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As Qatar Emir Visits Canada, Just What is Doha Up To?

Sheikh Tamim bin Hamad Al Thani, Emir of Qatar

By HENRY SREBRNIK (Sept. 19/24) Qatar…home of Hamas leaders, Al-Jazeera, host of soccer’s 2022 World Cup, and wealth beyond measure. And everyone’s favourite centre for “negotiations” to end the war Hamas unleashed on Israel a year ago. It’s become everyone’s go-to country, a veritable “light unto the nations.”

However, as the 1946 song “Put the Blame on Mame” has it, in a different context, of course, “That’s the story that went around, but here’s the real lowdown” … about this duplicitous Persian Gulf emirate.

Even before the Gaza war began, there was an upswing of commentary celebrating a shift in the policies and behavior of Qatar: away from promoting and subsidizing radical Islamist groups, and towards “deconfliction” and moderation. 

Sheikh Tamim bin Hamad Al Thani, the country’s emir, has been basking in the glow of international approval, depicting the country as a global influencer and peacemaker. The Qataris want to make themselves indispensable. 

It plays into Doha’s ongoing attempts to create an illusion of rebranding as a moderating actor in the Middle East and beyond, pushed by various propagandists in the West on Qatar’s payroll, including more than a few American university centres and departments awash in Qatari money.

The emir and other officials spent two days in Canada Sept. 17-19, meeting with Prime Minister Justin Trudeau and cabinet ministers. The Gaza war was on the agenda, of course. Indeed, Jewish-Canadian leaders urged Trudeau to criticize him over his patronage of Hamas. But being able to tap into Qatar’s wealth via business and trade was more likely on Trudeau’s mind.

Qatar has one of the highest per capita incomes in the world, at $110,000 a year. And while its total population is some 2.7 million, most of these are guest workers, including European lawyers and consultants at the top of the scale, and at the bottom South Asian labourers. Only some 313,000 are native Qataris, the ones who benefit from the riches it derives from the sale of oil and gas.

The Peninsula, an English language daily newspaper published in Doha, ran an article on the occasion of the emir’s visit by noting the expanding trade and investment cooperation between Canada and Qatar, especially with the signing of a Memorandum of Understanding (MoU) in June between the Qatar Financial Center and the Canada Arab Business Council, a non-profit organization that aims to enhance trade and investment relations between Canada and the Arab world. 

The MoU “aims to establish an integrated framework for cooperation and coordination in specific sectors through joint initiatives and the exchange of information and expertise, with a focus on stimulating growth and promoting innovation in areas such as financial services and professional business services.” Ahmed Hussen, Minister of International Development participated in a signing ceremony with Lolwah bint Rashid Al-Khater, Qatar’s Minister of State for International Cooperation.

More than 9,000 Canadian expatriates live in Qatar, working in Canadian and Qatari companies and institutions. From January to July, Canada exported goods valued at $103.45 million to Qatar, while Qatar’s exports to Canada amounted to $90.27 million.

There is also a partnership in academic programs, as the University of Calgary has been in Doha since 2006, offering a Bachelor of Nursing program, along with the College of the North Atlantic, which transformed into the University of Doha for Science and Technology. Furthermore, there are several Doha-based schools that offer Canadian curricula. 

In their meeting, Sheikh Tamim expressed his aspiration to work with Trudeau to advance their bilateral cooperation across multiple sectors in order to “contribute to enhancing regional and global peace and stability.” Bilateral relations between the two countries were discussed, especially in the fields of investment, economy and international cooperation, “in addition to developments and situations in the Gaza Strip and the occupied Palestinian territories.”

Qatar has been very successful in its efforts to shape public opinion in Canada, as well as in the far more important United States. The amount of money that Qatar has poured into universities, schools, educational organizations, think tanks, and media across America, and the number of initiatives that Qatar uses to influence American opinion, is overwhelming. 

According to a 2022 study from the National Association of Scholars, Qatar is the largest foreign donor to American universities. It found that between 2001 and 2021, the petrostate donated a whopping $4.7 billion to U.S. colleges. The largest recipients are some of America’s most prestigious institutions of higher learning. They include Carnegie Mellon University, Ivy League Cornell University, Georgetown University in Washington, Virginia Commonwealth University, and Texas A & M. These schools have partnered with the regime to build campuses in Doha’s “education city,” a special district of the capital that hosts satellite colleges for American universities. (Texas A&M decided earlier this year to shutter its branch campus in Qatar.)

Georgetown University in Qatar, for instance, was hosting the “Reimagining Palestine” conference Sept. 20-22. The event engages scholars, experts, and the public “in timely and relevant dialogues on globally significant issues,” according to a description of the gathering. One of the speakers, Wadah Khanfar, “was active in the Hamas movement and was one of its most prominent leaders in the movement’s office in Sudan,” the Raya Media Network, a Palestinian outlet, tells us. In the months following Oct. 7, the campus has hosted a variety of seemingly anti-Israel events.

Since 2008, Qatar has donated nearly $602 million to Northwestern University, whose journalism school is ranked as one of the best in the world, to establish a school of journalism in Qatar.  The Northwestern University campus in Qatar and Qatari broadcaster Al-Jazeera in 2013 signed a Memorandum of Understanding to “further facilitate collaboration and knowledge transfer between two of Qatar’s foremost media organizations.” Are Northwestern’s interests really aligned with Qatar?

Qatari state-financed entities also often fund individual scholars or programs in the United States without official disclosure or being directly traceable to a government source, thus avoiding public scrutiny. For example, Ivy League Yale University disclosed only $284,668 in funding from Qatar between 2010 and 2022. Researchers at the Institute for the Study of Global Antisemitism and Policy (ISGAP) in a report released in June, though, found that this amount reflected only a small fraction of the money and services the university and its scholars had in fact received over that period. The most common channel for hard-to-track Qatari support for Yale came from individual research grants originating from the Qatar National Research Fund, and their report found 11 Yale-linked QNRF grants which came to at least $15,925,711.

Recent research from the Network Contagion Research Institute indicated that at least 200 American universities illegally withheld information about approximately $13 billion in Qatari contributions. Also, according to the report, from 2015 to 2020 institutions that accepted money from Middle Eastern donors had on average, 300 percent more antisemitic incidents than those institutions that did not.

Overall, the report found that “a massive influx of foreign, concealed donations to American institutions of higher learning, much of it from authoritarian regimes with notable support from Middle Eastern sources, reflects or supports heightened levels of intolerance towards Jews, open inquiry and free expression.”

Much of Doha’s engagement with the world is run out of the Qatar Meeting, Incentive, Conference and Exhibition (MICE) Development Institute (QMDI), which promotes Qatar as a good place for business. The annual Doha Forum gathers major policymakers from around the world. 

Qatar’s influence-buying strategies are a textbook example of how to transform cash into “soft” power. The relationship between one of Washington, D.C.’s top think tanks and Qatar, for example, began in 2002, when the emirate underwrote a Doha conference featuring then Qatari Foreign Minister Hamad bin Jassem Al Thani and former U.S. Ambassador to Israel Martin Indyk, at the time the director of the Saban Center for Middle East Policy at Brookings. (Hamad oversaw Qatar’s $230 billion sovereign wealth fund until 2013.) In 2007, Brookings followed up by opening a centre on Doha.  It didn’t end well. In 2021 the institute ended its relationship with Qatar amidst an ongoing FBI investigation.

Still, Washington treads carefully when it comes to criticizing Qatar. It’s not just about money. After all, the Al-Udaid Air Base is home to the U.S. military’s Central Command (CENTCOM), and the country is just across the Persian Gulf from Iran. In fact, Washington’s relationship with Qatar is so close that in 2022 the White House officially designated the emirate a “major non-NATO ally.” The Qataris, realizing that their very existence would be threatened were the U.S. to relocate its CENTCOM operations to the UAE or Saudi Arabia, in January hastened to nail down the agreement for another decade. 

Yoni Ben-Menachem, a senior researcher at the Jerusalem Center for Security and Foreign Affairs, told the Jewish News Service (JNS) that the Gulf country is more dangerous than Hamas or Hezbollah since it is extraordinarily wealthy and thus in a position to influence U.S. administrations.

Qatar has for many years been involved in financing the campaigns of the Democratic Party, he claimed, “especially Hillary Clinton’s campaign” in 2016. He added that former U.S. President Bill Clinton is known to have flown to Qatar to bring back suitcases full of cash.

According to Jonathan Ruhe, director of foreign policy at the Jewish Institute for National Security of America (JINSA), Qatar has portrayed itself as “indispensable to U.S. interests in the Middle East, including negotiations with the Taliban, reconstruction aid for past Gaza conflicts, and building the massive Al-Udeid base for U.S. forces.” 

Yet although it hosts the Pentagon’s regional command, Qatar has long supported terrorism. For decades, it has opened its doors to Islamist terrorists, Taliban warlords and African insurgents. Doha housed the Taliban’s political office before that group returned to power in Afghanistan in 2021.

Beginning in 2012, the Israeli government allowed Qatar to deliver cash to Gaza. Over the next nine years, Qatar provided $1.5 billion. Prior to the outbreak of the present conflict, Doha subsidized Hamas to the tune of $360 million to $480 million a year. With one third of that money, Qatar bought Egyptian fuel that Cairo then shipped into Gaza, where Hamas sold it and pocketed its revenue. Another third went to impoverished Gazan families, while the last third paid the salaries of the Hamas bureaucracy. 

The leaders of Hamas, including Khaled Mashaal and the late Ismail Haniyeh, who was chairman of the Hamas Political Bureau until assassinated by Israel in July, have been regular guests in Doha, living in luxury. (The emir sat in the front row with mourners during Haniyeh’s funeral in Doha.) Qatar has defended Hamas’s presence in the country. 

“This was started to be used as a way of communicating and bringing peace and calm into the region, not to instigate any war,” Prime Minister Mohammed bin Abdulrahman Al Thani told U.S. Secretary of State Antony Blinken last October. “And this is the purpose of that office.” Blinken seemed to buy this. At a press conference in Doha in February, he asserted that “we’re very fortunate to have Qatar as a partner.”

As far back as 2007, when Hamas seized control of Gaza, Qatar recognized that “adopting” the group would be a worthwhile opportunity: connections with Hamas in Gaza grants Qatar influence and status in the Middle East and beyond. In addition, they bolster the popular Arab perception of Doha as working for the Palestinian cause. In 2012, the emir became the first head of state to visit Gaza, pledging $400 million to Hamas. At the same time, the Qataris became the exclusive mediators between Israel and Hamas.

The U.S. has accused the Qataris of harboring members of Iran’s Islamic Revolutionary Guards Corp (IRGC). But at the same time the Qataris are an important intermediary between America and Iran. Doha has enjoyed good relations with the Biden administration, which it helped in the American hasty withdrawal from Afghanistan three years ago.

While organized as a private company, the Al-Jazeera television network is the voice of Qatar’s regime. Founded in 1996 and financed by the then-emir of Qatar, it has described terrorist attacks that killed Israeli non-combatants as martyrdom operations and even posted articles describing Israel as “the Zionist entity.” For years, Al-Jazeera aired all of Osama bin Laden’s speeches. The late Muslim Brotherhood spiritual leader Yusuf Al-Qaradawi was based in Doha and for years hosted a prime-time program on the network. The war on Israel was declared on Al-Jazeera by Hamas military commander Muhammad Deif last October 7. Its operations in Israel were finally terminated by Jerusalem in May.

Qatar has been using the immense wealth it has accumulated to turn Al-Jazeera into an international media conglomerate, spreading Muslim Brotherhood propaganda, Hamas’ original sponsor, on a global scale. The Muslim Brotherhood was founded in Egypt in 1928 by the cleric Hassan al-Banna as a reaction to his perception that the Muslim world had become week in relation to the West. The royal family of Qatar has since been using the Muslim Brotherhood to minimize political opposition against them. In exchange for allowing the Brotherhood to use the country as a base for its international operations, the Brotherhood makes sure that there is no political threat based on organized religion against the Qatari monarchy.

A major shock to Qatar’s economy occurred when some Gulf Cooperation Council members — Bahrain, Saudi Arabia, and the United Arab Emirates — imposed an embargo on Qatar from 2017 to 2021. The reason for the embargo was Qatar’s support for the Brotherhood.

Qatar owns other news media that are equally awful. The London-based daily newspaper Al-Quds Al-Arabi in June published an article entitled “War Criminal Blinken Wages Diplomatic Campaign to Eliminate Palestinian Resistance and Buy Time for Israeli War in Gaza.”

Qatar is not a neutral agent, despite its attempts to portray itself as such. Time and again, it has supported the region’s most radical nations and paramilitaries, all to the detriment of American and Western interests. Its malign influence activities the United States reflect the broader issue of foreign manipulation in America’s political landscape. 

“Qatar has been playing a dual role since the beginning of the Gaza war. On the one hand, it is a well-known supporter of Hamas, and even finances it with a lot of money, and on the other hand, it is trying to help in the deal for the release of the Israeli hostages,” remarked Dr. Udi Levy, a former senior official of Israel’s Mossad spy agency in April. But the U.S. relationship with Qatar will continue as long as the American government finds it useful in the on-again off-again negotiations to have Hamas release the remaining Israeli hostages.

Henry Srebrnik is a professor of political science at the University of Prince Edward Island.

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Why NBA Teams Start Defending Before Half Court

Image Source: Infographic by author

An NBA defender who meets a ball handler near the opposite baseline is trying to interfere with the possession before the offense gets organized. The immediate reward need not be a steal. Making a guard change direction, protect the ball, or find another receiver can interrupt the route into a play. But pressure has several possible results, and slowing that first journey does not necessarily slow the whole game.

In Logan Murdock’s November 2025 report on full-court defense, Phoenix Suns guard Jordan Goodwin described his aim: “Try to make them take at least six seconds off the clock.” That was his target, not a measured average. Indiana Pacers coach Rick Carlisle described another purpose: getting opponents to play faster than they prefer. Both approaches interfere with timing, though one delays the setup while the other hurries decisions.

The shot clock helps explain the difference. In a normal NBA possession following a made basket, the offense has 24 seconds, with the countdown starting when the inbound pass is legally touched on the court. It must also advance out of the backcourt within eight seconds. Crossing half court does not start a fresh shot clock. Time spent getting there leaves less time to create a shot. A defensive deflection that stays inbounds does not restart the countdown.

Defensive pressure also needs careful interpretation in basketball betting. An NBA matchup on the Bovada website cannot be reduced to whether one team presses: the combined score depends on how often both sides get the ball and what they do with their chances. A defender delaying the first pass into an offense can leave less time for a good attempt. A turnover followed by a quick basket has a different effect.

Those possibilities make defensive intensity an incomplete description of a scoring outlook. A team can force its opponent to work harder while creating quick attacking chances for itself. It can also concede an easy chance when pressure fails. Understanding the tactic means separating its purpose from its outcome, rather than treating an aggressive defender as evidence that the game must produce fewer points.

Pressure does not always mean a trap

One defender following the ball is different from two defenders closing around it. The first can contest the dribbler while teammates remain with their own assignments. A trap commits another player to the ball, so teammates elsewhere must cover the passing options and protect the basket.

A stopped dribble changes the contest. Once a player voluntarily picks up the ball, he cannot simply start dribbling again. He can still pivot, pass, or shoot, but moving away from pressure with another dribble is no longer an option. A defender can therefore restrict movement without taking possession. This is also why a guard’s choice to keep the dribble alive deserves attention: it preserves a way to move while searching for a pass.

Watch where the ball goes next. A trap can succeed by forcing an awkward pass that another defender intercepts. The players surrounding the ball do not have to be the ones who take it away. Reaching for a steal also differs from keeping the ball handler contained; abandoning position can give the guard a route past the pressure.

The offense has answers. In the Murdock report referenced earlier, Golden State guard Brandin Podziemski described using his body to shield the ball against smaller defenders and quickness to get beyond longer opponents. Beating the first defender can leave that player trailing, creating a temporary advantage farther upcourt. The remaining defenders then have to respond to an attack before their teammate has time to recover.

Three possible outcomes of early pressure: delayed setup, hurried decisions, or an attacking advantage when pressure is beaten

The work before a highlight

Former NBA guard Keith Bogans gives a defender’s perspective in his conversation with Vernon Maxwell. Discussing Jaden McDaniels, Bogans says that seeing a defender pick up a superstar across the court gets him excited in the way a dunk or crossover excites other viewers.

*

His reaction focuses on the challenge being accepted. The scorer has someone to deal with before reaching a preferred attacking position. Bogans also describes the recognition that such defensive work receives from teammates and coaches, even when it attracts little attention elsewhere.

The assignment does not end when the scorer passes. The defender still needs to follow the play and be ready for the ball to return. Early pressure can force a star to give up the ball without removing him from the possession. Watching the next pass shows whether the defense has actually disrupted the attack or merely moved it.

When defense creates offense

Indiana scored 19 points off turnovers in Finals Game 6 against Oklahoma City on June 19, 2025. The figure does not isolate full-court pressure.

A change of possession ends one team’s opportunity and begins another’s. The team winning the ball can attack immediately or organize its offense, depending on the space and defenders ahead. Pressure therefore cannot be assessed only by the time an opponent spends bringing the ball forward.

Look beyond the pickup point. Does the offense arrive late but still organized? Does it make a hurried pass? Does the ball handler escape and make the remaining defenders cover extra ground? The first defender can use up time without winning the ball. If the guard gets past him, watch whether the other defenders can stop the drive without leaving someone open.

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In ex-Knick Michael Sweetney, Jewish friends mourn a beloved coach ‘who knew exactly how to show up’

Tamir Goodman stuck out like a sore thumb, a yarmulke-wearing redhead at a practice for a showcase of Greater Washington’s top high school talent. The year was 2000, and Goodman, an Orthodox Jewish hoops prodigy, had already been on the cover of Sports Illustrated. What he did not have at that practice was a friend.

But when the all-star team’s coach had players pair up for shooting practice, one teammate approached Goodman: the 6-foot-8, Georgetown-bound power forward Michael Sweetney.

“He’s like, “Hey, I’ll be your shooting partner,” Goodman, 44, recalled by phone Thursday. “And from that moment, we just never left each other.”

Sweetney, who went on to play for the New York Knicks, later said he had never met a Jewish person before that day. But when he died Wednesday of complications from a heart attack, he had not only one Jewish friend mourning his passing, but hundreds.

Mike Sweetney, left, with Tamir Goodman on a trip to Israel in 2019. Courtesy of Tamir Goodman

Orthodox Jewish New Yorkers, who got to know Sweetney through his years teaching basketball at their schools, summer camps, synagogues and even birthday parties, remembered him in tributes Thursday as a humble mentor, a model of courage and a loyal friend in times of Jewish vulnerability.

Those early shooting sessions with Goodman, it turned out, had planted the seed for Sweetney’s post-NBA basketball endeavors, including a four-year stint at Yeshiva University, where he served as an assistant during the men’s team’s famous 50-game win streak.

“The world lost a giant today,” Elliot Steinmetz, Yeshiva’s head coach, wrote Thursday on X. “I lost a close friend. The basketball world lost a beloved star. Our Jewish community lost an ally and someone who knew exactly how to show up.”

Sweetney, who was 43, is survived by his wife, India, and three children.

A perfect matchup

Sweetney brought undeniable but understated starpower to the basketball-obsessed Orthodox community. That community’s embrace also helped Sweetney find purpose after his playing career and reignite his love for the game.

After starring at Georgetown, Sweetney was selected ninth by the Knicks in the 2003 NBA Draft — eight picks after LeBron James. But Sweetney’s career in the league lasted just four years, derailed by struggles with weight and depression that followed his father’s sudden death. (He later revealed he had contemplated suicide as a rookie.) He played another decade for pro teams in China and Latin America before washing out of the sport.

Sensing that his friend was in a bad place, Goodman invited Sweetney to Israel in 2019 to help with a basketball camp he had started.

“I told him a lot of good things happen when you come to Israel,” Goodman said. During the visit, Sweetney opened up about the challenges he had been experiencing. Goodman suggested he go into coaching, and soon connected him with Steinmetz — a Knicks die-hard — who offered him a job.

“When Tamir called me about him, initially, I’m like, ‘Oh, cool, I get to talk to Mike Sweetney, that’ll be fun,’” Steinmetz said Thursday in an interview. “Once I spoke to him the first time, I’m like, ‘That’s just such a nice guy.”

A Yeshiva League staple

Sweetney’s entry into the world of Orthodox Jewish basketball, initiated by Goodman, helped facilitate his turnaround, transforming a point of professional failure into a source of inspiration for others.

A classic back-to-the-basket player in his day, Sweetney relished working with the Yeshiva forwards, who delighted in trying their post moves on a former NBA lottery pick.

“All the bigs’ favorite part of practice was going up against Mike,” recalled Gabriel Leifer, a team captain during Yeshiva’s win streak.

Sweetney was getting something out of the work, too. Those who worked with him up close could see his passion for the sport — which had become a dark place for him — coming back to life.

Sweetney signs autographs on Yeshiva’s home court. Courtesy of Elliot Steinmetz

Harold Katz, a coach who occasionally helped with the Yeshiva program, said that despite his NBA pedigree, Sweetney had no pretenses when it came to learning the school’s motion offense. Instead, he seemed to enjoy it. “He would always say it’s fun — like playing this way is fun.” Katz remembered. “He’d say, ‘I wish I played in this.’”

Sweetney told the New York Post in 2019 that the Jewish world had helped him find stability after basketball.

“I’m comfortable here. I’m treated well here. It’s been amazing,” he said at the time. “To be happy and be at peace, I would’ve been shocked. I wouldn’t have thought it was possible.”

The coaching roles — at Yeshiva and at Ramaz, an Orthodox high school where he coached the girls’ team — also helped Sweetney book speaking engagements and countless youth basketball clinics. He also became an advocate for Black-Jewish relations.

“It starts off that, ‘Oh my God, there’s this big NBA guy who’s at all the YU games,’” Steinmetz said, “but then people start talking to him and they fall in love with his personality because he’s just such a warm, caring guy.”

Driving to and from Yeshiva games over the years, Steinmetz and Sweetney grew close — a friendship that held even after the latter left Yeshiva in 2023 to work in the mental health arena.

The true testament to the kind of person Sweetney was, Steinmetz said, came after they stopped working together, on Oct. 7, 2023. Steinmetz was in Israel at the time; the first text message he received as the attacks were unfolding, he said, was from Sweetney.

“He’s like, ‘Please confirm for me that you’re okay,’” Steinmetz said. “Two days later: ‘Hey, did you get home yet?’ He just cared. He wasn’t checking a box — he cared.”

If you are in crisis, please call, text or chat with the Suicide and Crisis Lifeline at 988, or contact the Crisis Text Line by texting TALK to 741741.

The post In ex-Knick Michael Sweetney, Jewish friends mourn a beloved coach ‘who knew exactly how to show up’ appeared first on The Forward.

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Sacred fasting meets Ozempic

Millions of people worldwide – as many as 1 in 8 adults in the U.S. – are on GLP-1 medication, such as Ozempic, Mounjaro, Wegovy and Zepbound, for treating diabetes or for weight loss.

These drugs are adding a medical twist to religious observances that involve fasting, such as the Jewish holiday of Yom Kippur, which will be observed from sundown on Sunday until nightfall on Monday. Traditionally, fasting on Yom Kippur means forgoing food and water for about 25 hours, which can strongly affect a person’s metabolism.

Other religious traditions include different types of fasts. For example, Muslims who fast during Ramadan neither eat nor drink from dawn to sunset, but they break their fast each night. Christian and Hindu traditions also include dry fasts as well as partial fasts, such as Lent and Navratri, in which people avoid certain foods.

As a specialist in obesity medicine, I work with many patients who take GLP-1 drugs. Most people can safely fast for Yom Kippur or other religious or cultural observances. But depending on their circumstances, they may need to plan ahead, take certain precautions and be clear on when it’s medically advised that they break their fast.

Common GLP-1 side effects and fasting

GLP-1 drugs such as Ozempic, Mounjaro, Wegovy and Zepbound mimic a natural gut hormone– glucagon-like peptide 1 – that lowers your blood sugar by triggering insulin release when your blood sugar is high. These drugs also slow how quickly food passes through the stomach, which reduces appetite to aid in weight loss.

GLP-1s have some common side effects that can occur in anyone taking them, including nausea, vomiting, dizziness, constipation and dehydration. Fasting may exacerbate them, especially in people who are prone to an upset stomach. GLP-1 side effects are also more common when a patient is increasing their dose, which usually happens monthly as tolerated until they reach their full dosage.

That’s why, if you’re planning to fast for Yom Kippur, it’s best to avoid starting a new GLP-1 medication or increasing the dose of your medication sooner than two weeks or so before the holiday.

GLP-1 drugs work by simulating a gut hormone produced in the body, spurring the release of insulin and slowing down digestion.

Timing your dose

If you take GLP-1 drugs as weekly injections, which is the most common way of dosing these medications, you should stick to your schedule even if you plan to fast. These drugs stay in your system during the entire week, so moving or skipping that weekly dose right before fasting can interfere with their effects on blood sugar or weight loss.

If your weekly injection falls on Yom Kippur, you can generally go ahead and administer it as scheduled. Some patients do report increased nausea on their injection day – if that happens to you, you may wish to delay the injection until after the fast, if you’ve cleared it with your doctor.

Patients who inject GLP-1 drugs daily may need to adjust the timing. For patients taking these medications for diabetes treatment, it may make sense to do the injection right before the meal that breaks the fast or to hold off until after the fast. This helps reduce the risk of stomach side effects, which can occur when these medications are taken on an empty stomach.

More recently, many patients have switched to oral GLP-1 medications. These pills must generally be taken on an empty stomach with a small amount of water, at a set time before taking any other drugs or any food or beverages.

Because fasting for Yom Kippur includes abstaining from drinking, taking the pill as directed may involve breaking the fast. That means you’ll need to decide in advance whether to take the medicine before the fast begins, after the fast ends or on an alternative schedule. It’s best to avoid simply skipping the daily dose scheduled for Yom Kippur and taking a double dose after the fast.

Skipping the dose won’t be harmful if you’re taking the medication for weight loss. But if you have diabetes, skipping it could dangerously elevate your blood sugar. And doubling the dose later could lead to serious side effects, such as pancreatitis, an inflammation of the pancreas that can lead to hospitalization.

Diabetes versus weight loss

If you’re using GLP-1 medications solely for weight management, fasting for 25 hours should not pose serious issues beyond stomach upset. In rare cases, though, combining these drugs with fasting can stress the pancreas enough to cause pancreatitis.

Fasting on GLP-1s carries the biggest risks for diabetic patients. That’s because GLP-1 medications are often used alongside other drugs that work primarily by lowering blood sugar, which raises patients’ overall risk of a blood sugar crash.

The greatest concern is in patients taking a GLP-1 medication together with insulin or drugs that stimulate insulin production, such as sulfonylureas. The GLP-1 medication itself may not cause a drop in blood sugar. But because it suppresses appetite and lowers glucose levels, these other medications can magnify the risk of low blood sugar during a prolonged fast.

If that’s your situation, talk to your doctor about whether you can adjust the timing, dose and type of insulin you take and reduce your dose of sulfonylurea in order to fast safely.

In general, people who have Type 1 diabetes or poorly controlled diabetes are strongly advised not to fast – as are people who:

  • Experience frequent or severe drops in blood sugar.
  • Have hypoglycemia unawareness – an absence of warning signs for high blood sugar.
  • Are managing diabetes during pregnancy.
  • Have severe kidney disease with a high risk of dehydration.
  • Experience severe gastrointestinal side effects from GLP-1 medications.
Not overeating along with drinking plenty of water beforehand is helpful for anyone fasting – but crucial for people on GLP-1 medications.

From prefast prep to the post-holiday meal

Regardless of what GLP-1 medication you take and for what indication, if you plan to fast you’ll need to do some pregaming, monitor how your fast is going and be mindful of how you break it.

  • First, if you are unsure about anything, talk to the clinician who is monitoring your GLP-1 drug treatment so you can decide together whether fasting is safe for you and whether your situation requires any special precautions.
  • Before fasting, it’s important to eat a normal meal that includes protein and to avoid both overeating and undereating. Overeating is never recommended when on GLP-1 medications, and undereating can set you up for more side effects during the fast. Although GLP-1 therapy can substantially reduce appetite, patients should avoid skipping the prefast meal entirely.
  • GLP-1 medications don’t just decrease appetite – they can also suppress the body’s natural thirst signals. So before your fast begins, aim to stay hydrated to prevent getting dehydrated while fasting.
  • If you are diabetic, make sure you fast under close guidance from your doctor – and make sure you are checking your blood sugar during fasting. Using a glucose monitor is a good idea, particularly if you are taking insulin or other glucose-lowering medications. The goal is for your blood sugar to remain within your usual daily nonfasting range.
  • Be ready to break your fast right away if you start feeling dizzy, confused, faint, nauseated or acutely ill, or if your blood sugar dips too low or spikes too high. These symptoms are dangerous and need to be addressed immediately. Stash a rapid source of carbohydrates – even just some glucose tablets or a few hard candies – within reach so you can access them quickly if needed.
  • Finally, plan a gentle, balanced meal to break the fast rather than an unusually large meal, which may provoke nausea, abdominal pain, reflux or vomiting. It’s generally best to avoid higher-fat foods, too, since they can slow down digestion.The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The post Sacred fasting meets Ozempic appeared first on The Forward.

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