How Many Slices of Pizza Can a Diabetic Eat?

Pizza is a favorite dish across the globe, but when you are dealing with diabetes, the irresistible combination of thick, melted cheese, sweet or spicy tomato sauce, and satisfying crust make it difficult to predict what it will do to your blood sugars. How many pieces of pizza can a diabetic eat at a meal?

Generally speaking a diabetic can eat 1-2 slices of pizza. Each individual will need to take into account the total carbohydrates, calories, sodium, and fat. Diabetics should try to keep the total carbohydrate between 30 – 60 grams, although some meal plans allow 75 grams.

Pizza nutrition information

There are countless variations, but traditionally pizza is made of dough, tomato sauce, and cheese. Depending on the type of pizza, the method of preparation, and the ingredients, the macronutrient and calorie content will vary.

Although each variety of pizza will differ, the following information is the general nutrition content for one slice of regular cheese fast-food pizza provided by the U.S. Department of Agriculture (USDA).

Calories: 285

Fat: 10.4g

Sodium: 640mg

Carbohydrates: 35.6g

Fiber: 2.5g

Sugars: 3.8g

Protein: 12.2g

Can diabetics safely eat pizza?

Yes, anyone living with diabetes can eat and enjoy pizza. Despite several food myths and judgments revolving around certain foods (especially those that are high in carbohydrates), with some planning, people with diabetes can safely eat pizza, in moderation.

How much pizza can diabetics eat?

As a person dealing with diabetes, one of the most important nutrition factors is keeping track of your carbohydrate intake. When using the carb-counting meal plan, 15 grams of total carbohydrates counts as one carb choice.

Most carb-counting meal plans for people with diabetes recommend 2-5 carb choices per sitting.

According to the nutrition data above provided by the USDA, a single slice of thin crust pizza contains 35.6 grams of carbohydrates, making it about 2.33 carbohydrate choices. However, this depends on the type of pizza you are eating, how it is prepared, and the ingredients included.

A slice of regular cheese, fast food pizza is considered over two carb choices. However, this may not be the case for every variety of pizza.

According to the information provided by the International Diabetes Center at Park Nicollet in Minneapolis Minnesota, one carb choice is identified as ⅛ of a medium (12 inch) frozen pizza.

If you are not counting your carbs and just monitoring your portions, see my article on the diabetes plate method to help balance your meals.

Although this pizza has an appropriate amount of carbohydrates per serving with a good amount of protein, it is high in calories, sodium, and fat, particularly saturated fat, which is the non-healthy fat.

Eating pizza with diabetes

While it is completely safe to eat pizza as a person with diabetes, there are a few factors to take into consideration:

• Check in on your hunger. How much pizza do you want to eat?
• How many carbohydrates does your body respond well to during meals?
• Do your medications determine how many carbohydrates you can consume during meals?
• How filling is the pizza you are having? Consider thick crust vs. thin crust, toppings, amount of cheese, etc.

Balance your macronutrients

Pizza is one of those foods that contain all three macronutrients; fat, carbohydrates, and protein. Although this may seem ideal, the carbohydrate and fat content may be rather high.

There are a few things you can moderate to make pizza more blood sugar friendly to avoid spikes in glucose later on:

• Choose a lower carbohydrate crust that has more fiber and protein
• Add toppings that are fiber-rich
• Choose lean proteins
• Use moderate amounts of cheese

Type 1 diabetes

If you have a Type 1 Diabetes diagnosis, you have an increased risk of experiencing delayed and sudden hyperglycemic episodes (high blood sugar levels). This means after consuming a meal, specifically a high-carbohydrate or high-sugar food, you may feel fine at first and then suddenly miserable.

Some symptoms of hyperglycemia you may experience include fatigue and muscle weakness, loss of concentration, extreme thirst, and trouble seeing.

Avoiding high carbohydrate foods, like pizza, may seem like the only safe option.  However, diabetes doesn’t need to stop you from eating the foods you enjoy the most, and often there is a solution as simple as dividing your insulin shots.

Dividing insulin shots: If you would like to eat regular pizza without any alterations with a Type 1 Diabetes diagnosis, it’s recommended to divide your insulin shots.

Before you begin eating, count out your macros beforehand to determine how many shots of bolus you will need to take and when you should take them.

For instance, if you decide you need four units, spreading the injections out at different times such as an hour before, thirty minutes before, thirty minutes after, and an hour after eating your pizza should help prevent your blood sugars from spiking.

You can customize your injection times to how your body will respond best. However, it is important to speak with your healthcare provider or a Diabetes Care and Education Specialist/Registered Dietitian before you decide to make changes to your required insulin needs.

Type 2 diabetes

If you are living with a Type 2 Diabetes diagnosis, you may not have to worry about insulin injections, but it is still crucial to consume pizza smartly to keep your blood sugar levels stabilized.

-Track your carbs & fats: Knowing how many carbohydrates you are about to consume is essential to keeping your blood sugars in check.

Pizza with thicker crusts is higher in carbohydrates per slice compared to thin crusts. Not only that but unless the crust is whole grain or a non-crust alternative (like cauliflower crust) it is made with refined white flour which is more likely to cause a spike in glucose.

You also have to consider added sugar which is often hidden in tomato sauce, as this adds even more carbohydrates.  

-As for fats, this comes from cheese, olive oil, and toppings like pepperoni, sausage, and bacon. Fat slows digestion down, which means your body delays metabolizing carbohydrates, which explains why you may experience high blood sugar levels the morning after eating pizza for dinner.

-Get in some exercise: If you plan on having pizza, consider going for a light jog beforehand or a brisk walk after eating your pizza. This will help your blood sugar levels to rise more gently. Another way to control blood sugar spikes after eating pizza is by adding fiber-rich toppings, like spinach or broccoli.

Diabetes-friendly pizza tips

If you love pizza and have diabetes, there is no reason to skip out on one of your favorite foods. There are several ways pizza can be part of a balanced and healthy diabetes diet:

• Let go of guilt and food stigmas. If you love pizza, there is no reason to avoid it. Eating pizza in moderation as a diabetic is perfectly fine. Several studies support that restricting your favorite foods can cause increased cravings and potentially over-eating later on.
• Pair your pizza with fibrous and protein-rich sides and toppings. Including a salad or topping your pizza with grilled pieces of chicken makes your pizza meal more nutritionally dense and filling.
• Be mindful of portion sizes. A crucial part of managing your diabetes is keeping track of portion sizes and counting carbohydrates. Thin crust pizzas often contain fewer calories and carbohydrates.

Making a homemade diabetes-friendly pizza

Making your own pizza at home is one of the best ways to track your macronutrients and allows you to control what ingredients are used. Some ingredients to focus on when making your own pizza are the following:

Crust

Include a pizza crust that contains fiber and protein. Go a step further by swapping out your crust with a low-carbohydrate option. Some diabetes-friendly crust options include:

• Whole wheat
• Ancient whole grains
• Grain-free
• Whole grain tortilla
• Almond flour or rice flour crust
• Cauliflower crust or zucchini crust
• Egg white wraps or tortillas
• Cappello’s and Cali’flour Foods are both frozen pizza crust options
• Simple Mills offers boxed pizza mix crust that can be whipped up quickly with minimal ingredients

But in the end, it is most important to choose a pizza crust you will enjoy! Just because cauliflower crust is low in carbohydrates, if you don’t enjoy it then it defeats the purpose of eating one of your favorite foods. With that said, if you do opt for a thicker crust, keep portion size in mind.

Toppings

Again, think fiber and protein-rich! Some diabetes-friendly pizza toppings include:

• Bell peppers
• Onions
• Mushrooms
• Olives
• Spinach
• Broccoli
• Tomatoes
• Chicken
• Lean sausage

Side dishes

If you’re not much of a toppings person, another option to get more fiber and protein into your pizza meal is by adding a side dish. Include a salad or other vegetable sources like:

• Steamed broccoli
• Grilled asparagus
• Oven-roasted carrots
• Sauteed brussels sprouts
• Fresh green bean casserole

Diabetes-friendly frozen pizza brands

If you’d rather stick a frozen pizza in the oven versus making your one from scratch, you can shop smart next time you go to the grocery store by choosing these diabetes-friendly frozen pizzas:

• Urban Pie Pizza Co.
• Banza Chickpea Crust Pizza
• Simple Truth Organic Ultra Thin Crust Greek Style Vegetable Pizza
• Killer Bee Plant Based Wood-Fired Pizza
• Amy’s Roasted Vegetable No Cheese Frozen Pizza

In comparison, the following is a copy of the label for a Jacks, thin crust pepperoni pizza. One serving, or 1/8 of the pizza contains 340 calories, 15 g fat (7 g saturated fat), 700 mg sodium, 35 g carb, and 15 g protein per slice.

Ordering pizza with diabetes

Going out for pizza or ordering one for delivery or pickup from your favorite local pizzeria is a special occasion. However, it can be tricky to order a diabetes-friendly pizza when you don’t know how the pizza was prepared or all of the ingredients it was made with.

Choosing a diabetes-friendly pizza at a pizzeria simply comes down to the type of crust and toppings you choose. Again, go for the thin crust or whole wheat crust option and add fiber-rich vegetables and lean proteins to build a pizza that fits into your balanced and healthful diabetic diet.

You can also check online at the company’s website to find nutrition information ahead of ordering.

Specific values for 2 well-known pizza establishments

From “Nutrition in the Fast Lane” Guide to nutrition and dietary values for fast foods:

• I am not promoting these products, as I am not sponsored by these businesses. I am providing examples to better give you a mental visual of the concept.

Domino’s Pizza, ⅛ of a 12 inch round cheese pizza

• Classic hand-tossed    31 g carbohydrate.   2 carb choices
• Crunchy thin crust.     15 g carbohydrate.   1 carb choice
• Ultimate deep-dish.     27 g carbohydrate.  2 carb choices

Pizza Hut, ⅛ of a 12 inch round cheese pizza

• Fit ‘N Delicious.     22-23 g carbohydrate.     1.5 carb choices
• Hand-tossed.          25 g carbohydrate.          2 carb choices
• Thin ‘N Crispy.       21 g carbohydrates.        1.5 carb choices
• Pan Pizza.               25 g carbohydrate           2 carb choices

The history of pizza

The earliest versions of pizza are said to be enjoyed by the ancient Egyptians, Greeks, and Romans in a flatbread style. However, Naples, Italy is the true birthplace of pizza.

Pizza was served with tomatoes, cheese, oil, garlic, and anchovies by street vendors to the peasants of Naples. Then in 1889, Queen Margherita paid a visit to Naples and enjoyed her pizza topped with fresh mozzarella, tomatoes, and basil, giving birth to the classic “Margherita pizza” that is loved by millions today.

Pizza gained popularity in the United States starting in the 1940s when immigrating Italians brought over their classic pizza traditions. From there, pizzerias began popping up in major cities like Boston, Chicago, and St. Louis, although the first documented pizzeria was established in 1905 in New York City.

Conclusion

Although there are no brands of pizza made specifically for diabetics, you have several options to choose from that are diabetes-friendly. With some smart planning and preparation, it is very doable to eat pizza with diabetes. In the end, it all comes down to taking a balanced approach to your diet and nutrition. Instead of focusing on the foods you think you must avoid, focus on the overall quality of your diet so you are mindful of your diabetes while enjoying your favorite foods!

Resources

Pizza Calories and Nutrition Facts (verywellfit.com)

Can People with Diabetes Eat Pizza? (healthline.com)

Pizza and Diabetes: Dietitian-approved tips for eating pizza with diabetes | Milk & Honey Nutrition (milkandhoneynutrition.com)

How To Eat Pizza When You Have Diabetes – Pizza Bien

Can Diabetics Eat Pizza? – Diabetes Self-Management (diabetesselfmanagement.com)

LeeAnna Stock-Luoma RD, LD, CD, CDCES

Thanks for stopping by my Dealing With Diabetes blog! My name is LeeAnna.