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    Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

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  • Living with diabetes blog

  • March 28, 2009

    With diabetes, eating pizza not always a treat

    By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

60 comments posted

Controlling Your Diabetes

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For people who don't live with diabetes, eating pizza is usually a treat. The worst problem is you might eat too much.

My dietitian friends tell me pizza can be a healthy food (protein, vegetables and complex carbohydrates). "Can be" is the key. Those thick crusted, deep dish, meat lovers specials with extra cheese are probably not what my dietitian friends are talking about as far as a healthy meal.

Here are some interesting statistics from an industry Web site:

  • Americans eat approximately 100 acres of pizza each day or about 350 slices per second.
  • Pizzerias represent 17 percent of all restaurants.
  • Pizza is a $30 billion per year industry
  • Pizza accounts for more than 10 percent of all food sales.
  • Sixty-seven percent of Americans order pizza for a casual evening with friends.
  • Each man, woman and child in America eats an average of 46 slices or 23 pounds of pizza a year.

For people with diabetes, just thinking about pizza creates all kinds of emotional turmoil:

  • "Pizza, never touch the stuff, it causes my blood sugars to go crazy."
  • "I wish I could eat pizza, it's one of those things I haven't figured out how to cover with my meal insulin."

High fat foods such as pizza can cause a delay in the absorption of the carbohydrates for 2-3 hours after eating and can elevate the blood sugar for up to 8 hours.

So what's a person with diabetes to do? As you know, there are no hard fast rules in diabetes management; many times it's trial and error. You can do everything such as diet, activity and medication consistently and the blood sugar results will vary.

Some tips:

  • Experiment with one brand of pizza (preferably a thin crust). Test your blood sugar before and after the pizza and watch the patterns in your blood sugars. When does your blood sugar start to rise? If you are on an insulin pump or a multiple daily injection program (MDI), you can time the rapid insulin accordingly. It may mean taking the insulin after you eat.
  • If you are on an insulin pump, you can use an extended/combo or square/dual wave bolus, according to the patterns of blood sugars you've seen. Ask your diabetes educator to explain how these functions work and how to set these programs up on your insulin pump.
  • After you have one pizza mastered, you can move on to others.
  • If you are on insulin programs or oral diabetes medications other than the multiple daily injection program (MDI) or insulin pump, don't adjust your medication for the pizza intake (ask your doctor if you have any questions or concerns about this issue). Just be aware your blood sugar may run a little higher a few hours later or even into the next morning depending on when you ate. On the other hand, pizza may not have much of an effect on your blood sugar. Naturally, the amount of pizza you eat will make a difference in your blood sugar results.

Is eating pizza worth it? I'll be anxious to hear from you this week.

- Nancy

60 comments posted

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  • May 11, 2013 6:20 p.m.

    I have found a way to enjoy pizza! We buy the thin wraps that are whole wheat & low carb- I then put whatever I like on it - I can eat the entire wrap with all the veggies I want & I use turkey pepperoni on it - - does not make my blood sugar spike at all - - if you are a pizza lover this sure works great for me.

    - Nancy

  • April 18, 2013 4:37 p.m.

    Thanks, I appreciate the insight.

    - ramsey

  • March 26, 2013 3:47 p.m.

    I have had a few patient that wake up with higher blood glucose readings and have a long fasting time between bedtime and am (10-12 hours). These patients noticed when they have a bedtime snack (usually not pizza) they will wake up with a lower am blood glucose reading. My personal theory is the liver does not kick out any extra glucose early morning because the body is not hungry.

    - Nancy and Peggy

  • March 22, 2013 11:22 a.m.

    This is common medical advice but in my case it is sheer nonsense. I've had type II diabetes for four years with my blood sugar stabilizing at between 150 and 120, the higher numbers always in the morning. But a few months ago I had a craving for late night frozen pizza, the next morning my blood sugar fell to 110-the lowest it has ever been. Since then I have tried with repeated with the similar results. I can count on my blood sugar being 20-30 points lower than expected by eating a 12 - inch thin crust pepperoni pizza at night. (By the way, I do not have a weight problem, my diabetes was diagnosed after a sudden weight loss and even with a pizza diet my weight has held strong). Can anyone explain this?

    - ramsey

  • February 18, 2013 10:51 a.m.

    I was diagnosed with type 2 diabetes about 2 years ago. Pizza was and still is my favorite food. Since being diagnosed I have lowers my numbers to the prediabetic range. I lost 18% of my body weight by using simple rules. I added exercise the second year. 1. Never eat pizza until you feel completely full. Stop one peace short of stuffed. 2.Order thin crust and don't eat the crust at all. The top is the best part anyway. 3.Eat an amount of salad (lettuce and Tomatoe are fine)equal in size to the crust you would have eaten, before you eat the pizza. I prefer to use a small amount of regular salad dressing over the real low calory stuff. 4.Drink a lot of diet soda, unsweetened iced tea, or water with the pizza. Several glasses. Most pizza places have free refills. Let me know your thoughts.

    - patrick

  • January 15, 2013 2:46 p.m.

    First, thanks to all who took the time to post, I am a newly diagnosed type II and I appreciate the knowledge being passed on.. even the jerk comments, because it reminds me of how cranking and irritable we can get when our blood sugar spikes. I found a place that makes thin crust and whole wheat crusts, I alternate, get a personal pizza and usually eat 3/4 of it. I get garlic and anchovies on it (I have weird taste and ate that before I was diagnosed) I also do extra time on the treadmill after - always. I see a small spike but no noticeable difference between the thin crust and the whole wheat.

    - newbie

  • December 6, 2012 5:34 p.m.

    I cook for my brother who is diabetic. We find that making pizza crust from croissant dough does not affect(raise) his blood sugar like regular pizza dough does. Just parbake then load with toppings, to make it crispier.

    - Wanda

  • October 28, 2012 1:55 p.m.

    Generally my pizza is thin crust and toppings consist of extra sauce, garlic, mushrooms, and any assortment of veggis (spinach and broc mostly)and, when in the mood, some anchovies. Never any meat but that's not a health decision, just a preference. To avoid too many carbs I just double up. I take the toppings from a second slice and just put them on top of the one slice. That way I can eat the toppings from 3 or 4 pizza's but only eat the thin crust slice from one or two.

    - Paul

  • October 7, 2012 3:49 p.m.

    I tried whole wheat crust using pesto or olive oil, vegetables, chicken,palm full of pizza cheese and sprinkle parmesan over the pie. It seems to keep me within my numbers.

    - Audrey

  • July 6, 2012 4:12 p.m.

    Did you reply to me properly with your large mesasge? Because I only received the btw comment. Just read your comment about ketones, that sounds right (not that I'm an endocrinologist), but I'm still wondering how you can justify not' calling it a byproduct when most (if not all) of the literature I can find does? I'm not having a go at you, you just didn't give your definition of byproduct', so it's still hard to tell what your problem is. So, what's Med School like in Serbia?

    - David

  • June 6, 2012 5:46 p.m.

    Papa Johns has offered a whole wheat crust.

    - Lacy

  • March 5, 2012 1:46 a.m.

    When i eat pizza I give my insulin bolis half way thru the meal and it works great. I. Was advised by my nutritinaliest.

    - Natalie

  • February 9, 2012 4:00 a.m.

    Pizza dos not have to be a bomb. I have a eleven year old with diabetes type 1, and it s not easy to avoid pizza.So I made a compromise.I make a whole wheat dough, very thin and a lot of vegetables like artichokes,peppers,fresh tomatoes,a little bit of ham and a low fat cheese.My teen is happy and his blood sugar does not rise too much.And of course one jar of coca cola zero.

    - barbara

  • January 28, 2012 10:43 p.m.

    I'm a Type 22. I''ve had good luck with Kashi's Margherita pizza. It's a thin, mulitgrain crust, lots of fiber. I add veggies & lean Italian sausage, some low-fat cheese. I can eat 3 slices. Another very low carb solution for a great pizza taste is to broil a large portobello mushroom, add toppings & heat until cheese melts. Super!

    - Rosemary

  • January 3, 2012 2:01 p.m.

    I found out my blood sugar is 127. I haven't done a lot about it, I have never had to worry about what I eat before. Sometimes I get sick to my stomach after I eat, plus irritable, depressed and tired. I am now keeping a record of what I eat and going to keejp it to protein and vegs. Also I was wondering if I can drink organic decaf coffee. Any suggestions please. I have a lot to do and am 76 yrs old. Looking for a job. thanks

    - jeanne

  • October 29, 2011 12:03 a.m.

    Pre-diabetic, still learning. But wonder about making my own pizza from Trader Joe whole wheat dough. Use tomatoe bruschetta and vegies then sprinkle with parmesan only. Wondering if that is possible.

    - Linda

  • October 26, 2011 9:56 p.m.

    I am a lucky one: one good slice, meaning not the tiny runt one, (thin crust, regular cheese, any veg) NY style from our local shop, for dinner and my morning blood glucose is always perfect. Can't always say that for more 'regulation' type dinner choices w/ portion control in place. Go figure.

    - Bonnie

  • October 12, 2011 10:39 p.m.

    Eating pizza is so worth it. I was diagnosed with type 2 three weeks ago; I'm having fun cooking for myself and discovering new diabetic friendly recipes. I will admit, though, that I am sick and tired of grilled chicken and/or salad. So, I'm planning on baking a homemade pizza this weekend using a whole wheat crust recipe, some good low fat cheese, and some lean meats (Canadian bacon, ground turkey, etc).

    - Jerrad

  • September 14, 2011 8:32 a.m.

    Susie, I think your initial response to the new diagnosis is typical. There is a "fear" component because of a knowledge deficient related to learning about this new chronic disease you now have. I would recommend you see a diabetes educator and dietitian to learn all you can about diabetes care/diet and how to manage it. Remember food is fuel for our bodies and essential to survival. You just need to learn how to eat healthier. "Mayo Clinic Diet Book" is an excellent resource for learning to eat healthier. Regards, Nancy

    - Nancy and Peggy

  • September 11, 2011 5:00 p.m.

    I found out this week that I have type 2 diabetes. Suddenly I am afraid to eat. I have barely eaten all day. My husband, who is also type 2 ordered us a pizza with cheese and vegetables. Is this ok? How many pieces can I eat (dominos). Where can i find an exchange lis? Help!

    - Susie

  • August 16, 2011 10:47 a.m.

    We know that large slugs of concentrated simple carbohydrates are not good for our metabolic system. In pizza, these slugs come mainly from the crust, not the topping. If I'm right, then the less crust the better. (I'm convinced that concentrated simple carbohydrates - such as sucrose and white flour - are addictive, especially when combined with salt and fat. This, rather than the toppings might be the major source of our love for pizza, and many other foods that are not good for us.) It's an interesting thought: what would it take to make a pizza low in simple sugars and starches?

    - Charlie

  • July 4, 2011 7:11 p.m.

    Pizza - Generally, what has been said in the pizza article is true but, as always, not for all diabetics, of course. I can enjoy two medium pieces of thin crust pizza with out too much of a BG rise. Do I want more than two pieces? Of course, but 2 is better than none! I enjoy a huge green and veggies salad with it and either 1 glass of beer or wine. The pizza has not ever shown to bother my next morning BG level. I choose 1 to 1.5 bolus units more for a pizza meal or any pasta dish for years using MDI (injection) and now on a pump; do not use the Square or Dual wave; just add a bit more to my bolus pre meal. I have found that to watch the type and amount of carbs has been very helpful for me. I suspect that for any of us not all carbs are equal HINT: we do not always have to eat the entire crust! :0)) Type 1 for 53.5 years; doing OK most of the time.

    - Lee

  • June 15, 2011 11:04 p.m.

    Oooh...as much as I LOVE pizza, I can't touch 'em. My numbers shoot waaay too high for me to be able to eat them comfortably.

    - Nancy

  • May 19, 2011 3:13 p.m.

    Diabetics rejoice - Papa Murphy's has an ultra-thin crust pizza called the "De Lite." It eliminates one of the major evils of pizza, the high carbs from the crust. They also offer several healthy topping combinations, including one with only vegetables. Give it a try - it might be your ticket back to enjoying America's favorite food! P.S. - Papa Murphy's also has delicious salads ready to go, which can help you balance your meal.

    - Kyle

  • January 18, 2011 4:38 p.m.

    My son was recently diagnosed with type 1 diabetes. He didn't care about anything but giving up pizza. We found a brand, stuck with it & eventually figured out exactly how many units of insulin he needs to cover it, some baby carrots and a drink. He is SO happy & has his favorite meal once a week. Good luck!

    - Lori

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