is a type of way of delivering novorapid over a period of time slowly dribbling in over that time rather than all of it in one hit. The best way of experiment with this is lunch time rather than be up all. I think that it is worth experimenting as all kids love pizza and whilst is not a great healthy food when they are older they will want pizzas with their friends etc, anyway this is the idea :

"Here is the technique doctors often teach in Italy to deal with pizza,
which I agree is not an easy task (even for Italian diabetics) especially when
you eat pizza at night and, as you said, you can't really walk it off (and in
Italy we love eating pizza at night!).

The idea is that when you eat the pizza, you bolus (normal bolus) for the
amount of carbohydrates you estimate for the amount of pizza you eat. For
a whole pizza from Tuscany/Liguria (the zones where you are going), which is
pretty light and thin, I would say about 90-100g carbs (a Southern Italy's
pizza is often a bit heavier). Let's say you eat it at 8pm. This insulin
should keep your blood sugar ok until 10-11pm. At that time you do an
additional bolus for about 1/3 of the insulin you did before but as a
Square-Wave Bolus over 4 hours. (If you do not do this additional bolus, values will go up during the night)

In my case, it means 6 U of insulin when I eat the pizza and 2 more at 11pm
(released from 11pm to 3am)."

Hope that helps in some small way. 🙂

 

[everydayupsanddowns]

60/40 tends to work for me too (for pizza meals not much more in total cho than usual - say 1.5x or 2x) usually with an hour and a half or two hours between doses. For more extensive blowouts I've even been known to go 50/30/20 or something similar. Similar approaches seem to work with chips too for me, though it's always a bit of a gamble.

 

[MIsmail]

Chips on the other hand, I can't get the hang of!

I'll second to that!

With regards to kids: It's often difficult due to their activity levels. I recon do some experimenting until you can work out the exact amount of carbs, then adjust for activity.

With these sort of things, I under estimate (the amount of insulin) then compensate later and finally add it up to see how much exactly.

It's tough, but it works for me.

 

[ruthelliot]

thanks everyone. I really have messed up tonight. He was going low at bedtime so i gave him a small 10g supper and now he is at 24. Could be a long night fixing this!

 

[Adrienne]

Oh dear, poor you. This is the problem with pizzas, they come up and surprise you later. Hope the night isn't too bad for you. 🙂

 

[ruthelliot]

Took till 5am but got him down eventually. Maybe wasn't just the pizza as he went really high at bedtime again last night and was coughing a lot through the night so who knows maybe a combination of things! Thanks anyway for the advice.

 

[Patricia]

Sorry just saw this - hope things have gone up rather than downhill?!

Just to say re pizza: on MDI we used to split the dose 1.5hours, but not overcarb. On the pump we now do 50/50 dual wave, which almost always works quite well. Thin based pizza, where a whole store-bought small one is 85-100 CHO.

E is almost always a *little* high after that four hours of active insulin though,...a little square wave in addition may be the answer...

Good luck !