Sep 26, 2006

Fast Days Need Slow Consideration

Jan Chait

It was Yom Kippur and I was in charge of the food for after the fast. As usual. I can almost hear my fellow Sisterhood members now: “We need to put somebody in charge of the food on a day we're not supposed to eat. I know! Let’s let the diabetic do it!”

For those of you who are not in the know, Yom Kippur—which, translated, is "Day of Atonement"—is a full fast day. That is, no food or drink from dinner before sundown one day until after sundown the following day.

Anyway, as soon as the service concluding Yom Kippur was over, I dashed downstairs and, with a helper or two, put the food and drinks out and began plating the desserts. After which, I was going to eat. But somebody came in with empty drink pitchers to be refilled. And then...oh, I don't know. Something else happened. There's always something else.

The end result was that, by the time I got out of the kitchen to break my own fast, there was no food left. Except maybe a piece or two of herring. I don't like herring.

And I was low. Hey, I take insulin, I hadn't had anything to eat or drink all day and I'd been running around feeding everybody else. Herring doesn't have enough carbs in it to make a difference. Even if I liked herring.

Fasting in some form is a practice in many religions, but the only ones I know of, or could find, that call for a full fast are Judaism, Islam, and Baha'i.

For Muslims, the month of Ramadan (which began last weekend) calls for fasting during daylight hours. Each day during the month a light meal called Sehri may be eaten before the sun rises. After the sunset prayers comes a big meal called Iftar.

People of the Baha'i faith fast from sunrise to sunset for 19 days, generally from March 2 through 20.

And, as noted, Jews observe Yom Kippur, which is on October 2 this year.

In none of those faiths is a person with diabetes required to fast. For all, health takes precedent over religious obligations and, according to this article in the September 2005 issue of Diabetes Care, fasting by a person with diabetes can lead to hypoglycemia, hyperglycemia (high blood glucose), diabetic ketoacidosis, dehydration, and thrombosis (a blood clot). Therefore, it's imperative that you consult with your doctor before undertaking a fast.

Let me repeat that. Talk to your doctor.

And that's before the fast, not after as I did one year. (Although it was fun watching the blood drain from his face.) OK, so I went low. Again. I was sitting on the bimah (pulpit) at the time. Have you ever tried to sneak candy into your mouth in front of a sanctuary full of people whose stomachs were growling? I must not have been very successful: I'm still waiting to be asked to sit on the bimah again.

In addition to talking to your doctor, you might want to peruse some Web sites that address the issue.

Probably the most comprehensive is www.friendswithdiabetes.org. Started by Rabbi Hirsch Meisels, an observant Jew who has had diabetes for nearly 30 years, the site evolved from his own explorations. "When I had to repeat the same information countless times to families, I decided to write them down and fax them to the people asking the questions, then our Rabbinical leader advised me to print them up," he explained.

While the information is geared toward observant Jews, much of it is applicable to anybody with diabetes. For information on fasting, click on "diabetes guides" and go to the "Tishrei" publication. (Relax—Tishrei is merely the name of the month in which Yom Kippur is observed.)

I did find a site for Muslims with diabetes who are interested in fasting during Ramadan at www.islam-usa.com/h9.html. Unfortunately, there is a page missing, but the site does include some sample menus for Sehri and Iftar.

An article written for health care professionals regarding diabetes and fasting for Muslims can be found on the Diabetes Australia Web site here. There's some helpful information in there for you, plus you get to see what "they" (the health-care professionals) say about "us."

Why do we fast when we're not obligated to? For spirituality. For atonement. To heighten our awareness of the deprivation experienced on a daily basis by so many people.

Whatever your reason, have an easy fast. But, most of all, make it a safe fast. And if your doctor says you shouldn't fast—don't. Instead of observing a religious practice, you could be on a fast track to the emergency room.

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