You have a pt with T1DM (on MDI) who tells you that for religious reasons, he would like to fast one day each month (from after dinner until about 3 PM the next day - about 20 hours). Which response and action would be most appropriate?
A. Discuss possible changes and the best way to address them, such as more frequent monitoring, consideration of insulin pump therapy, and plan to address high or low bgs.
B. Readdress the hazards of fasting with the pt, including hypoglycemia and DKA. Warn the pt that fasting is not advised for those with T1DM.
C. Offer to explain the health concerns to the pt's pastor in hopes that an alternative arrangement can be made for this pt.
D. Tell the pt that if he chooses to fast, he should take only half his basal insulin and no bolus insulin. For hypoglycemia, he should use a glucagon injection