Why Pizza Spikes Your Blood Sugar at Midnight | Fat, Protein & T1D episode artwork

EPISODE · Aug 5, 2026 · 6 MIN

Why Pizza Spikes Your Blood Sugar at Midnight | Fat, Protein & T1D

from Your Best T1D Year · host Neil Greathouse

Some meals spike you and move on. Pizza spikes you, waves goodbye, and comes back four hours later like a horror-movie villain. If you've ever been 110 at bedtime and 260 at midnight, this episode explains the ambush, and it's backed by real research.A 2013 study led by Howard Wolpert in Diabetes Care fed people the same carbs, but one meal was high in fat. The high-fat meal required about 42% more insulin over the following five to ten hours and drove hyperglycemia for hours, even with extra insulin. The reason is that fat slows gastric emptying, so glucose trickles out over hours instead of arriving at once. Neil explains the tools that help, extended, combo, and dual-wave boluses, and why carb-counting math alone can't cover pizza.In this episode:Why high-fat meals like pizza cause a delayed, second-wave spikeThe Wolpert study: 42% more insulin for a high-fat meal, same carbsHow fat slows gastric emptying and stretches out your glucose riseExtended, combo, and dual-wave boluses, explained simplyThis Week's Challenge: Next time you eat a high-fat meal, just watch what happens two, three, four hours later. Witness the second wave, then ask your care team if an extended bolus makes sense for you.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1

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Why Pizza Spikes Your Blood Sugar at Midnight | Fat, Protein & T1D

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