Diabetic patients in the Yom Kippur fast - Who Can Fast and how to Treat the Fasting Patients

Yisrael Katz*, David Zangen, Gil Leibowitz, Auryan Szalalt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Jews all over the world fast on Yom Kippur, a fast lasting 25 hours. For diabetic patients and their physicians the fast is a significant challenge. The Jewish law exempts patients from fasting if the fast endangers the patient's health. In order to know if they can fast safely, many diabetic patients consult their physicians. In this review, the authors summarize the potential risk for fasting in diabetic patients and propose treatment protocols for patients who intend to fast. The principle recommendations are based on data related to fasting diabetic patients during the Ramadan fast, which is shorter than Yom Kippur. Furthermore, practical suggestions are based on a recent Israeli study on type 1 diabetic patients fasting for 25 hours, taking into account the Jewish law. Every diabetic patient who intends to fast should consult his physician for assurance that fasting is safe. The physician should pay special attention to patients on intensive insulin treatment or on sulfonylureas. Some, but not all these patients, should avoid fasting. In case these patients decide to fast, intensive monitoring of blood glucose is required during the fast to prevent severe hypoglycemia.

Original languageAmerican English
Pages (from-to)586-591
Number of pages6
Issue number9
StatePublished - Sep 2009
Externally publishedYes

Bibliographical note

Funding Information:
Abbreviations: HCV, hepatitis C virus; SVR, sustained virologic response; ALT, alanine transaminase; HAI, histologic activity index; RT-PCR, reverse-transcription polymerase chain reaction. From the 1Division of Gastroenterology, Scripps Clinic and Research Foundation, La Jolla, CA; 2Group Hospitalier, Pitie-Salpêtrière, Paris, France; 3University of Florida, Section of Hepatobiliary Disease, Gainesville, FL; 4Hospital Vall d’Hebron, Barcelona, Spain; 5Armed Forces Institute of Pathology, Washington DC; 6Schering Plough Research Institute, Kenilworth, NJ; and 7Massachusetts General Hospital, Harvard Medical School, Boston, MA. Received August 24, 2001; accepted December 21, 2001. *Members of the International Hepatitis Interventional Therapy Group are listed in the Appendix. Supported in part by research grants from Schering Plough Corporation, Kenilworth, NJ, and the General Clinical Research Center grants at Scripps Clinic (MO1-RR00833) and the Massachusetts General Hospital (MO-1RR01066). Address reprint requests to: John G. McHutchison, M.D., Scripps Clinic and Research Foundation, Division of Gastroenterology/Hepatology, 10666 N. Torrey Pines Road, N203, La Jolla, CA 92037. E-mail: [email protected]; fax: 858-554-9947. Copyright © 2002 by the American Association for the Study of Liver Diseases. 0270-9139/02/3503-0026$35.00/0 doi:10.1053/jhep.2002.31870


  • Fasting
  • Intensive monitoring
  • Yom Kippur


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