Division of Endocrinology & Diabetes

Fasting and Diabetes

Martin M. Grajower, M.D.
Assistant Clinical Professor of Medicine (Endocrinology)
Albert Einstein College of Medicine
Adjunct Attending Physician, Endocrinology
Montefiore Medical Center

During Yom Kippur, Jewish females 12 years and older and males 13 years and older must fast for more than 24 hours. But for people with type 1 diabetes, a drop in food and fluid intake can trigger dramatic metabolic imbalances such as hypoglycemia (low blood sugar) and diabetic ketoacidosis (when by-products of fat breakdown known as ketones build up in the body).

So should people with type 1 diabetes forgo the fast? In the August 2011 issue of Pediatric Diabetes, physicians led by Dr. Grajower say such people can safely fast on Yom Kippur as long as their endocrinologists offer guidance—on adjusting the insulin dose, how often to check blood glucose and under what conditions to stop the fast. The advice applies to people of all ages; a separate article in the July 2011 issue of Diabetes and Metabolism, Research and Review covers the management of type 2 diabetes on Yom Kippur as well as fasting before surgery and other nonreligious occasions.

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