We have tried a variety of pizzas and none of them works - we always get an extended high that lasts for many hours and then re-surges again after breakfast. I tried making pizza on english muffins with no fat cheese but that too caused the problem. After thinking about pizza and pasta I decided that it was probably not only the fat in the crust and cheese but the density of the bread (and cheese) that was causing the problems. I could just imagine a chewed lump of dough and cheese sitting in dd's stomach resisting being digested until the insulin was gone. So I experimented. Bread alone caused no problem. Low fat cheese sticks alone caused no problem. And various tomato sauces in meals caused no problems. Next, I made "pizza" by cutting the softest, fluffiest, and sweetest, dinner rolls I could find in half and using them as the base of the pizza. I used King's Hawaiian dinner rolls, strips of low fat string cheese and squeeze pizza sauce. My dd and son liked them well enough and were please to get any kind of pizza - and no high at all. They worked great in terms of BG numbers. 'course the cheese did not melt nicely. The third time we made them I used part-skim shredded mozzarella. I also pushed all the rolls together on the tray so that they looked like one large square pizza. Still had great numbers and the cheese melted nicely. My dd ate about four of them for a total of about 37 carbs. ( We also included juice to alter the glycemic index of the whole meal) The only complaint after eating them three times is that the roll is too sweet. Next time I am going to use a more traditional yet fluffy dinner roll.