Management of diabetes mellitus on Yom Kippur and other Jewish fast days.
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.
Grajower
Martin M
MM
Division of Endocrinology, Albert Einstein College of Medicine, Bronx, New York, USA.
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
D000959:Antihypertensive Agents; D001786:Blood Glucose; D007004:Hypoglycemic Agents