Integrating Fiqh evidences in the recommendation for management of diabetes during Ramadan

• Main Authors: Shahar, Mohammad Arif, Che Mohamad, Che Anuar, Hisham, Ahmad Irfan Ikmal, Omar, Ahmad Marzuki
• Format: Conference or Workshop Item
• Language: English
• Published: Malaysian Endocrine & Metabolic Society (MEMS) 2016
• Subjects: RC Internal medicine
• Online Access: http://irep.iium.edu.my/52041/1/integrating%20fiqq%20evidences%20into%20the%20recommendations%20of%20amangement%20of%20diabetes%20during%20ramadan.pdf; http://irep.iium.edu.my/52041/; http://www.mems.my/section.php?sid=4&dc=past

Introduction: In the year 2005, The American Diabetic Association (ADA) published the Recommendations of Management of Diabetes During Ramadan and an update was released in 2010. In 2015, another update was produced by the International Group for Diabetes and Ramadan (IGDR). One of the issues addressed in the update was on the risk stratification for patients planning to fast during the holy month. Despite this stratification, patients with diabetes choose to continue to observe their fast regardless of the risk, as shown in the CREED study. Lack of Islamic Jurisprudence (Fiqh) evidences presented in the document, issue on fasting as a personal choice and lack of clinical evidences pertaining to diabetes and Ramadan may account for the low acceptance among Muslims. Objectives: 1. To compare the ADA and IGDR risk classification criteria with Fiqh evidences and to identify any discordant. 2. To compare the advice on observing fasting for diabetic patients based on the ADA and IGDR recommendations with Fiqh ruling. Methods: The recommendations published by ADA (in 2005 and 2010) and IGDR (2015) were reviewed with particular focus on the risk stratification criteria. Searches were performed from selected classical and contemporary sources of Islamic Jurisprudence (Fiqh) via Maktabah Shamilah: 1) Quran and commentary of the Quran: Ibn Kathir, Qurtubi, Ar Razi, Munir etc, 2) the Prophet’s tradition (Sunnah) from major 6 books of sunnah and their commentaries (Fathul Bari for Sahih Bukhari, Minhaj for Sahih Muslim, and commentaries for other book of Sunan) and book of fiqh and usul fiqh: Majmu’ Sharhul Muhazzab, Bidayatul Mujtahid, Mausua’h Fiqhiyyah al Muayassarah, Muwaffaqat etc., in order to verify the fiqh arguments by the recommendations as well as to explore other available scholarly opinions. Each risk criteria were then classified as “evidence available from Quran”, “evidence availabe from Sunnah” or “Ijtihaad”. Results: While most of the classification criteria are mainly Ijtihaadi that is not without support from Fiqh evidences, many cut-off points are arbitrary and require proper clinical studies and further detailing. The Fiqh evidences bring a notion that fasting is not a personal choice. Rather, fasting is an obligation with exemptions in certain condition set by Islamic Law (Syari’a). The advice “to allow fasting” and “fasting not recommended” are loose and may cause possible misguidance. Advice “obliged to fast”, “may choose not to fast” and “eligible for exemption (rukhsoh)” is more appropriate in Fiqh point of view. Conclusion: The integration of evidences of Fiqh into current recommendations or guidelines for management of diabetes during Ramadan is necessary to ensure that fasting related advice not only addresses safety issues but also in line with the principles of Islamic Jurisprudence.