So, yesterday was one of the 2 25 hour fasts (no food, no liquid) in the Jewish calendar, and I decided to give fasting a shot. There’s a website for observant Jews with diabetes that gives some suggestions (http://www.friendswithdiabetes.com), but I figured, since the question has been raised here before, that I’d put how I survived the fast out there.
IMPORTANT NOTE FOR THOSE ATTEMPTING THE JEWISH FAST DAYS: If your blood sugar drops too low, you are REQUIRED by halacha (Jewish ritual law) to break the fast. My understanding is that this is also true for Moslems, e.g. during Ramadan, but I do not pretend to have any expertise in Islamic ritual law.
Caveat: I take 1 shot of Lantus at night. If you split your basal, you probably want to leave your PM dose alone and reduce your AM dose. If you take only an AM dose, then you’re on your own :-).
What I did was this:
Before the fast, I had about a gallon of fluid over a few hours and a pretty hefty dinner. I ended up with a 2hr post-prandial of 85 and a bedtime of 82.
I didn’t have a snack for the 82, because I know that on my normal 10u of Lantus, I have a dawn effect of about 30-40 points.
I took 6u of Lantus instead of 10u, knowing that I’d need to correct in the AM.
In the AM, I was around 145 when I officially dragged my carcass out of bed. I took 3u of Humalog, which dropped me down to 117 2 hours later (I have spectacular insulin resistance in the AM. In the afternoon, 2u can drop me 100 points in 2 hours).
I tested the heck out of myself. Around 6PM, I dropped to 75, (which prompted more frequent testing and a tube of glucose right at hand) but by 7PM, I was trending up a bit, and when the fast finished at 8:56, I was at 91. I pretty much stayed in the 75-95 range the whole day.
After the fast, I ate like a pig Took normal Lantus dose, and have had a really good blood sugar day.
If I were only doing a day fast, I’d probably leave the Lantus or only chop off a unit or 2. (For a day fast, I usually wake up and have breakfast before the fast starts and then go back to sleep.)
For pumpers, that website I gave has recommendations on basal reduction. Look in the article on Tishrei - they have Yom Kippur instructions. If you can read the Yiddish, more power to you