On Yom Kippur, it is customary to fast for 25 hours, and while going without food for a whole day can be a challenge for anyone, it's especially difficult for someone with diabetes.
You must aim to maintain proper blood sugar levels at all times. The general rule is that fasting needs to be approached with the utmost care.
"Fasting should be rare if you have diabetes because an individual with type 1 or type 2 on oral medication can experience hypoglycemia (low blood sugar)," Amy Kranick, a Certified Diabetes Educator with Diabetes Care Club in Nashville, told Everyday Health.
Risks from low blood sugar include seizure, coma, or even death if left untreated.
On the opposite side of the coin, fasting without using prescribed insulin could lead to high blood sugars or diabetic ketoacidosis, depending on the individual. This is a serious diabetes complication caused by buildup of acids called ketones in the blood.
Fasting is possible, but not recommended
If the Jewish High Holidays—which include Rosh Hashanah and Yom Kippur—are important to you, you may want to observe the fast. But considering the risk of fasting with diabetes, this isn't a recommended idea.
"Both [Judaism and Islam] have guidelines that exempt those people who will be affected with harmful health consequences by fasting," Toby Smithson, Certified Diabetes Educator in Buffalo Grove, Illinois, and a spokesman for the American Dietetic Association, told Everyday Health. "In the Jewish religion, it is considered a mitzvah (a good deed) if one must eat for health reasons."
If you're set on fasting, make sure you consult with your doctor or diabetes healthcare team to establish a plan for the days and weeks leading up to Yom Kippur.
It's also crucial to consider that fasting alone may not be the only issue to plan for—medication timing ranks as a top priority. The skewed eating schedule may be a factor when you need to take insulin or oral medication to control blood sugars.
In the event that you do decide to fast, the most important advice is to fast smart. Understand the signs and symptoms of hyperglycemia and hypoglycemia.
Symptoms of hyperglycemia include:
• Increased thirst
• Fatigue (weak, tired feeling)
• Difficulty concentrating
• Frequent urination
• Weight loss
• Blurred vision
• Blood sugar more than 180 mg/dL
Symptoms of hypoglycemia:
• Blurry vision
• Sudden mood changes
• Rapid heartbeat
• Sudden nervousness
• Pale skin
4 ways to protect yourself
Here are four ways to take care of yourself when fasting:
- Test your blood glucose levels more frequently.
- Wear a diabetic medical alert ID bracelet.
- Learn the appropriate treatment for high or low blood sugar, including glucose gels, glucose tablets, or glucagon injections.
- Keep emergency contact information where others can find it.
Most important, do not do anything without first speaking with your doctor or diabetes educator.