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The sliceThree slicesTake the slice apartThe pizza bolus50/50 · 2–5 hoursFat at three hoursAutomated pumpsWhich pizza?
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Bolus 4 · Episode 1674

Pizza Hut Pizza

One slice off the Pizza Hut label — 36 carbs, 17 fat — and what happens when a teenager eats three. This is one of the early episodes, before the estimator: Scott and Jenny build the pizza bolus by hand, and every number on this page is the label's or the recording's.

Scott Benner and Jenny Smith, RD, CDCES, LD
Open the Bolus 4 estimator

No estimator on this one. Nobody types a slice into the tool and nobody states a carb ratio — this episode is about how to shape the bolus, not how many units. So there are no unit figures anywhere on this page. Run the slice through the estimator yourself, with your own settings, when you're done. 2:29

01 · Bolus 4 · Episode 1674

One slice. Then two. Then three.

Large, original pan, pepperoni — the slice Scott pulled the Pizza Hut label for. 36 carbs and 17 grams of fat, and it never comes alone.

2:29

One slice

36carb17fat
Large original pan, pepperoni. Jenny remembered it as “36 or 38”; the label Scott read says 36 carbs and 17 fat. Protein wasn't read aloud.

Two slices

72carb34fat
Jenny's “a child who really eats two pieces” — “17 grams per slice is 34 grams of fat.” Before the breadsticks, the fries, or the dressing on the salad.

Three slices

108carb51fat
Scott's teenager plate. His count out loud wandered — “30, 60, 90… 110, 115” — three times 36 is 108. Fat: “over 50 grams,” 51 by the label.

Half a large

144carb68fat
Jenny: “at least four, maybe six slices in a half of a pizza.” Four slices is 144 carbs and 68 fat — which is why “putting in 70 grams of carb for half” leaves a college athlete high, and stuck high, for hours.

Nothing here went through the estimator. The carbs and fat on the one-slice card are the label's; the other cards are that slice multiplied, the way Scott and Jenny multiply it on the recording.

Off the Pizza Hut label · protein wasn't read on the recording  ·  Click any item to hear that moment
02 · Bolus 4 · Episode 1674

Take the slice apart

Where the 36 carbs and the 17 grams of fat actually live. No part of the slice was weighed on the recording — this is what Scott and Jenny said about each piece, not grams per piece.

5:13
1Pan crustheavy dough, made with oil — and DATEMcarb · fat
2Tomato saucenot mentioned on the recording—
3Mozzarellanatural fat, already in itfat
4Pepperoninatural fat, already in itfat
One slice, off the label
36carb17fat
Protein wasn't read on the recording  ·  Click any ingredient to hear that moment
51g
of fat in three slices

It isn't added on top like butter or dressing, so nobody sees it — it's baked into the crust, the cheese, and the pepperoni. That's the part that turns a pizza into a five-hour meal.

Where the fat hides5:13
  1. It's built in, not poured onSour cream, butter, heavy cream, salad dressing — you can see those. The oil in the crust, the cheese and the pepperoni you can't, so the plate never looks like 51 grams of fat.
  2. Fast-food dough isn't home doughScott read the Pizza Hut ingredient list: DATEM, enzymes, and stabilizers to keep the dough uniform and extend its shelf life. His homemade pizza is flour, water, yeast, salt, maybe oil — thinner, lighter on cheese, and he counts it like any other food.
  3. Fat slows the carbs down, then leans on the insulinIt holds the carbs in your stomach longer, stretching how long the meal hits — and at two and a half to three hours the fat itself starts making the insulin work less effectively.
03 · Bolus 4 · Episode 1674

The pizza bolus

Pumps first came out with an extended bolus because of pizza. Jenny's starting shape, and where it goes from there.

6:54
Jenny's starting place8:10
50 / 50
the split
Half the carbs up front, half extended. A starting place, not a finish line.
2–5 h
the stretch
A minimum of two hours. Four or five for a big plate or a meal with breadsticks and fries around it.

Pizza sits in the moderate range for glycemic index — Jenny put it around 55 to 70 — and the fat and protein pull the impact lower and later still. That's the case for extending.

How to build it7:39
  1. Still pre-bolus — just not for all of itSomething has to be working when the first slice lands. Put the whole thing up front and the insulin crushes you long before the pizza shows up; digestion is slow, the dough isn't simple sugar, and there's no fast spike coming.
  2. Line the insulin up with where the carbs areThree slices bolused as 36 carbs three times, all at once, is insulin arriving hours before the food does. Stretch it with an extended bolus — or, if your pump can't, with small boluses along the way while the carbs are still coming online.
  3. Evaluate before you press anythingFlat at 100, or already rising from 120? Just sat still in a car on the way to the pizza place — blood sugar drifting up? Or running around outside all afternoon and quietly falling when the pizza box arrives? The trend decides the pre-bolus, situation to situation.
  4. Then bring in a second tool at the fatAt around two and a half to three hours the fat hits — that's where a temp basal or an override earns its keep, on top of the extended bolus.
  5. An hour later and 200 and climbing? Something was missedMore insulin now. Then, as Jenny tells families: it was an experiment, no beating yourself up — next pizza night you put more in the picture, or at a different time.
On an automated pump12:45
  1. Some systems can extend, some can'tScott's example: Tandem can set an extended bolus; Omnipod 5 in automated mode can't. Switching to manual for the meal is an option.
  2. But keep your manual settings honestThe algorithm has been changing what you're getting. If you drop into manual with the settings you typed in on day one, they may be nowhere near right. Keep them current so the switch is safe.
Takeaway15:26

Know which pizza before you ask how to bolus it.

Thin crust, pan, deep dish — different foods wearing the same name. The pattern Scott sees online most: big number, all up front, slow digestion, a low, juice for the low, then the pizza finally lands on top of the juice and the whole day is spent high. Fat, extended boluses, and the right slice count are the way out.

04 · Bolus 4 · Episode 1674

Which pizza are you eating?

Jenny's carbs-per-slice guide, from the hand-size thin slice to Chicago deep dish.

14:22

Left to right: thin crust, pan, Chicago deep dish. Same word, three different foods — about 20, 30–35, and 50–60 carbs a slice by Jenny's guide.

14:48
Jenny's slice guide14:48

The guesstimate she teaches when there's no label to read.

The sliceCarbs, about
Thin crust — a slice the size of an adult woman's hand, fingertip to wrist20 g
Pan style — a Pizza Hut, a Domino's30–35 g
Chicago-style deep dish — an inch or more thick50–60 g
Scott's homemade, thin, not a ton of cheese — what he counts for Ardenabout 20 g

The Pizza Hut label says 36 for a large original pan slice, right where Jenny's pan-style range lands. Scott notes Domino's runs lower per slice by a fair amount — a lighter, thinner slice by the look of it. Weigh it, or know your chain.

Take a picture of this one

The pizza rules

Everything Scott and Jenny would want on the fridge, in one card.

50 / 50to start
Half the carbs up front, half extended. Adjust from there.
2–5 hextended
Two hours minimum. Four or five for a big plate or a full meal.
2½–3 hthe fat hits
Temp basal or override when the fat starts sitting on your insulin.
17 gfat per slice
Two slices, 34. Three, over 50. Nobody's bolusing for it — that's the problem.
20 · 35 · 60thin · pan · deep dish
Jenny's carbs per slice when there's no label: about 20, 30–35, 50–60.
Which pizza?ask first
Know the pizza you're eating before you ask how to bolus it.

“Most of you don't bolus for your fat.”

Scott Benner4:55

“Instead of even extended bolus, we just refer to it as a pizza bolus.”

Jenny Smith7:01

“Fat sort of sits on your insulin and it makes it work less effectively.”

Jenny Smith11:52

“It was an experiment. There's no beat yourself up about it.”

Jenny Smith13:35

“You need to know which pizza you're eating before you even ask that question.”

Scott Benner15:26
The tool

Bolus 4 Estimator

Run this food through it with your own settings.

Open it →
The method

Meal Bolt

The tutorial the whole series is built on.

Read it →
The series

Bolus 4

One food per episode, with Scott and Jenny.

All episodes →
Everything on this page is a simulation for education, not medical advice. Nothing here should change your insulin dosing without your care team.
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