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

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  • March 28, 2009

    With diabetes, eating pizza not always a treat

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

48 comments posted

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

48 comments posted

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  • 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

  • December 12, 2010 Midnight

    For Canadians who would like to convert readings to US measurements there is a great website http://childrenwithdiabetes.com/converter.htm Example 200 US reading is 11.11 Canadian reading

    - Pine

  • September 17, 2010 5:52 p.m.

    There can be a danger when eating pizza from an unknown pizza shop. There have been instances when granulated sugar is added to the pizza sauce to make it sweeter.

    - Antonio

  • August 13, 2010 10:52 a.m.

    I make my own pizza at home. Thin wheat crust. If I do desire a tomato sauce I use canned San Marzano tomatoes with a little salt and pepper, some fresh mozzarella, and some fresh basil. I also make a couple of varieties of white pies. The first is a shrimp scampi pie, and the second is made with fresh goat cheese, caramelized onions, and portobello mushrooms. I always start the meal with a large salad, and limit my quantities, and I never seem to have issues.

    - Jeff

  • August 4, 2010 10:49 p.m.

    I'm a newly diagnosed T2. We have a pie shop, Pizza Luce', that makes their pies with whole grain flour(unbleached). I can have 3 slices and my BS levels stay in my target area. Using Metformin and exercise/diet to manage. I have pizza 3 times a month with no problems.

    - Minneapolis Mark

  • July 27, 2010 9:12 p.m.

    Pizza is highly NOT recommended for type II diabetics - at least if you want tight blood sugar control. I have almost completely eliminated pizza from my diet. The reason: I had ONE slice a year ago and it made me very sick - my sugars went sky-high, super-blurry vision, the whole works. So fight the pizza temptation, folks. It will save you a lot of grief later on.

    - Young diabetic

  • June 1, 2010 10:19 a.m.

    My family has pizza once per week and I too love it. I realized it spike my sugar level so I asked about whole wheat pizza. That worked. Being lactose intolerant meant no cheese either. Now I have whole wheat pizza, veggies, pepperoni, pineapple no chees pizza and I love it. You just have to see what suits you, check your blood sugars and work with it. Don't eat too many slices either.

    - Anita

  • April 4, 2010 9:58 p.m.

    You better believe pizza is worth it. I'm a brand new type 2 insulin dependent diabetic. I can only eat one piece of this pizza, but I just make sure that I have a salad with a large varity of veggies in it to make it fulfilling and worthy of filling the void of not eating to many bad carbs. I've found that you can and never will get away with cheating anytime when it comes to your diet. So bottomline put the quality of life above anything that can effect your health in the immediate future or long-term. As far as I'm concerned pasta and rice have a more significate effect on my blood sugar than anything so far. So good luck all you diabetics and just believe you can do whats best for you now and in the future . Realize you are not only gaining strength, but you are leaving a postive impact on the people that are involved in your life.

    - Michael

  • March 23, 2010 1:02 p.m.

    Interesting to read. I am Type II 11 years. A1c was >11 when diagnosed. Diet and exercise for 8 years - A1c <6. Now use Byetta. I do low carb and exercise. Therefore with pizza its not the toppings (including fat!) that is the problem for blood sugars. Its the crust that affects blood sugars. Each has to decide for him or herself if it is better to cover carbs with meds or exercise or just avoid the carbs. I don't want to scare you but I avoid bread, pasta, rice, potatoes, and milk and high carb veggies (Beans, corn, peas lentils, etc.) I identify with those on this blog who eat the toppings and avoid the curst. Right on for me.

    - Paul66

  • January 30, 2010 1:14 p.m.

    For Type 1 pump users - all you need to do is bolus for the initial spike b/c of the crust then set the square wave bolus at the same time to activate for about 2 or 3 hrs - after a while you eat the same brand of pizza a couple times, you see a pattern so you can up to dosage of the square wave bolus - works like a charm though pizza tends to make me fat & quick!

    - Bill

  • January 14, 2010 5:57 p.m.

    Eat pizza once a week. Type II. I eat Two slices. 1/4 of a twelve inch pizza. I exercise (Bike) 1 1/2-2 hours a day and piza doesn't seem to bother me. I don't take any meds. Diet management alone

    - Pamara

  • December 18, 2009 10:10 a.m.

    I see that NO ONE bothered to mention exercise after eating. You can't eat and sit on your lazy butts. This causes blood sugars to spike. After eating, go for a 30 minute walk, longer if you can. You will be amazed how much you can eat and still keep your blood sugars from getting too high. This past thanksgiving day after I ate about 50G of carbs or so, I spiked to 204. I immediately got on a treadmill and walked for 30 min. My BS dropped a whopping 100 points! I am not on any meds either. I am a type 2. I can have my pizza, all I want, IF I want to walk 1/2 hour for each slice I eat. Not a fair exchange though. 3 slices = 1 1/2 hours of walking. I am a carnivore basically. I detest Veggies, always have and won't put them in my mouth.

    - Zolar1

  • October 31, 2009 11:22 a.m.

    i'm writing this for my 10 year old son . We have it figured out there is 60 carbs in a personal pan pizza hut pizza he put that into his pump and does fine with it .His blood sugar seems to be alittle higher but he is very out of control it doesn't seem to matter what he eats.

    - Tricia

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