# Pizza



## Cate (Nov 19, 2010)

Hi folks,

I'm curious...how would you bolus for a pizza?  I know it's a difficult one, but I'm interested in how you deal with it when you eat it.

We had pizza last night, I did my first ever square wave bolus (it's only taken 6 years...) spread over 2 hours.  I was a bit high when I went to bed, but had enough active insulin on board that the bolus wizard reckoned I didn't need a correction - I thought I did but decided to trust the pump as I'd never used a square wave before.  Tested at 5am, was exactly the same as when I went to bed, so corrected for it then, woke at 4.9 which is fine.

So do I need a dual wave with a hit at first then a longer release to combat the spike?  Or something else entirely?  Any thoughts?  I'm actually relatively happy with how the first attempt went, but clearly need to make some changes next time.


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## Freddie99 (Nov 19, 2010)

My other half and I both attended a talk by Gary Scheiner on carb counting a few weeks ago and pizza was one of the subjects. What he reccomends people do is to put in the dose for the pizza over two hours and then when that is done to pop on a temp basal of 150% for eight hours. This is because the fat makes you more insulin resistant apparently, as opposed to delaying the release fo the food from the stomach. For my tuppenceworth I'd be inclined to say it was a combination of both.

Tom


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## Cate (Nov 19, 2010)

Ah yes, I thought I remembered some recent discussion of it, but couldn't find the thread or remember the details!

The 150% over 8 hours might well have fixed things, so I'll try that next time round (any excuse to have pizza again...my waistline/BP/cholesterol scores will kill me... ).

Have you/anyone actually tried this temp basal approach, what was the result?


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## tracey w (Nov 19, 2010)

TomH said:


> My other half and I both attended a talk by Gary Scheiner on carb counting a few weeks ago and pizza was one of the subjects. What he reccomends people do is to put in the dose for the pizza over two hours and then when that is done to pop on a temp basal of 150% for eight hours. This is because the fat makes you more insulin resistant apparently, as opposed to delaying the release fo the food from the stomach. For my tuppenceworth I'd be inclined to say it was a combination of both.
> 
> Tom



Tom is the  dose over two hours extended or multi wave? Im presuming you mean extended as you say for 2 hours. Im always interested to learn new ways of bolusing to see if it works.


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## shiv (Nov 19, 2010)

Cate - yes I've tried it and it worked for me! The 150% and the 8 hours can be adjusted obv  to your specific needs...needs lots of experiment...good excuset to eat pizza!

Tracey - Tom is referring to what we [medtronic users] call a square wave, so say for example (as I have just done as I had pizza tonight!) I gave 6.4units spread over 2 hours.


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## tracey w (Nov 19, 2010)

shiv said:


> Cate - yes I've tried it and it worked for me! The 150% and the 8 hours can be adjusted obv  to your specific needs...needs lots of experiment...good excuset to eat pizza!
> 
> Tracey - Tom is referring to what we [medtronic users] call a square wave, so say for example (as I have just done as I had pizza tonight!) I gave 6.4units spread over 2 hours.



Thanks Shiv, thats extended bolus at Roche, will have to have  a pizza and try it out


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## Cate (Nov 19, 2010)

Thanks Shiv, that does sound promising!

I can't *quite* justify having pizza again this weekend, but I'll plan it in and see what happens - perhaps I should have it at lunchtime so I can test the temp basal without having to stay up all night...


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## Freddie99 (Nov 19, 2010)

I've yet to give it a bash as I've not had any pizza for a while. I'd also do it over the day time as I'm pretty useless when I sleep!

Tom.


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## tracey w (Nov 21, 2010)

TomH said:


> My other half and I both attended a talk by Gary Scheiner on carb counting a few weeks ago and pizza was one of the subjects. What he reccomends people do is to put in the dose for the pizza over two hours and then when that is done to pop on a temp basal of 150% for eight hours. This is because the fat makes you more insulin resistant apparently, as opposed to delaying the release fo the food from the stomach. For my tuppenceworth I'd be inclined to say it was a combination of both.
> 
> Tom



Ive been thinking about this? Before if i had pizza (quite rare), or more likely chinese/curry, i would dual wave over around 5-6 hours and it seems ok ish, sometimes better than others.



What im asking is this. If GS says give full dose for pizza over 2hours extednded/square wave. Would you also do this for high fat meals like chinese/curry and fish and chips etc. And temp basal for 8 hours. Would this work the same, be more efficient than how i would do it now?


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## bev (Nov 21, 2010)

In theory - yes it would. But for Alex it doesnt seem to work properly - but then have only tried it once or twice and may have got the dual wave part wrong - so maybe it wasnt a 'true' picture of whether the Temporary basal worked. Alex doesnt eat curry or chinese so cant help you with that one - but will try it again with fish and chips and pizza.Bev


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## tracey w (Nov 21, 2010)

Thanks Bev,

Thats where im getting confused. You said dw, which is what i would do, im happy that it would only be 2 hours and not say 5.

But this theory is extended over 2 hours, so not a lot up front, i feel i would just go sky high if i did this?


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## tracey w (Nov 22, 2010)

Ok, so i had pizza last night so i could test this.

DEE ZAS TER! 

not for me,

Started on 7.3, after 2 hour extended 18.6. Well you can imagine the rest, after two corrections and tbr for several hours finally woke on 7.2

Maybe it could work on dw instead, but i think i will stick to how i normally do things


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## bev (Nov 22, 2010)

Hi Tracey,
Can you explain what an 'extended' bolus is as I am puzzled. We do a dual wave of 50% up front and then the rest over 2 hours.Bev


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## tracey w (Nov 22, 2010)

bev said:


> Hi Tracey,
> Can you explain what an 'extended' bolus is as I am puzzled. We do a dual wave of 50% up front and then the rest over 2 hours.Bev



Extended is the square wave Bev, this is apparently what GS said do for pizza?I kind of knew this would happen should of stuck to dw.


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## shiv (Nov 22, 2010)

Yep. Just goes to show how different we all are  he said it works for most people...I guess you're not 'most' then tracey


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## bev (Nov 22, 2010)

What he said was to do a 'normal bolus' i.e. a dual wave or similar over the two hour period and when that has finished to increase the basal. So, what did you *actually* do Tracey - I get confused easily....Bev


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## Cate (Nov 22, 2010)

bev said:


> What he said was to do a 'normal bolus' i.e. a dual wave or similar over the two hour period and when that has finished to increase the basal. So, what did you *actually* do Tracey - I get confused easily....Bev



We were talking about doing a square wave (extended wave for AccuCheck pumps apparently!) over 2 hours followed by 150% bolus for 8 hours.  I *think* that's what Tracey was planning to try...

Still not had pizza again yet, but the way this week's going it might be on the menu soon


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## tracey w (Nov 23, 2010)

bev said:


> What he said was to do a 'normal bolus' i.e. a dual wave or similar over the two hour period and when that has finished to increase the basal. So, what did you *actually* do Tracey - I get confused easily....Bev



Me too Bev, i think i got mixed up as medtronic calls them different. Ive re read the thread and i presumed tom meant extended bolus/square wave, but multiwave seems more sensible. I know i needed more upfront to begin with but i didnt do that 

I may give it another go with a multiwave over two hours instead of six next time.


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## tracey w (Nov 23, 2010)

Cate said:


> We were talking about doing a square wave (extended wave for AccuCheck pumps apparently!) over 2 hours followed by 150% bolus for 8 hours.  I *think* that's what Tracey was planning to try...
> 
> Still not had pizza again yet, but the way this week's going it might be on the menu soon



yea thats what i did i think a multiwave is definately needed. Personally i would put about 70/80% up front next time.


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