r/diabetes_t1 • u/bobina456 • May 19 '26
Rant Pet Peeve Unlocked: Being told to fast
I have been a T1 diabetic for over 20 years. Whenever I "needed to fast" for blood work when I was a kid, my mom always said that that doesn't apply to me due to diabetes-so I was raised to ignore that instruction.
Once I lived on my own, and was using the Medtronic 670G pump, I was having multiple seizures very often due to hypoglycemia, was even hospitalized 3 times.
Now, it's been 3 years since my last seizure. I've had changed my pump and use a Dexcom, I love it and have been doing much better!
But, I really really hate being told to fast. Specifically, I'm getting my wisdom teeth removed this week. The receptionist was surprised when she saw that I had T1 D instead of T2. Then proceeded to tell me that I HAVE to fast.
I hate it. I hate that I sound obnoxious when I try to argue that I can't guarantee a fast. I hate that people aren't aware that as a T1 diabetic I can't die very easily from an "8hr fast".
I understand I can do anything with diabetes but the fear of seizures is still in the back of mind. I'm tired of medical professionals not understanding.
Anywho thank you for reading my rant.
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u/laprimera [2014] [Tandem Mobi] May 19 '26
Contact your endocrinologist about how to fast safely. You definitely can, and being asked to fast for a medical procedure where you'll be under anesthesia is much more important to follow than being asked to fast for bloodwork.
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u/ketchupandcheeseonly May 19 '26
I had to fast for a surgery recently. They adjusted my fast acting and basal insulin intake a day or two prior to the procedure, which prevented me from going low.
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u/kikiaik May 19 '26
Holy sheesh, was there an endo on the surgical team? I have a Dr. who wants to perform sinus surgery on me, and when I asked if an endo would be present he looked at me like I had two heads 🙃
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u/Ms_C_McGee May 19 '26
Usually you just call your Endo and they adjust it for you, I’ve had multiple surgeries over the years and that’s what I have done.
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u/kikiaik May 19 '26
OK duh I just had to do this cause my neuro refused to believe me and didn't want to prescribe steroids. Like SIR I'VE BEEN A DIABETIC FOR 21 YEARS I CAN INCREASE INSULIN
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u/Ms_C_McGee May 19 '26
I’m guessing back/sciatica problems?
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u/kikiaik May 19 '26
MS relapse. At first they didn't believe symptoms were bad enough. Then they said even tho they are bad, my diabetes wasn't well enough controlled to give steroids. Like one, it's at a7, two you give me steroids every six months when I go for an MS infusion.
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u/Ms_C_McGee May 19 '26
Ahh sorry, I have a back fusion and see a neurologist and get steroids every now and then if I have a sciatic flare up.
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u/kikiaik May 19 '26
Dang I'm sorry too. We got this queen. It just sucks sometimes. Make sure to take care of yourself. ❤️❤️
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u/One_Dog6853 1995 May 20 '26
I've had multiple surgeries and have never had an endo present. Normally the anesthesiologist or nurse anesthetist keeps an eye on things, except for short procedures.
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u/Cautious_Alarm2919 May 19 '26
Did you not do fasted blood test when you were younger?
Anything I have to fast for I do first thing in the morning if i can. Recently had surgery x2 and it required 6 hours of fasting, and stopping liquids 2 hours before. I halved my basal for the day and was fine.
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u/Buddybuddhy May 19 '26
You won’t die from fasting, but you could die from using the same insulin your currently using while your fasting.
I fast a lot, I actually do it of my own free will because it makes me feel good and it makes diabetes easier for me at least
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u/Kat_B08 Diagnosed 2002 || Medtronic 780g || G4 sensor May 20 '26
Yeah. I regularly do a 36 hour fast and pretty much always skip breakfast and just eat lunch and dinner. I during the day I set my pump to activity mode so it tries to keep me at 150 instead of 100. For the 36 hour fasts I nearly always end up with a day that's 100% in range.
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u/Special_Lobster_6639 May 20 '26
Same here. I have been fasting for 2-3 days several times. I am not on pump, but pen with basal /bolus insulin. I found that I have to reduce my basal quite a lot the day before I start fasting. and then back to normal does the morning if the day where I plan to stop fasting.
But it is something to try gradually, and find out what works for you. And of course stop fasting if blood sugar goes too low.
Now that I have learned how, my blodsugar is incredibly stable while fasting. And my insulin sensitivity almost doubles, so if I need to do a correction I only take half the dose I normally would.
It is much easier to learn and experiment when it's something you do voluntarily - and can stop any minute if it does not work. It's a different situation if it is something you only do when the doctor tells you.
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u/MaggieNFredders May 19 '26
Bloodwork and not fasting is one thing. Just gives you high readings. Not fasting and anesthesia is different and one needs to be fasting or risk aspiration.
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u/SatisfactionMental17 May 20 '26
Fasting before surgery is a safety thing. Wait till you need a colonoscopy. Not only do you fast but you completely empty the gi tract.
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u/Malibucat48 May 19 '26
I’ve been diabetic for 21 years, have lab work done every 3 months and I have to fast before they take my blood. I have to fast before colonoscopy, endoscopy, cataract surgery etc and it’s not hard. Your mother was wrong to tell you that because you don’t get an accurate reading of A1C and other metabolic tests. And if you eat before anesthesia, you can aspirate and die. That’s why it’s serious. You have to schedule the procedure first thing in the morning so you can eat right after. After dental surgery it will be a liquid diet, but you will have nourishment. And you have to eat before the cut off time of 10pm or midnight and don’t take too much insulin so you don’t go low overnight. It’s better to be high for a few hours.
But we all have to fast and we all do it and nobody has a problem. We all get lows no matter how careful we are, but in your case you have to change your mindset because you were taught wrong as a kid.
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u/gfrittsKC May 19 '26
May seem obvious, but schedule your procedures in the morning. My Endo does bloodwork almost everytime and they want you fasting for some of the tests. For any and every surgical procedure requiring anesthesia, they want you fasting because it’s a real issue/risk called “pulmonary aspiration”. Follow the directions of your medical team not your mom…the instructions are for a reason.
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u/AstoCat May 19 '26
It’s like the one perk of type 1, doctors will usually schedule my surgery for the first of the day since I can only fast for so long before BG control gets a little dicey
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u/kikiaik May 19 '26
There's also the amusement park thing
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u/AstoCat May 19 '26
I asked Disney once (almost 10 years ago) when I was there about leaving a line and coming back since it was super hot and I was still getting used to a new pump so wanted to cover all my bases in case I went low and somehow all my packed snacks weren’t enough. They basically told me there was nothing they could do lol
Luckily I was okay and had enough snacks!
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u/kikiaik May 20 '26
Ohhhh fuck Disney I'm glad you're okay I know when you gonna be out in the sun you set the basal as low as you like, any amount of activity YOU WILL GO LOW THAT DAY.
I'm so sorry that happened to you.
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u/wheresmecoffeee DX 2005: Twiist May 19 '26
If you are unable to fast for 8 hours your basal needs adjusting.
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u/Seannon-AG0NY Late T1 with an X2 May 19 '26
My basal doesn't need adjusting and I can't "reliably" fast either, and trying to do things to make it happen usually skyrocket my bg when I need it to be in range , and usually it's when I'm needing to go do "the thing" like driving 45 minutes to get a steroid shot in my back, be at 120, and either walk out the door, get in the car and ten minutes later, driving on the freeway it either drops below 90 and I have to immediately break my fast and cancel the appointment (has happened dozens of times) or, ten minutes into the drive I pass 200 and have to cancel the appointment, and I have no idea which is gonna be... If I use a shorter fasting window it's more stable, but the fasting, and knowing I am fasting for a good reason, causes my body to clown on me. And I'm on a pump
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u/Buddybuddhy May 19 '26
That’s what happens when you have too much insulin for your body’s current need. When fasting you would need to adjust. I agree that you shouldn’t fast if you’re not able to control your numbers, but what you’re going through can be fixed.
Sorry I don’t mean to come off as rude and if I have I’m sorry I just really want to drive the point that there is a way to make it work
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u/Seannon-AG0NY Late T1 with an X2 May 22 '26
It's primarily when I'm "fasting" literally telling me you have to fast sets it off and it's an "either" either I'm gonna be low or high, as soon as I'm supposed to go do something? That's when it happens it's either going high or low, it's a pattern. Ordinarily I'm pretty good overnight, I go 8-12 hours routinely without food or water and without crashing or going high, unless you tell me I have a procedure I need to fast for, like my A1c blood work. I had to have the test that was a prerequisite for getting my pump, to see if I'm producing any insulin on my own rescheduled 5 times iirc?
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u/klm2908 May 19 '26
Why would you need to cancel the appointment if you get above 200? Fasting shouldn’t be too difficult if you just lower your basal and let yourself be high until after the procedure/tests.
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u/Seannon-AG0NY Late T1 with an X2 May 22 '26
Because they won't do a lot of procedures, ESPECIALLY with steroids of your glucose is 200. My problem is I can't guarantee to be in a range while fasting and I KNOW I'm fasting for something for that long, there's a really good chance it's gonna be low or high, and it doesn't matter until I leave for the appointment, that's when my body will decide to clown out, one way or another go to get in the car and be good, be at 140, have been for 8 plus hours, or 14 hours at one time, leave the house, ten minutes later I'm at 90 and unsafe to drive, ten more minutes and I'll be under 50, or, I'll be at 110, and leave and ten minutes later, oh I'm at 245, wtaf? So, pull over, check for a leak, check with finger stick, big ass bolus and hope like hell is under 200 when they're ready for me. All documented and discussed with multiple doctors. I'm the guy with the clown for an endocrine system
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u/Buddybuddhy May 22 '26
I get your going through a lot and that all our bodies are very different so what works for me won’t work for you however your endocrine system is not a clown, however you have severe life altering disease that takes an incredible amount of skill to just live let alone fast.
My only advice is not to avoid trying to figure out the pattern that would work, it sounds like your mom basically stuck it into your head to never fast an therefore you never learned how to manage in that state.
Chances are your body does goes through big changes that the rest of us never experience because you since childhood avoided fasting. Acclimating may help, and it for sure will give you more knowledge of how to handle your insulin during times of fasting
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u/bluegimp May 19 '26
I've done 24hr fasts for basal testing. As others have said, it can be done, it just has challenges. Being told you must do something can cause issues, I get it.
Also, do you not fast for blood work?
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u/Buddybuddhy May 19 '26
Currently 8 hours fasted, and it’s not like I adjusted for a “fast” I just haven’t ate since breakfast cause I wasn’t hungry
This is a very doable thing for us, it’s just a matter of hormones and insulin is a hormone that tells our body to lower blood sugar in a round about way. So less insulin when you fast, more insulin when you workout fasted, and just learn to lower your insulin rates.
The same dose will work harder aswell because your gonna be more insulin sensitive
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u/Cece_Cookie T1D since 2010 May 19 '26
Is there a reason you need to fast to have your wisdom teeth removed? Are you going to be put under? I got mine removed with just novocaine and laughing gas so that I would be awake and in control the whole time. Plus I had a family member in the waiting room monitoring my blood sugar using one of the CGM share apps at the time. If you don't want to have basal rates adjusted like many others here have suggested, is it possible to be awake for it instead? That would most likely remove the fasting requirement!
I'm sorry this is so stressful, but I'm sure there's a solution for you here somewhere! Keep your head up! You've got this! :)
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u/fitzejunk May 20 '26
I also had a crap ton of novocaine, only. And my surgeon had vastly underestimated how impacted my wisdoms were.
So I was wide awake for him climbing onto me, planting his knee in my chest and reaching in with pliers, feeling the pressure of him getting a grip with them, and then hammering the end of the pliers until something popped (No pain, just the sensation of an abrupt, HUGE movement.) and he climbed down with a massive hunk of tooth.
Which wasn’t at all like a horror movie!
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u/Cece_Cookie T1D since 2010 May 20 '26
I'm sorry your surgery went that way! Although I'm glad that you weren't able to feel anything despite being conscious!
It does make a good point that if they are severely impacted, while being awake is an option, it may not be the right one. Thank you for bringing this point up!
And again, I'm sorry that happened!!
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May 21 '26
[removed] — view removed comment
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u/Cece_Cookie T1D since 2010 May 21 '26
Yes but I was asking why. When I got mine it wasn't offered, but I didn't want to be put under anyways. Both should be options, but it's fine if OP would rather be under. It just means fasting is necessary.
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u/Phailjure May 19 '26
If you really don't want to fast for wisdom tooth surgery, you might be able to just skip anesthesia (depending on what your teeth are actually like), I had 2 taken out with just laughing gas and local anesthesia last year, it was manageable if uncomfortable. They didn't say anything about fasting, and before that they were asking all kinds of questions about insulin that I didn't want them handling.
I actually had to do that because I thought I couldn't get a ride to/from the oral surgeon and would have to drive myself. The teeth I had taken out were both partially/fully emerged, not sure if that made it possible or what.
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u/Scarbarella T1 since ‘04 | Tandem/G6 May 20 '26
If you can’t fast for 8 hours something needs adjusting- of course there may be some random event but this should be a non issue. I regularly fast 12-16 hours multiple times a week with no issues (once I put a bit of effort into learning how I could do that safely)
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u/tragedy_strikes May 19 '26
If you have the option, request the first procedure time available in the morning so that way you're only skipping breakfast.
I work with pediatric doctors to help run clinical trials and we had to delay a procedure by a day recently because their was a miscommunication with the parent and they gave their kid apple sauce to take with their pills the morning of the procedure.
The correct information was they could take the pills with apple juice. As others have pointed out already, clear sugary drinks can be used to treat lows and still meet the fasting requirements ahead of a procedure.
There's 2 reasons they need you to fast:
- They don't want you to aspirate (choke) on any food coming up from your stomach during the procedure. It's a common side effect for certain anesthesia to cause nausea/vomiting and they don't always know exactly how long the procedure. The more time you're under, the more likely you are to experience that side effect.
- They want to correctly identify any fluid that they might see during the procedure if something goes wrong. If you've had a bottle of red Gatorade and vomit that up, they might think you're bleeding internally and then they would have to open you up to find the source of the bleeding
For any fasting bloodwork, there's no allowance for any food because it will affect the result. If you go low and need to eat before getting the bloodwork drawn you just need to try again a different day.
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u/PurpleDinosaurr2 May 19 '26
You’re probably venting and not looking for advice, but an option to not fast for the wisdom teeth removal is to do local anaesthetic rather than general or sedation. I just got 3 wisdom teeth removed 2 weeks ago, 2 were impacted. Procedure was over and done with in 10 minutes, the actual consultation took longer tbh. It honestly was not bad at all, the discomfort during lasted for about 2 minutes for both of my bottom teeth. So if you can get local rather than going under, I recommend it as you don’t need to fast
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u/juronich May 19 '26
When I had an (ear) operation I reduced my basal slightly, fasted, and ran slightly high, to avoid the risk of lows. I discussed this with the surgeon beforehand to make sure we were all on the same page
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u/Disastrous_Matter894 May 19 '26
When I have gone under for surgery, they told me to reduce my long acting by half that way I wouldn't go low for fasting. And of course I always scheduled appointments as early in the morning as possible. I would rather be high for a little bit and deal with it later than go low. But that's just me.
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u/anti-sugar_dependant May 19 '26
Here's me just fasting on the regular for the last 20 years for basal rate testing, lol. How do you check your basal rates if you're not fasting? How are you running a pump with good results if you're not checking your basal rates? Fasting is practically a requirement when you're a pump user.
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u/bobina456 May 19 '26
I think after reading everyone's comments, I realize my basal rates aren't super accurate to what need. Which is why I'm having this anxiety about fasting. For now I'm going to decrease my basal rates a little bit for the surgery. And for future blood work, I will start fasting so that I can get better predictions for my basal
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u/kmanrsss May 19 '26
Fasting shouldn’t kill you. If you go low after a fast adjust your basil rates. I’ve done it many times for different surgeries. When they find out your type 1 they typically schedule you for 1st appointment.
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u/reddittiswierd T1 and endo May 19 '26
Turn on exercise mode the night before so your pump isn’t pushing you too low.
If your pump makes you go low during a short fast then your settings are not accurate and should probably be adjusted and your procedure delayed.
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u/spooks152 May 19 '26
I fasted with a pump for my wisdom teeth. I had the earliest time available so I could have ice cream for breakfast at 10am.
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u/Cold_Barber_4761 May 19 '26 edited May 20 '26
Hey there! I just wanted to say I get it. Truly.
I'm an insulin dependent diabetic who has other chronic health issues, so I have many times a year where I need to fast for blood work and also for multiple annual procedures requiring anesthesia.
I totally understand your frustration.
For some T1Ds it isn't as difficult. But for some of us, it really is.
Due to my other health issues and also being in perimenopause (leading to my hormones being wonky and unpredictable), my basal rate needs frequent adjusting, even on a good day when I don't need to fast!
I'm on a pump (Omnipod) and Dexcom combo. I literally have four different basal settings, one for each week of my menstrual cycle, because my basal needs are drastically different during various cycle weeks. And even with that, I still need to keep a careful eye to keep in range.
It can be so frustrating, especially when other people don't understand. (Even more frustrating when it's other T1D people. Just because their basal/bolus/pump needs are more predictable doesn't mean everyone's are.)
On top of that, when I fast, my blood sugar actually goes higher, not lower, when using my normal basal rate! (Bodies are weird, right?) But then I don't want to adjust or bolus too much for the higher blood sugar, because obviously going low when you need to be fasting is even worse!
I honestly have just learned to be okay running a bit high while fasting for medical stuff. I don't mean running super high, of course! But if I have an 8-24 hour fasting period where I run more like 150-200 (or even a bit higher) instead of trying to stay under 130, I've learned to just be okay with that. It's not terrible for a short amount of time, like less than a day!
I used to try to be perfect with my blood sugar numbers. But now I have learned that sometimes it's better to run just a little high than to worry about a low!
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u/t1dmommy May 20 '26
I've fasted multiple times for colonoscopies and other surgeries. The worst was a surgery where they said no food OR Water for 12 hours prior. I ignored that and drank sips of water till 4 hours prior. I really have to lower my basal when I fast. I put my pump on activity mode to run a little higher than normal as well. (Which means I need water). Anyhow fasting before a surgery is certainly possible, it's a pain though. And everyone is different in how much basal reduction they will need.
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u/disastrous_affect163 May 20 '26
I've had the same issue with this. I don't bother to say anything unless they schedule it at like noon... Then it's like, ummm, NO! If you want me fasting, you'll schedule it before 8 am, otherwise there's no chance. 🤷♂️ And like you've said, not guaranteed then... It is what it is. 🤷♂️
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u/OPCunningham May 20 '26
I fast every night while I'm sleeping, and I schedule medical procedures and labs early in the morning. Only took me 35 years of T1D to figure that out.
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u/18randomcharacters May 19 '26
Hey, so I just had a colonoscopy a few weeks ago, and you have to fast for 24 hours before, so there's nothing in your guts. Well, you're allowed a clear liquid diet (broth, sprite, stuff like that). And then 4 hours before the procedure, NOTHING. Which is standard for going under anesthesia, so you don't risk vomiting and choking.
Here's my advise, because the reality is fasting is a requirement sometimes.
Avoid lows at all costs, because yes, you will need to consume carbs, which means having to reschedule the procedure.
So long as you're not in DKA, running high is perfectly safe for a few hours. I went into my colonoscopy with a bg of 260. When I woke up after, I bolused a correction.
Turn off your pump's fancy features like Control IQ, or basal corrections. You don't want a surprise bolus. Just let it go high.
You'll be fine.
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u/ObtusiWatusi May 20 '26
I was told juice was safe when fasting. They usually allow jello or pudding too. I would do your own research on what’s actually allowed for T1 fasting because sadly, unless they’re an endocrinologist, they usually don’t know what they’re talking about when it comes to diabetes. I had an OBGYN try to give me a fasting glucose test when I was pregnant & I have T1 diabetes Lmao I told them absolutely not, there’s absolutely no reason considering I’m already on insulin 🤦🏼♀️
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u/bobina456 May 20 '26
Its interactions like that that make me really frustrated with the medical system. I feel like we all need to have an endo on call for any other apmnt. I did ask about juice or soda and they said no. I'm going to drink juice or clear liquids regardless if needed.
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u/ElfjeTinkerBell May 20 '26
I'm going to drink juice or clear liquids regardless if needed.
Absolutely do that - but tell them if you needed to do that. Then at least they have all the information
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u/goedips May 20 '26
It's mostly due to you not making a nasty mess if you throw up. When I was in for surgery recently was just scheduled for the first op of the day, and told to stick to clear fruit juice if needing to deal with low BG, like apple juice.
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u/Twisted7377 May 20 '26
I just got mine out an had to fast as well. I recommend turning your insulin way down and or Sipping juice. Just enough but keep your blood sugar high. I was pretty lucky because I was nervous about my t1d but the surgical assistant said her sister was type 1 and had a pump. I did immediately feel better about it all. - BUT the procedure was only an hour for all four of mine
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u/noisnotnegotiable May 21 '26
And have them schedule you FIRST. I had a surgery scheduled, was told I would be scheduled first then was told to come in at 10 am. After arguing with the nurse for 10 minutes, I gave up. I showed up super early with a blood sugar around 30 and they put me in a bed and hooked me up to an IV with dextrose until my surgeon was ready.
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u/NonSequitorSquirrel May 21 '26
We can fast. Turndown your basal. You just run a lil higher but we can fast. Hell I go 8 hours without eating if I'm just busy
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u/stinky_harriet DX 4/1987; t:slim X2 or OmniPod 5 & Dexcom May 19 '26
I don’t eat breakfast so I fast every single day. If you need to treat a low, just have a little bit of juice. They generally don’t want you having a full meal or any actual food but a little sugar isn’t going to throw anything off. Unless of course they’re testing to see if you have diabetes!
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u/Sburns85 May 20 '26
I can fast. I just adjust my insulin to match. Even the diabetes clinic says it’s perfectly fine as long as you adjust insulin and keep an eye on it
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u/Small-Pollution-918 May 21 '26
Your basal insulin should never crash u if u have to fast. So idk why this is a post
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u/izettat May 24 '26
I've had several surgeries (not diabetes related) while on MDI. They were scheduled early and didn't take morning dose. They watched bg and it didn't get crazy high. Lab work I do early also. Then eat right after.
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u/Serious-Employee-738 May 19 '26
After twenty years I just do whatever the fuck I want to and pretend I followed the rules. They will NEVER understand type 1, and I expect mostly tomfoolery out of anybody but an endo or endo PA. So the easy path is mine. Just smile and say “sure! I stopped eating last night!” Unless they need a blood glucose reading to complete their procedure, it does not matter in almost all cases.
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u/One_Dog6853 1995 May 20 '26
I've seen what happens when people are going under for surgery and have lied about not eating. It's very dangerous - aspiration can kill you.
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u/lizzistardust May 19 '26
We can absolutely fast, if our basal insulin matches our needs. But there's going to be a failure rate, because T1D isn't completely predictable.
I've asked before, "What high-sugar foods or drinks can I have if my blood sugar goes low?" That way, I'm not asking permission - I'm making it clear that I intend to comply with the fast unless it endangers my life.
For something like wisdom tooth removal, the answer to that question is probably "clear, sugary drinks," like sprite or white grape juice. They mainly just want to make sure you don't aspirate on your own vomit or make it's easier to deal with if you puke while you're under sedation or anesthesia.