Take Very Good
Care of YourselvesDeuteronomy 4:15


Drinking on Purim

The Halachic (Torah) Viewpoint

The Gemarah (Talmud) says that on Purim one is required to drink," " - 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 an 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



Continue reading some more great Purim articles on our website---Happy Purim and enjoy a safe one!!!

 Copyright to Jewish Diabetes Association 2019—reprints allowed with mention of the website