title: Management of diabetes mellitus on Yom Kippur and other Jewish fast days.
abstract: OBJECTIVE
  To create guidelines for patients with diabetes to fast safely on Yom Kippur and other Jewish fast days, with the primary goal of avoiding hypoglycemia.
  
  
  METHODS
  Almost 30 years of experience in endocrinology and the pharmacokinetics and pharmacodynamics of current drug therapy were applied to develop these guidelines and recommendations. A few illustrative cases are presented.
  
  
  RESULTS
  Patients with either type 1 or type 2 diabetes were able to fast safely when a treatment plan was proactively formulated before the fast day. An understanding of which medications lower basal and which lower prandial blood glucose levels, as well as their duration of action, is critical.
  
  
  CONCLUSIONS
  The overwhelming majority of patients with type 1 or type 2 diabetes can, from the perspective of blood glucose control, safely fast on Yom Kippur. Physician-patient discussion is important to prevent the patient from relying only on personal judgment and potentially taking too much medication, with the resultant development of hypoglycemia.
authors.affiliation: Division of Endocrinology, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Martin M
authors.initials: MM
authors.lastname: Grajower
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007003:Hypoglycemia / Q000209:etiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007599:Judaism; D008297:Male; D008875:Middle Aged
chemical_list: D000959:Antihypertensive Agents; D001786:Blood Glucose; D007004:Hypoglycemic Agents