My first Yom Kippur with diabetes, last year, I didn't really know what I was doing, so I didn't reduce the Lantus enough, I exercised too much, and had to eat in the morning.
This year I'm going to halve my Lantus dose, walk only in the morning, (so I'm not going to Kol Nidre, and then I'm walking to shul, and then I'm not leaving shul until it's all over) and hope for the best.
I had wanted to ask this, but I figured no one would have fasted. Since I was diagnosed so young, I've never fasted for Yom Kippur. Every year around this time, I think about this. I always feel like I'm missing out on a big component of the holiday. I feel odd every time someone tells me to "have a meaningful fast" as a greeting. Of course, you're not supposed to fast if it could hurt your health. If this were something that we did often, I think I could figure out a way to do it safely. But because it's once a year, I just can't imagine being able to make it through the day without going low. And I would spend the whole day worrying about where my bloodsugar was rather than thinking about my actions over the last year.
Of course, the standard advice is that you're supposed to sit down and discuss the matter with a doctor and your rabbi.
Jonah, let us know how your fast went and how it affected your Yom Kippur.
I had fasted on Tzom Gedalia as a warm up, with 9 units of Lantus, and gone hypo and had to eat in the afternoon. So I thought I was gonna be taking very little insulin on Yom Kippur. Wrong.
Using Tzom Gedalia as a warm up fast has two flaws. They are that on shorter fast days, I will not get dehydrated so your blood sugar will just plain drop. On Tisha B'Av and Yom Kippur, by the afternoon my blood sugar will have stopped dropping and may rise from dehydration. The other flaw is the se'uda before Yom Kippur, which is such a big meal that there's no real way for me to be sure to handle it well. I wanted to be sure I didn't overdose it and go hypo right at the start of Yom Kippur, but I ended up underdosing it instead.
On erev Yom Kippur, I took a lowered Lantus dose. I ate a large seuda right before Yom Kippur, and I totally messed up in calculating the amount of insulin I'd need. My blood sugar at midnight, heading to bed, was 331. Ouch. I took five units of Novolog. I still woke up high (264) the following morning. So I tested for ketones. They were negative, so I decided to take a Novolog correction of three units, then 8 units Lantus. Walked two miles to the shul of my choice. My blood sugar was AOK when I got to shul (don't remember what it was). It rose to the upper 100s later, and I corrected. I am pretty sure that dehydration was keeping my blood sugar up. I finished the fast with a perfect blood sugar of 101, and no ketones.
I spoke to another diabetic last week who fasted with a pump (which I gather is easier) but drank water.
Next year I might either eat a smaller seuda or else eat it midday.
My first Yom Kippur with diabetes, I was on once-daily Glucotrol XL (taken evenings), and discussed strategies with my doctor in advance of the observance. My doc had told me to not take the Glucotrol for the pre-fast meal, and to make sure my blood glucose did not drop below 50. No problem that year.
My second Yom Kippur with diabetes, I was on twice-daily Glucophage XR (morning and evening). Again, I did not take the Glucophage on Erev Yom Kippur, but I ended up having to break fast about a half-hour early because my blood glucose was down to the low fifties. (My next visit, the doc reduced my Glucophage dose by half.)
Right now I'm on diet-and-exercise, and my only diabetes-related issue with fasting is that of obsessively checking my blood glucose levels while fasting...
I fasted last year and found out that the pre-Yom Kippur feast was a bad idea for the fast, I mean, I lowered the basals to accommodate and then ate a lot. Bad idea.
Also, I found out that dehydration keeps my blood sugar up on a 25 hour fast in a way that doesn't happen on a 12 hour fast.
I will be fasting again on Yom Kippur.
I cannot fast due to having an eating disorder history and very brittle diabetes. Instead, I eat very plainly. No butter, no salt, no sweets, no condiments, and no sugar substitute. I also make sure to bring as many nonperishable foods (my shul starts a drive on RH which is brought back at the break-the-fast) as possible.
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