For diabetics, the Pesach Seder can be a challenge – a life-threatening one, if they eat the wrong things. Diabetics who need to restrict their intake of sugar, processed flour and calories usually seek rabbinical guidance on how to handle the four cups of wine and several matzahs that are required eating at the Seder.
In advance of the Seder, Chief Ashkenanic Rabbi David Lau issued a guideline for diabetics, including the specific quantities and kinds of items they can use or substitute in order to fulfill the Jewish legal requirements for eating and drinking at the Seder.
Wine and grape juice pose a major challenge, because many of them contain added sugar, in addition to the natural sugar they already contain (that natural sugar is present even in non-sweet dry wines). Rabbi Lau said that the requirement for drinking the four cups at the Seder could be fulfilled with grape juice, which is lower in calories than wine (70 calories/100 cc). According to Jewish law, fulfilling the obligation requires drinking 32 cc's (about 1 fluid ounce) as a minimum for the first three cups, and three times that for the fourth cup. Thus, the total intake of sugar from grape juice will be relatively low – as will the calorie count, with about 160 calories consumed altogher.
A typical square machine-made matzah contains about 100 calories, and the minimum obligation is to consume about half of such a matzah (or its equivalent in hand-made matzah) three times. Here, too, the calorie count is about 150 calories, and in order to compensate for the consumption of these carbohydrates, Rabbi Lau recommends cutting down on potatoes or other carbs during the Seder meal.
Diabetics can skip Haroset, the date or apple-based spread that contains nuts and wine, or taste just a tiny bit of it if they wish, said Rabbi Lau, as any rules regarding consuming it is suspended for unhealthy people.
These rules apply, said Rabbi Lau, to individuals who have been instucted by doctors to specifically limit their intake of certain foods. Diabetics who regulate their condition using insulin injections or pumps should take on the “regular” Passover obligations that apply to healthy people, while compensating for their blood sugar levels with an extra injection, if necessary.
In any event, Rabbi Lau stressed, diabetics and anyone else with a health condition should consult with their doctors when making their “eating plan,” and follow the guidelines set by their physicians.