I almost died from eating pizza.
Yup. This is a true story (and luckily – one with a good ending).
My name is Beatriz and I have Type 1 Diabetes.
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As nearly every Type 1 Diabetic knows, eating pizza is a huge challenge. You may be thinking to yourself, “Seriously? How can eating pizza be hard, Beatriz?”
Pizza is the perfect storm of fat, protein and carbohydrates – which is what Type 1 Diabetics need to account for when dosing the right amount of insulin for the food they intake.
If that just sounded complex, it’s because it is. But, have no fear – I’m here to guide you through it.
Understanding Type 1 Diabetes
Before I dive into my complicated relationship with pizza, I’d like to tell you about my diagnosis and what it means.
I was diagnosed with Type 1 Diabetes in 2008 at the young age of 13. I was in my prime middle school years, super skinny and equally awkward, when my entire life changed.
For those of you who are unfamiliar with Type 1 Diabetes – here’s the scoop:
Type 1 Diabetes is an autoimmune disease in which the pancreas loses its ability to create insulin – a vital hormone that breaks down the sugars in our body and converts them into energy.
Unlike Type 2 Diabetes (the more commonly known of the two) there’s nothing you can do to cause it and, unfortunately, nothing you can do to cure it.
It’s treated by managing blood sugar levels with manual insulin injections or using an insulin pump (like I do). Plus, add on the countless finger pricks and continuous glucose monitors (CGM) to help in all capacities.
Sounds simple? Not quite so. So many different things affect your blood sugar levels – like exercise, stress, and food – like pizza or ice cream.
We all know that every food is different – some are high in carbs but low in fat and vice versa.
For me, pizza was the ultimate challenge, but one of my favorite indulgences. So, without further ado, here’s how I – quite literally – resurrected my love for pizza as a Type 1 Diabetic.
From Love To Fear: How My Relationship With Pizza Went Downhill
My story with Type 1 Diabetes and pizza starts on an autumn night after having a long volleyball clinic. I had just arrived home and went to go get pizza with my Dad and sister.
We ended up at a restaurant that served very thin crust pizza. I was newly diagnosed at the time, about a year in, but hadn’t had much practice with dosing for foods as such. I took my estimated guess – with confidence – and dove right in.
Fast forward an hour – we’re walking home and I knew something wasn’t right. Right as I walked into our apartment, hypoglycemia (low blood sugar) came in fast, resulting in a quick downward spiral – hypoglycemic seizures, losing consciousness, and a call to 911.
I was very fortunate that my family knew what to do to save me – but, my memory of eating pizza became haunted. I had even vowed to never eat it again. *Spooky*
For a long time, I questioned where it all went wrong. Was it the exercise before? Was it taking too much rapid-acting insulin? Should I have just stuck to the coined “diabetes-friendly, healthy diet” and ordered a salad with the addition of croutons as a ‘treat myself’ moment?
Truth is, I’ll never know.
But over time, as most things go, the self-doubt diminished and I regained my confidence in managing my diabetes.
And when it came to pizza – I knew I needed to change my approach for eating pizza.
Resurrecting My Love For Pizza – With Great Blood Sugar Levels
My dream: a pizza meal that would go right. This was the goal.
How could I achieve it?
I brainstormed the options available to me:
- Low carb / low glycemic index solutions,
- Cauliflower pizza crust,
- Slices of pizza heavy on the veggies,
- Reducing portion sizes,
- Creating a set meal plan for pizza,
- And more.
I knew that I didn’t want to constrain myself to the typical diabetes diet. Why?
With Type 1 Diabetes, it’s important to live a regular life. As long as you can manage your blood sugars, avoid hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar), you have the freedom to live the life you choose.
Seriously – even my dietitian told me this.
My goal was not to lose weight with some janky weight loss program – it was to balance my blood glucose levels while indulging in one of my favorite foods, pizza, guilt-free.
Here’s how I resurrected my love for one of the greatest foods of all time – pizza.
1. Correction bolus.
Say hello to my friend – a correction bolus.
What is a correction bolus? This is when you deliver rapid-acting insulin to correct a high blood sugar.
Note: Your doctor (or certified diabetes educator (CDE)) will help you determine what your correction bolus ratio is as it’s different for everyone!
Why did this work? Pizza is a fast food high in fat – which means your blood sugar spike is prolonged, leaving you higher for a longer period of time.
Let’s look at an example.
In this graph, we have a more visual understanding of how different macro meals affect your blood sugar spikes. As you can see, fatty meals have the longest affect.
Pizza contains all three of these nutrients: carbohydrates, protein (when you order toppings like pepperoni), and fat.
In a Penn State study on the relationship between diabetes and pizza, Robert Gabbay, Associate Professor of Medicine at Penn State, confirms this and shares —
“Pizza is a complex food and causes prolonged post-meal hyperglycemia…Our study shows that after a high-carbohydrate, high-fat meal like the pizza used in this study, spacing out insulin given by an insulin pump in two doses, one of which is over an eight-hour period, may keep glucose levels in a more favorable range than a single dose of insulin or a double dose taken over a shorter period.
Now – I will translate what this means for us non-doctors.
Instead of trying to guess the right amount of insulin in a single dose, start small.
I personally aim for 50% of what I would usually give for a specific carb count.
Then, especially if you have a continuous glucose monitor (CGM) like Dexcom, monitor your blood glucose wave.
At the two hour mark, check in with your blood glucose level and deliver a correction bolus – if needed.
An easy trick that has worked for me, is to deliver 75% of what you would have originally given yourself for the full carb count ratio.
Again – everyone is different, so consult your doctor for the right correction bolus amount for you.
2. Exploring low carb options.
While I was originally hesitant to explore low carb options, I knew I would be stubborn if I didn’t.
I am so happy I decided to try these options, because I was so pleasantly surprised!
First off, I’d like to thank cauliflower crust for becoming a trend. This wildly made it so much easier to start finding low carb options.
While I have tried many different brands – there are two that stood out to me:
- Trader Joe’s Cauliflower Crust and
- Real Good Foods.
Trader Joe’s Cauliflower Crust can be found in the frozen aisle of your local TJ’s. It is a great solution for cooking with friends, family, or by yourself at home. All you need to do is buy your ingredients (like tomato sauce, olive oil, mozzarella cheese, tons of veggies – or whatever your heart desires) to make your perfect entree.
Real Good Foods takes an interesting spin on pizza. Are you ready for this? The crust is made from chicken! So, not only do you get more protein, but you can enjoy a low carb option without the lack of flavor.
My personal favorite of the Real Good Foods pizza line is the pepperoni. The best part is that the chicken crust really doesn’t taste or feel like chicken. I’m not sure how they do it, but it really is a great alternative! Plus, my curiosity for chicken-crusted pizza also introduced me to the rest of their line which includes breakfast sandwiches and entrees like enchiladas (great alternative to tacos) and more.
3. Finding a balance.
Of course everywhere you go isn’t going to have cauliflower crust or accurate carb counts. This is where you need to practice balance.
Finding a balance when eating pizza is tricky. At the end of the day, we all want more than just one slice of pizza.
When I am out ordering pizza with friends or family, I typically try to include other foods into my meal.
For example, we’ll typically order a few different pies for the table, but I always make sure to order an appetizer or starter-sized salad to accompany my meal.
This way, I can still have a satisfying meal without having to eat more pizza than I’m comfortable counting for.
This is also extremely helpful if you ever find yourself in Chicago eating deep dish pizza (Lou Malnati’s is my personal favorite).
As a previous midwestern woman and proud Type 1 Diabetic, I hope this post gives you the confidence to try it – because it is definitely worth it.
Yes, I was able to resurrect my love for pizza – and if you’re in the same boat, I am cheering for you!
Everyone should be able to enjoy pizza – whether you have diabetes or not.
Following these steps and researching options that fit your needs is the first step.
Not every pizza meal will be a win, but you will learn and conquer your fear in no time!
Written By Beatriz from The Letter Bea.