Glycemic management during Jain fasts

Abstract

This review describes the various fasts observed by adherents of the Jain religion. It attempts to classify them according to their suitability for people with diabetes and suggests appropriate regime and dose modification for those observing these fasts. The review is an endeavor to encourage rational and evidence-based management in this field of diabetology.

Consensus recommendations on sulfonylurea and sulfonylurea combinations in the management of Type 2 diabetes mellitus – International Task Force

“…Hindus observe fasting during Navaratri, Karva Chauth, and Guru Purnima; Buddhists observe during Lent; Jains observe in the occasion of Paryushana. [ 194 195 196 ] In the diabeto-centric viewpoint, patients taking antidiabetic agents should be monitored regularly for the event of hypoglycemia and other associated complications. Furthermore, the antidiabetic dose should be modified or omitted during the fasting period in order to prevent future complications.…”

“…Long-acting SUs such as GLIB should not be used; however, modern SUs with low tendency of hypoglycemia such as GLIM and GLIC MR can be considered with dose reduction. [ 194 195 196 ] In addition, patients with diabetes and who are undergoing fasting should be educated properly for the daily blood glucose monitoring and about hypoglycemic symptoms in order to maintain a safe fasting during rituals.…”

RSSDI-ESI clinical practice recommendations for the management of type 2 diabetes mellitus 2020

“…[ 608 ] Periodic voluntary fasting, is a common religio-cultural practice adopted by individuals from various religions across the world for centuries as a crucial pathway of spiritual purification. [ 881 882 ] Fasting or food abstinence, initiates metabolic and psychological changes and adaptations which need close monitoring, primarily in patients with derailed metabolism. Therefore, individuals with diabetes, or pre-diabetes must fast only after appropriate risk assessment and counselling with healthcare practitioners (HCPs) and religious leaders and make an informed decision.…”

“…[ 888 889 ] Jain fasts: During the pious month of Paryushana (eight days for the Shwetamber sect, and ten days for the Digamber sect), Jains usually fast from dusk to dawn unlike Hindu fasting which extends from dawn to moon-rise. [ 882 ] …”

The President's message, 2019-20 strengthening endocrinology: Towards a sustainable future

“…ESI's active team have simplified guidance on endocrine and diabetes care during the Ramadan and the Hajj, (leadership: AH Zargar, Shehla Sheikh)[ 9 ] as well as during other region-specific and religion-specific fasts and feasts. [ 10 11 ]…”