Take Very Good
Care of YourselvesDeuteronomy 4:15



It’s More Than Firecrackers and Candy Bars

This Thursday the 25th of Feb. is the Fast of Esther, followed, Saturday night and Sunday (In Jerusalem [and some othe places-check your local calendar for exact times] Purim is celebrated Sunday night and Monday). 


The Jewish festival of Purim celebrates Jewish survival. The Biblical Book of Esther, which tells the story of how Esther saved the Jews of Persia from annihilation at the hands of the wicked Haman, is read. The holiday is also celebrated with costumes, parades, plays, carnivals, the giving of charity, food baskets, special pastries, and a festive meal.


There is no question that Purim is one of the most hectic days on the Jewish calendar. It is often characterized by excitement, merrymaking, and frantic activity, as each person attempts to accomplish the unique mitzvos (commandments) of the day amid the heady, joyous atmosphere. In the midst of all the chaos, we sometimes lose track of what exactly is the essence of this day.


We are taught that Purim contains a tremendous, hidden potential. Its powers are so great, that even the holiest day in the year Yom Kippur is called only Yom Kippurim- a day that is like Purim.


On Purim, every Jewish person, both young and old, has the potential to reach the highest levels of serving HaShem (G-D)-- with joy. Our Torah tells us that the Shechina (Holy Spirit) sits only in a place of joy---this is one of the main reasons that Purim is considered such a Holy day!


In fact, we are told that precisely because of the unbelievable greatness of the day, we are commanded on Purim to drink wine until we can no longer think coherently. Otherwise, if every Jew would be taking optimum advantage of the powers that Purim holds, our prayers would be so effective that the Massiah would surely be here already! {related from the Chidushei HaRim }

The Purim Meal (Seudat Purim)

It is traditional to have a Purim Seudah (feast) on Purim day. And it is customary to serve food at the Purim meal that has symbolic meaning that links to the Purim story.

One custom is to serve an especially long, braided challah in memory of the rope used to hang Haman.

Triangular-shaped food such as kreplach (dough filled with meat and served in the soup or fried) and hamantashen (triangle shaped) pastries are eaten in memory of Haman's three-cornered hat.

It is written that King Ahasuerus reigned from India to Ethiopia. In Hebrew, the word hodu means both India and turkey. Thus, some people eat turkey on Purim. Others eat Ethiopian dishes such as Ethiopian lentils.

Since Esther ate as a vegetarian in order to keep kosher in the King's Palace, many people serve a vegetarian Purim meal.

Similarly, it is customary to eat poppy seeds on Purim, since tradition says that Queen Esther ate only seeds and legumes when she moved into the King's Palace in order to avoid eating non-kosher food.


As you can see if one really wants to it is possible to adhere to very nice healthy regimen even on Purim!




Ta’anis (the fast of ) Esther:

We would like to emphasize:

Although the JDA has presented guidelines concerning fasting on Yom Kippur, they are by no means meant to be used on other fast days!

Our Rabbinical advisors do not recommend that those with medical limitations fast without the permission of a Rabbi and Doctor.


Mishloach Manos (gift packages):

We quote from the book (sefer) "Nishmat Avraham", by Dr. Abraham S. Abraham who writes as follows [page 339]:

“I wonder whether one has fulfilled the mitzvah (commandment) of ‘sending gifts’ of food to a friend, if the friend is medically forbidden to eat that food- for example, a box of chocolates to someone with diabetes (when both the sender and the recipient are aware of the diagnosis). The "Pitchei Teshuvah" writes that the main reason for the mitzvah (commandment) of sending gifts on Purim is to give joy. It would appear that since the person with diabetes will have no joy in receiving the gift and, on the contrary, will possibly even be embittered by it, the sender will not have fulfilled (commandment) the mitzvah.” [Refer to the sefer (book) for a longer discussion on the topic.]



· One of the most forbidden words in the language of diabetes is the word “forbidden”. Almost every food that HaShem (G-D) created can be incorporated in a diabetes meal plan, with proper education and foresight.

· Let's look at "chocolate"—today it is actually not one of the worst foods that one with diabetes can use to incorporate in to one's meal plan, albeit in moderation and with proper planning. It is usually combined with fat, which slows down absorption, and it is low on the Glycemic Index.  It is very high in anti oxidants—we recommended using high quality dark chocolate with at least 72 % cocoa.

· A member pointed out that even some really fast-acting sweets, such as candies, which under normal circumstances, are usually best to avoid, are very helpful in the case of hypoglycemia. So, why shouldn’t one fulfill the mitzvah (commandment deed) of Mishloach Manos by giving someone with diabetes a gift that can save his life?

Based on these points, I feel more comfortable with the psak (halachic ruling) of Rav Zilberstien shlita, which affirms that one who gives sweet foods to one with diabetes has fulfilled the mitzvah.


Since Purim is an important day for giving charity many people go around collecting for organizations and other important causes.  This collecting is done in a very joyous way with costumes and music and often some heavy drinking.


JDA recommendations For Those Who Go Around Collecting on Purim:

$ Make sure to wear your medical ID necklace or bracelet.

$ Have enough Winkies in your pocket. Don’t rely on the fact that there will be plenty of candy around.

$ Keep your meter, strips, and lancets in your pocket.

$ DON’T DRINK! If someone offers you a drink, accept the cup graciously, but do not drink. This way, your host will be happy… and you will be safe.

$ Don’t smoke. Once you get used to it, it’s very hard to stop.

$ If you dance, make sure to eat enough carbs to avoid a low.

$ Last, but not least: We hope you make a lot of money… and keep the JDA in mind!

Drinking on Purim

The Halachic Viewpoint

The Gemarah (Talmud) says that on Purim one is required to drink,"òã ãìà éãò" - until he can no longer differentiate between ‘Cursed is Haman’ and ‘Blessed is Mordechai’. Many people are under the mistaken assumption that the only way to fulfill this obligation is by imbibing in alcohol without limit. Rav Yisroel Salanter and the S’fas Emes explain that it is quite to the contrary: If one reaches the state of “ad d’lo yodah” (meaning, if he becomes completely drunk), then he can no longer fulfill the mitzvah (commandment) at all. As King David describes {Psalms: 104,15}, “V’yayin yisamach levav enosh” (Wine makes happy the heart of man.). On Purim, we have a mitzvah (commandment) to drink, feast, and be happy. However, the mitzvah can only be fulfilled properly as long as we remember the essence of Purim: that Haman be cursed and Mordechai be blessed. Once you are past this state, no amount of drinking will be considered a mitzvah (commandment). Just as a person who is drunk cannot pray, he cannot do the mitzvah of mishteh v’simcha (the commandment to eat and drink on Purim).

In a nutshell: The gemarah’s (talmud's) reference to “ad d’lo yodah”- “until he can no longer differentiate”- is the MAXIMUM, and not the minimum.

Some derive this from the word “ad” (until) in the above phrase. They explain that the obligation is to drink until one can no longer distinguish between the cursed and the blessed, but the actual condition must not be reached.

It is also interesting to add that Rav Avigdor, one of the authors of Tosefus, states that the mitzvah on Purim is to observe someone else who is drunk, as this causes happiness and laughter. However, the individual who is drinking beyond reason is not fulfilling the mitzvah at all.

The smallest amount one may drink to fulfill the mitzvah is one revios of an alcoholic beverage, equivalent to approximately 3 to 5 ounces.

If you still want to fulfill the obligation of “ad d’lo yodah” in the literal sense, you can take a nap on Purim, as many tzadikim (righteous Rabbis) do [according to the p’sak (halachic decision) of the Remah in 695:2].


The Medical Viewpoint

“A panel of physicians urged doctors to downplay the potential heart-healthy effects of red wine, and to encourage patients instead to exercise and eat more fruits and vegetables.

The appealing idea that red wine can protect against heart disease has gained currency thanks to studies showing a lower rate of heart disease among people who regularly drank moderate amounts of wine.

But it remains unclear whether components in wine or the heart-healthy lifestyles of wine lovers are behind this boost in cardiac protection, say researchers writing in the January 23 issue of Circulation, a journal of the American Heart Association (AHA).

Wine drinkers, for example, tend to be thinner, to exercise more and to drink with meals, all of which may help remove artery-clogging fats from their bloodstreams, they explain.”

For details, refer to www.diabetesincontrol.com/issue37/item7m


We know that the researchers change their minds each year anyhow. Seems that they get so drunk… they’re starting to get confused! (Purim jest)


Diabetes and Alcohol:

A Dangerous Combination


How your Body metabolizes Alcohol

Alcohol moves very quickly into the blood, without being broken down (metabolized) in your stomach.  Your liver does most of the job of breaking down the alcohol once it’s in your body.  But it needs time.  If you weigh 150 pounds, it will take about two hours to metabolize a drink.

If you drink alcohol faster than your liver can break it down, the excess alcohol moves through your bloodstream to other parts of your body.  Brain cells are easy targets.  [When someone is acting up on Purim, this is why.]


Risk of Low Blood Sugar

If you take insulin shots or oral diabetes medications, you run a strong risk of having a low blood sugar when you drink alcohol.  How does alcohol add to your chances of having a low blood sugar?  It has to do with your liver.

Normally, when your blood sugar level starts to drop, your liver steps in; it goes to work changing stored carbohydrate into glucose.  Then it sends the glucose out into the blood, which helps you avoid or slow down a low blood sugar reaction.

However, when alcohol enters your system, this changes; Alcohol is a toxin.  Your body treats alcohol as if it were a poison, so the liver wants to clear it from the blood quickly.  In fact, the liver won’t put out glucose again until it has taken care of the alcohol.  If your blood glucose level is falling, you can quickly wind up with very low blood sugar.  This is why drinking as little as 2 ounces of alcohol (about 2 drinks) on an empty stomach can lead to very low blood sugar.

When you combine alcohol and exercise, [which is usually the case on Purim, when you are carrying all your Mishloach Manos (gift packages), and going around to collect money for charity (JDA?)] you increase the risk of going low.  This can happen because exercise helps lower your blood sugar levels.  Hours after you do exercise, your body is still busy replacing the energy your muscles used up.  To do this, it clears glucose from the blood and adds it to the muscles storage.  This is how exercise helps in lowering blood sugars (normally a very good thing.  However, when combined with alcohol it only aggravates and, already, difficult situation).

Now, if you take insulin or oral medication for stabilizing BG, they too are working to clear glucose from your blood.  Unless you eat, or your liver adds glucose to your blood, you could be heading for a low blood sugar level.  If you add some alcohol on top of this, it will stop your liver from sending out any glucose.  Your chances of going low are even greater.

One of the reasons that we need Basal or Long Acting Insulin is primarily because of the constant glucose output from the liver that is needed for bodily functions.  If the liver will be busy cleaning out the alcohol and it will not put out the glucose, there will be unused or extra insulin circulating in the blood, which will cause a low blood sugar. Let's use some common sense:  The Rabbis have been telling us that we are allowed to check blood sugars on Shabbos, even though there are some Rabbinical prohibitions involved.  Why?  Because of the danger of getting a low BG. If this is considered enough of a life-threatening situation to violate Shabbos, how can we put ourselves into such a dangerous risk by getting drunk?

Alcohol reduces ones body’s ability to swing back from a low blood sugar level.  If you have a low blood sugar, you may need to treat it more than once as time goes by.


Warning: The affect of Glucagon shots is also impaired when used for severe low blood glucose caused by drinking. Glucagon works by getting your liver to release more glucose into your blood, but alcohol stops this process.  You need to be able to treat your reaction with a carbohydrate, such as oral glucose tablets (Winkies) or gels.  So you need to avoid severely low glucose levels.  If you pass out, you will need glucose injected into your bloodstream by a health care professional.

Heavy drinking over time can hurt your liver.  It won’t be able to make glucose as well.  When this happens, your diabetes becomes harder to control.

Some of the signs of a low blood sugar reaction such as confusion or slurred speech, are similar to the effects of drinking too much, so if someone with diabetes will pass out, and people will smell the alcohol in his breath, they might just think that he/she is simply intoxicated and not even know that it is imperative to treat a low blood sugar, which can prove to be extremely dangerous.


Don't go Low!

Follow these guidelines to avoid low blood sugar levels, if you do want to have some wine:


Never drink on an empty stomach.  Plan to have your drink with a meal or after eating a snack.

The next morning, get up at the usual time, test your blood sugar, take your medication, eat breakfast, and then go back to bed if you feel ill.  "Sleeping-in" can result in a bad reaction.


A low blood sugar is the main worry. Check your blood sugar before you go to sleep, and eat a bedtime snack (solid protein and some carbohydrate) in the evening after drinking. Do this even if the bedtime blood sugar level is high, to avoid a low blood sugar reaction while you sleep.


NEVER drink and drive.  Ask a friend who has not been drinking to drive, or call someone to come and get you.


When Alcohol Is a Poor Choice

Some people with diabetes should not drink alcohol.  If you have nerve damage in your arms or legs, drinking can make it worse.  Alcohol is toxic to nerves.  Drinking can increase the pain, burning, tingling, numbness, and other symptoms associated with nerve damage.  Some studies show that even regular light drinking (less than two drinks per week) can cause nerve damage.  Heavy drinking may also make eye disease worse.  If you have high blood pressure, you can lower it if you stop drinking alcohol.


Many people with type 2 diabetes have high levels of the fat called triglycerides in their blood.  If you do, you should not drink alcohol.  Alcohol affects the livers ability to clear fat from the blood, and also spurs the liver to make more triglycerides








copyright Jewish Diabetes Association 2017 reprints allowed with permission only