introduction to hukum islam and fasting ramadhan
TRANSCRIPT
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
1/81
Introduction to Hukum Islam,
Fasting and
Implication to Islam
Dr Hj Suhazeli Abdullah
FMS KK Apin-ApinKeningau Sabah
Ramadhan And Diabetic Forum | MingGarden Hotel, Kota Kinabalu
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
2/81
2www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
3/81
Isi Kandungan Ceramah
Konsep ibadah puasa
Khasiat Puasa
Roh dan penghayatan
Khasiat kesihatan
Isu-isu kesihatan berkaitan puasa.
Panduan Puasa Pesakit Diabetes
www.suhazeli.com 3
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
4/81
Nikmat kehidupan
Nikmat anggota badan
Nikmat iman dan Islam
www.suhazeli.com 4
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
5/81
Nikmat Allah pada Diri
www.suhazeli.com 5
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
6/81
Petanda Amaran
6www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
7/81
Ramadhan Mubarak
7www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
8/81
Puasa untuk Allah
Diriwayatkan hadith dari Abi Soleh az-Zaiyat
sesungguhnya dia mendengar Aba Hurairah (r.a)
berkata: 'Telah bersabda Rasulallah (s.a.w): 'Telah
berfirman Allah (a.w): 'Setiap amalan anak Adamadalah baginya (pahala yg ditetapkan, iaitu gandaan
10 hingga 700 kali ganda itu), kecuali puasa. Maka
sesungguhnya puasa itu untukKu dan Aku (Allah (a.w)
membalas dengan pahalanya. Adapun puasa itu adalahperisai atau pelindung (bagi orang yg berpuasa).
[Hadith Bukhari, Kitab Puasa]
8www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
9/81What You Give, Youll Get Back 9www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
10/81
Matlamat Ramadhan
Al-baqarah-183.
Hai orang-orang yang beriman, diwajibkan atas kamuberpuasa sebagaimana diwajibkan atas orang-orangsebelum kamu agar kamu bertakwa.
10www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
11/81
Allah menilai Puasa Hamba
TAQWA
AmarMakruf
Kesihatan
EkonomiNahi
Mungkar
Didik
Nafsu
11www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
12/81
Berpuasalah, kamu akan sihat
www.suhazeli.com 12
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
13/81
Faedah Berpuasa dari sudut kesihatan
Kesihatan Rohani
Kesihatan Mental /
Emosi Kesihatan Spiritual
/ jiwa
Kesihatan Fizikal
13www.suhazeli.com
Slide courtesy from Dr Wan Mohd Razin Wan Hassan
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
14/81
Jangan Laaa
www.suhazeli.com 14
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
15/81
www.suhazeli.com 15
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
16/81
Puasa menjamin kesihatan Mental dan
Spiritual
Suasana keluarga yang
lebih mesra
Tekanan kehidupan
yang menurun Pembahagian masa
yang teratur
16www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
17/81
www.suhazeli.com 17
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
18/81
Ramadhan And Diabetic Forum | MingGarden Hotel, Kota Kinabalu
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
19/81
Sebumbung tapi tidak Serumah
19www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
20/81
www.suhazeli.com 20
Bersahur/ Berbuka bersama
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
21/81
Kesimbangan hormon Stress
Endorphin
Adrenalin
21www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
22/81
Kitaran hidup berubah
22www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
23/81
Senario Kehidupan 1
6.00 am Bangun tidur
7.30 am Pergi kerja
10.00 am Minum pagi
1.30 pm Makan tengahari
5.00 pm Minum petang
9.00 pm Makan malam 11.00 pm - Tidur
23www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
24/81
Senario Kehidupan 2
Berpeluang menghadiri kursus di hotel
ternama
Breakfast Symposium at 7 am
Morning Break at 10.30 am
Lunch Symposium 1.30 pm
Tea break at 4.00 pm
Dinner Talk at 9.00 pm
24www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
25/81
SENARIO RAMADHAN
4.30 AM SAHUR
6.00 AM SOLAT SUBUH DI MASJID
8 1.00 PM KERJA
1.30 PM - SOLAT ZOHOR 4.30 PM - BALIK KERJA
7.15 PM - BERBUKA PUASA
9.00 PM - SOLAT ISYA & TARAWIH
- TADARRUS QURAN
11.30 PM - TIDUR
25www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
26/81
Banyak melakukan ibadah
www.suhazeli.com 26
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
27/81
Merawat Kesihatan Mental dan Fizikal
Pulihkan mati pucuk
12 rekaat-30 minit-3X
seminggu.
Faedah kepada sistemkardiovaskular,
komposisi tubuh, isyarat
otak dan aktiviti otot
www.suhazeli.com 27
Kajian 3 pakar UM di ketuai oleh Prof Madya Dr
Fatimah Ibrahim
Berita Harian 17-Dis-08.
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
28/81
Kesihatan Fizikal
Mengurangkan tabiat buruk
Mengurangkan berat badan
Mengawalkan kencing manis
Menurunkan darah tinggi
Meredakan penyakit kronik lain
28www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
29/81
Buang Sifat Buruk
www.suhazeli.com 29
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
30/81
FATWA KEBANGSAAN TENTANG MEROKOK
Muzakarah Jawatankuasa Majlis Fatwa Kebangsaan,Bahagian Hal Ehwal Islam Malaysia (kini Jabatan KemajuanIslam-JAKIM ) kali ke 37 yang bersidang pada 23 Mac 1995 diPusat Islam Kuala Lumpur memutuskan:
Bahawa morokok adalah haram dari pandangan Islamkerana padanya terdapat kemudaratan.
Al Baqarah: 195. Dan belanjakanlah (harta bendamu) di jalan Allah, dan janganlah
kamu menjatuhkan dirimu sendiri ke dalam kebinasaan, dan berbuat baiklah,
karena Sesungguhnya Allah menyukai orang-orang yang berbuat baik.
30www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
31/81
Soal Mati
31www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
32/81
32www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
33/81
Kematian Perokok
www.suhazeli.com 33
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
34/81
Kurangkan berat badan
34
Unggul:
BMI 18.5-23.5 kg/m2
Pengurangan 5% atauminima 4.5kg memberikesan yang besarkepada kesihatan.
www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
35/81
35
Kelebihan kurangkan berat badan
Resiko Faedah penurunan 10kg
Darahtinggi
10 mmHg systolic BP
20 mmHg diastolic BP
Reduces the need for medication inhypertensive patients
Lemak 10% in total cholesterol
15% in LDL-cholesterol30% in triglycerides
8% increase in HDL-cholesterol
Note: SIGN (1996); MASO/AMM/MEMS (2004)www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
36/81
36
Kelebihan kurangkan berat badan
Resiko Faedah penurunan 10kg
Diabetes >50% in risk of developing DM
30-50% in FPG
15% in HbA1c
Osteo-arthritis
BMI >2kg/m2 assoc. 50% risk
Kematian 20-25%
in all-cause mortality30-40% in diabetes related deaths
40-50% obesity-related cancer deaths
Note: SIGN (1996); MASO/AMM/MEMS (2004)www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
37/81
Waktu buka Puasa
www.suhazeli.com 37
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
38/81
Organ penghadaman normal
Beri masa rehat
Kembali kepada fitrah
Menyahbuang toksin
yang ada dalam badan.
38www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
39/81
Hadis Rasulullah S.A.W
Tidak ada satu bekas yang lebih buruk yang dipenuhioleh anak Adam selain daripada perut. Cukuplah bagi
anak Adam itu beberapa suapan makanan yangboleh menegakkan tulang sulbinya. Jika perlu
dipenuhkan jug perut itu, maka satu pertiga darinyahendaklah diperuntukkan untuk makanan, satu
pertiga lagi untuk minuman, dan satu pertiga lagiuntuk pernafasannnya
(HR Ahmad, At-Tirmidzi dan An-Nasai)
39www.suhazeli.com
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
40/81
MENGAPA PERLU BERPUASA
PERUT ADALAH KILANG PEMPROSESAN
YANG SANGAT UNIK, KOMPLEKS, EFISIEN DAN
AMPUH
PERANAN DALAM SISTEM PENCERNAAN
MAKANAN
PERLU SERVIS
www.suhazeli.com 40
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
41/81
ISU FEKAH SEMASA PUASA
suhazeli.blogspot.com 41
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
42/81
Perkara berikut TIDAK membatalkan
Puasa
Ubat titis mata, titis telinga dan basuh telinga
Ubat tablet Bawah lidah yang digunakan oleh pesakit Angina
(Jantung).
Memasukkan ubat melalui faraj, memasukan alat perubatan,
membasuh, spekulum dan jari doktor atau bidan semasa
pemeriksaan vagina (sebelum bersalin).
Memasukkan teropong kesalur kencing lelaki atau perempuan
untuk penyediaan xray.
Menampal, mencabut, mengorek dan mencuci gigi atau
menggunakan alatan dan berus gigi, dengan syarat TIADA apa-
apa bahan yang memasuki perut dari prosedur tersebut.
suhazeli.blogspot.com 42Rujukan: Persidangan Fekah Perubatan ke-9.An Islamic view of certaincontemporary medical issues (Morocco, June 1997)
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
43/81
Perkara berikut TIDAK membatalkan
Puasa
Mengambil sampel darah untuk ujian makmal.
Penderma atau menerima pemindahan darah.
Oksigen dan Gas Bius.
Semua jenis bahan yang boleh menyerap kedalambadan melalui kulit seperti krim, jelly atau plaster
berubat.
Suntikan melalui kulit, otot, sendi atau pembuluhdarah, KECUALI memberi makanan melalui
pembuluh darah.
suhazeli.blogspot.com 43
Rujukan:
Persidangan Fekah Perubatan ke-9.An Islamic view of certain contemporary medical issues (Morocco, June
1997)Buku Fikah Perubatan oleh Dr Harmy et al. Keluaran PTS Millennia 2011.
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
44/81
Perkara berikut TIDAK membatalkan
Puasa
Sesalur dan bahan perantara untuk arteriografi(pemeriksaan X-ray khas jantung) atau organ lain.
Teropong dalam rongga perut (endoskopi) untuk
mencari punca penyakit. Membasuh mulut, berkumur atau semburan mulut,
dengan syarat tiada bahan masuk kedalam perut.
Teropong ke dalam salur peranakan atau
memasukkan alat kedalamnya. (ie. IUCD)
Mengambil tisu (biopsi) hati atau organ lain.
suhazeli.blogspot.com 44Rujukan: Persidangan Fekah Perubatan ke-9.An Islamic view of certaincontemporary medical issues (Morocco, June 1997)
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
45/81
JUMHUR
TIDAK MEMBATALKAN PUASA
Ubat titis hidung, semburan
hidung dan ubat sedut.
Suntikan kedalam dubur,
teropong dan pemeriksaan
digital ke dalam dubur.
Pembedahan yeng
melibatkan bius
sepenuhnya jika pesakit
mengambil keputusanuntuk berpuasa.
suhazeli.blogspot.com 45
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
46/81
JUMHUR
TIDAK MEMBATALKAN PUASA
Mesin atau dialisis buah
pinggang melalui perut
Penggunaan teropong
perut, dengan syarattidak memasukkan apa-
apa bahan cecair atau
bahan seumpamanya
kedalam perut.
suhazeli.blogspot.com 46
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
47/81
Panduan Berpuasa bagi
Pesakit Diabetes
Ramadhan And Diabetic Forum | MingGarden Hotel, Kota Kinabalu
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
48/81
Fast or Not?
Introduction
Risk associated with fasting in Diabetics
patient
Diabetis PatientIs it possible to fast?
How to manage Diabetes patients who decide
to fast?
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
49/81
Muslim Population and DM
World wide
1.1 -1.5 billion of Muslim
Diabetes prevalence 4- 6%
EPIDIAR study 1422/2011 43% T1DM and 79% T2DM fasting
during Ramadan 40-50 million people with DM fasting
Malaysia
Prevalence of T2DM above 30 yrs old 14.9% ( NHMS 2006) Estimated 2 million Malaysian had T2DM
1.2 million are Muslim
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
50/81
39
34
23
33
33
33
33
30
48
30
32
29
37
0 10 20 30 40 50 60
Turkey
Tunisia
Saudi Arabia
Pakistan
Morocco
Malaysia
Lebanon
Jordan
Indonesia
India
Egypt
Bangladesh
Algeria
56
57
52
52
56
54
56
55
5550
51
51
60
0 10 20 30 40 50 60
Turkey
Tunisia
Saudi Arabia
Pakistan
Morocco
Malaysia
Lebanon
Jordan
Indonesia
India
Egypt
Bangladesh
Algeria
Mean age type 1 DM Mean age type 2 DM
(years)
overall mean age = 31 years
gender = 50 % male
overall mean age = 54 years
gender = 49 % male
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
51/81
Ramadhan
9 month of Islamic lunar calendar
Duration 29 30 days
Duration of daily fast
- Malaysia 14 hrs
- Other countries may up to 20 hours
Meal consumption
- 2 meals
- after sunset ( Iftar) and before dawn ( Sahur)
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
52/81
To Fast during the month of Ramadan-Prayer and supplication to God-Discipline to be observed during the month-Rights of property to be
respected
(183) (184)
(185)
Al Baqarah
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
53/81
Diabetes is exempted for fasting
It is a chronic metabolic disorder - at risk of
complication
BUT. Many pt with DM insist to fast
ENSURE .. Aware the potential risk
.Appropiate advice given
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
54/81
Risks Associated With Fasting inDiabetes Patients
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
55/81
Epidemiology of Diabetes and Ramadhan
1422/2001 (EPIDIAR) Study
Large epidemiological study
Population based
Conducted in 13 Islamic country, involved
12,243 diabetes patients
EPIDIAR Study,Diabetes Care 27:2306-2311, 2004www.fms-malaysia.org
f
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
56/81
Epidemiology of Diabetes and Ramadhan
1422/2001 (EPIDIAR) Study
Results:
1. Increased risk of severe hypoglycemia were more
frequent during Ramadhan.
2. Fivefold increase of severe hyperglycemia3. Diabetic ketoacidosis- esp in T1DM
4. Dehydration - due to limitation of fluid intake, hot
climate, osmotic diuresis5. Thrombosis- due to hypercoagulable state ( increase
clotting factors, reduced anticoagulant
EPIDIAR Study,Diabetes Care 27:2306-2311, 2004www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
57/81
How to manage Diabetespatients who decide to fast?
www.fms-malaysia.org
dh di l d
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
58/81
1.Pre Ramadhan medical assessment and
educational counselling
1.1 Pre Ramadan medical assessment
- look for overall well being
- glucose control, BP control, lipids control
- advice the potential risk
1.2 Educational counseling/ Ramadan focus education
- VERY IMPORTANT to patients and family
- educate on self care, sign and sx of hypo/hyperglicemia,BG monitoring, meal planning, drug admin, management
of acute complication
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
59/81
2. Ramadan Focus Education
2.1 Care must be individualized
Management plan differ for each patient
2.2 Frequent monitoring of glucose level
Before sahur, 2hrs after Sahur
2hrs before Iftar, 2 hrs after Iftar
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
60/81
2.3 Nutrition
IS A CHALLENGE
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
61/81
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
62/81
Tips on nutrition/diet
1. Iftar
- dont delay Iftar
- limit intake of high sugar/ high fat food weight gain
- break fast with dates/ tamar 1-2 seeds
- take main meal later ( around Isyak prayer) complexcarbo, fibre, salt, a lot water
2. Sahur
- have Sahur as late as possible to avoid long fasting- eat adequate balance meal
- drink a lot of water
www.fms-malaysia.org
Sabda Rasulullah s.a.w.;
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
63/81
Sabda Rasulullah s.a.w.;
Senantiasalah umatku berada dalam kebaikan selama merekamenyegerakan berbuka dan melambatkan sahur.
(Riwayat Imam Ahmad dari Abu Zarr r.a.)
2.4 Exercise
- maintain normal physical activity
- avoid excessive physical activity
2.5 Breaking the fast immediately
- when having hypoglycemia symptoms
- hypoglycemia ( BG < 3.5 mmol/l)
- BG reaches < 3.9 mmol/l in the first few hours of fasting
- BG > 16 mmol/l
Recommendation for Mx of Diabetes During Ramadan, Diabetes Care, 28:2305- 2311, 2005
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
64/81
Kategori Puasa Diabetes Mellitus
Sebelum anda nekad untuk berpuasa, sila
berjumpa dengan pegawai perubatan dan
jalani beberapa ujian ringkas. Ini penting bagi
mengetahui status kencing manis anda.Pegawai perubatan akan mengkategorikan
anda sebagai pesakit kencing manis kepada 4
tahap risiko.
Ramadhan And Diabetic Forum | Ming
Garden Hotel, Kota Kinabalu
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
65/81
Kategori I
Tahap Risiko Rendah, kriterianya seperti berikut:a) Pesakit kencing manis yang stabil dan terkawal (rujuk d).
b) Pesakit kencing manis yang belum lagi menggunakan ubat-ubatankencing manis. Cukup dengan mengawal pemakanan mereka danparas gula dalam darah adalah terkawal (rujuk d).
c) Atau/dan mereka yang hanya mengambil sejenis ubat kencingmanis, namum paras gula dalam darah adalah terkawal (rujuk d).
d) Bacaan gula samada waktu puasa atau setelah makan antara 4.0mmol/l hingga 7.0 mmol/l.
e) Tiada langsung komplikasi bahaya Kencing manis seperti seranganangin ahmar, Serangan jantung, kegagalan fungsi buah pinggang dankerosakan sistem saraf.
Nota: Paras gula ini bukan indikasi tepat yang menyatakan andaberada dikategori terkawal atau tidak- Sila berbincang denganpegawai perubatan untuk maklumat yang lebih jelas.
Ramadhan And Diabetic Forum | Ming
Garden Hotel, Kota Kinabalu
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
66/81
Kategori II
Tahap Risiko Sederhana.
a) Pesakit yang menggunakan suntikan insulin jenis
tindak-balas-segera (Short Acting Insulin)
b) Bacaan gula samada waktu puasa atau setelahmakan antara 7.0 - 10.0 mmol/l.
Ramadhan And Diabetic Forum | Ming
Garden Hotel, Kota Kinabalu
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
67/81
Kategori III
Tahap Risiko Tinggia) Pesakit yang telah disahkan oleh pegawai perubatan
mengalami sakit buah pinggang. [Sr Cr >1.5 mg/dL / 132mol/L]
b) Pesakit yang telah mengalami komplikasi Kencing manis
seperti serangan jantung, kegagalan buah pingang, anginahmar dan kerosakan sistem saraf.
c) Pesakit yang tinggal berseorangan dan mengambil ubatankencing manis jenis insulin atau Sulfonylurea (Sejenis ubatkencing manis yang mempunyai resiko tinggi untukmenurunkan paras gula dalam darah terlalu cepat-
hipoglisemia).d) Orang tua yang sudah tiada daya.
e) Pesakit yang mempunyai penyakit-penyakit kronik yang lain.
Ramadhan And Diabetic Forum | Ming
Garden Hotel, Kota Kinabalu
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
68/81
Kategori IV
Tahap risiko Sangat tinggia) Mengalami serangan hipoglisemia atau ketoasidosis
(Hiperglisemia) dalam tempoh 3 bulan sebelumRamadhan. Atau mengalami koma dalam kedua-duakeadaan tersebut.
b) Mempunyai sejarah hipoglisemia yang kerap atau tidakpandai mengenali tanda-tanda hipoglisemia.
c) Pesakit yang sukar mengawal paras gula dalam tempoh 6bulan berturut-turut (Bacaan FBS >10.00 mmol/l)
d) Pesakit Kencing Manis jenis I.
e) Pesakit kencing manis yang menjalani dialysis.
f) Pesakit kencing manis yang hamil dan diberi ubat insulin.
g) Pesakit yang umur kurang dari 12 tahun.
Ramadhan And Diabetic Forum | Ming
Garden Hotel, Kota Kinabalu
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
69/81
Panduan
Kategori I dan II
boleh meneruskan puasa setelah mendapat khidmat
nasihat pegawai perubatan.
Kategori III tidak dibenarkan puasa.
Jika ingin meneruskan puasa, dinasihatkan membuat
pemantauan rapi oleh anggota kesihatan.
Kategori IV
tidak dibenarkan langsung berpuasa.
Ramadhan And Diabetic Forum | Ming
Garden Hotel, Kota Kinabalu
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
70/81
Galakan Berpuasa
Allow fasting in:
1. Patients who do not have the mentioned criteria2. Patient who accept medical advisement.
Encourage fasting in:
Overweight NIDDM patients whose diabetes is stablewith weight levels 20% above the ideal weight or
body mass index (body weight, kg/height, meterssquared) greater than 28.
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
71/81
Treatment regime adjustment..
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
72/81
Patient on diet control
No change needed
Adequate fluid intake
www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
73/81
Patient on OHA
In general, insulin sensitizer associated with lower risk ofhypoglycemia
1. Sulphonylurea ( insulin secretion)
use with caution
use Chlorpropamide is CI
SU 2x/ day
eg: Glibenclamide, Gliclazide full dose at Iftar, half
dose during sahur
SU once daily
eg: Gliclazide MR dose given at Iftar
www.fms-malaysia.org
DDP-IV INHIBITORS
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
74/81
DDP IV INHIBITORS
(Vildagliptin)
Good and safe alternative during
Ramadan
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
75/81
2. Metformin ( insulin sensitizer)- 2/3 given at Iftar, 1/3 at sahur
3. Glitazones (rosiglitazone, pioglitazone)
- No change in dose required
4. Short acting insulin secretagogue
- Repaglinides, Nateglinides- can be taken twice during Iftar and Sahur
www.fms-malaysia.org
Insulin adjustment
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
76/81
Insulin adjustment
Short acting insulin
+ intermediate
Humulin N,
Insulatard
Humulin 30/70,
Mixtard 30/70
CPG in Insulin Therapy, MOH 2010www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
77/81
Management of people wi th diabetes want ing to fast during Ramadan, BMJ 2010;340:c3053www.fms-malaysia.org
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
78/81
Breaking the Fast
All patients must always and immediately end theirfast if:
1. Hypoglycaemia (blood glucose of
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
79/81
Conclusion
1. Fasting during Ramadan for Diabetes patientscarries a risk discuss the risk with the patient
2. Patients who insists on fasting should undergone
assessment and receive appropriate education.3. The management plan should be highly
individualized and close follow up is essential
www.fms-malaysia.org
!
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
80/81
No Frustration!
Ramadhan And Diabetic Forum | Ming
Garden Hotel, Kota Kinabalu
http://www.youtube.com/watch?v=1aZP7V2No-k
-
7/28/2019 Introduction to Hukum Islam and Fasting Ramadhan
81/81
Sekian Terima Kasih
www.suhazeli.com