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 spike
• The Wolpert study: 42% more insulin for a high-fat meal, same carbs
• How fat slows gastric emptying and stretches out your glucose rise
• Extended, combo, and dual-wave boluses, explained simply

This 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.

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Books 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