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Question:

From the USA:

I have poorly controlled type 2 diabetes, multiple sclerosis, and a spinal injury that makes exercise impossible. I am currently on two oral hypoglycemic agents that are not working well so they gave me insulin twice, but I had a severe reaction both times. I have been trying to get information on what I can do about this dilemma and have hit a brick wall. Pork insulin is definitely out as I am an orthodox Jew.

Answer:

Please discuss this issue with your Rabbi. The prohibition is against eating pork and not injecting it. If it were absolutely necessary to eat a pork medication to "save a life", the Jewish religion would allow that too if there were no other alternative. Don't take my word, but do check with a reliable Rabbi knowledgeable in Jewish medical law.

Regardless of the religious issues, I'd make sure that your reaction was truly an allergic one and that might respond to changing to pork insulin, and not just erratic blood sugars that would better respond to either changing the dose or switching to another brand of synthetic insulin with a different time action.

TGL

Additional comments from Dr. Stuart Brink:

Insulin allergy is rare now that insulin is so highly purified and synthetic, but it is still possible. You should contact a diabetology specialist in your area or at the nearest medical school. They will either have some experience or be able to refer you to one of their colleagues with some experience. We used to do allergy desensitization for those allergic to insulin. Eli Lilly and Company has a desensitization kit that is available free of charge including instructions on how to proceed. Usually within one or two days you could be desensitized and then be able to use insulin. Depending upon what actual symptoms you had, this might be done in the hospital outpatient department or clinic or, if the symptoms were angioedema (swelling) or wheezing, then this would be done in the hospital setting so that quick response to increasing doses of insulin would be reversed. We would start with a diluted insulin of 1:10,000 and then slowly increase the insulin doses every 30-60 minutes with this insulin desensitization program.

Pork insulin is allowed by all religious authorities for Jews and Muslims. The Torah specifically says -- and all rabbinic teachings agree -- that one's health is more important than any religious law. So, if pork insulin were prescribed or the only type of insulin available, it is not a sin to use such a pork product. In fact, one is called a "wise fool" for ignoring one's health, and this is a bigger "shonder" for Jews than might be true for pork use of any kind. Health trumps everything else -- riding cars on Shabbat, not fasting on Yom Kippur, etc. I'm certainly not an expert on Muslim laws, but my understanding from Muslim colleagues is that this is similarly interpreted to place priority on health over any religious prohibitions whenever this type of dilemma appears.

SB

DTQ-ONCEMRM20030324
Original posting 2 Apr 2003
Posted to Daily Care and Type 2

  
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Last Updated: Tuesday April 06, 2010 15:09:44
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