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n the early stages of diabetes, soaring blood sugar levels can be effectively managed by oral medications prescribed for you by an endocrinologist or health care provider.

Diet, exercise and lifestyle can definitely help your condition.

However, there comes a time when oral medications cannot maintain normal blood glucose levels. So, your endocrinologist will recommend insulin.

Many diabetics are hesitant to make that move. They shouldn'€™t be.

As your body ages, diabetes progresses naturally. When it does, your blood sugar levels cannot be controlled just by oral medications and lifestyle.

To improve your chances at preventing serious complications, your blood sugar should be better managed. If it cannot be done with oral medication a good option is to shift to insulin.

Patients feel fear when informed that they need to shift to insulin. The reasons are many.

Some diabetics feel that they are only the one on insulin. There are many people who are on insulin treatment. So you aren'€™t alone.

People live longer, going into old age gracefully. This means as you live longer, diabetes progresses and the more you will need insulin to prevent complications and live to a productive old age.

Other patients think insulin will make them feel worse '€” that a high blood glucose level will make them feel so thirsty, fatigued, listless and tired. However, some feel these symptoms disappear once patients shift to insulin, as insulin effectively lowers blood glucose and relieves symptoms of diabetes.

An additional misconception is that starting insulin can cause eye and kidney failure.

However, most patients have very high levels of blood glucose for many years. Throughout those years their eyes and kidneys have been damaged by high blood glucose levels. These organs were already damaged before they even started insulin. When patients opt for insulin it was only when they have those complications hoping it would improve their condition.

On the other hand, starting with insulin early once your oral medications cannot effectively control your spiraling levels of blood sugar will effectively prevent damage to your eyes and kidneys and other diabetes complications.

Patients must remember that an effective way to prevent complications is to maintain a normal blood glucose level '€” and insulin can effectively do this.

Another misconception is that needles hurt.

Well, we'€™ve come a long way. Current insulin needles are so fine and short that they fail to cause much pain.

Since you will be injecting it into the subcutaneous area of your abdomen, it won'€™t be as painful as when you prick your finger for a blood glucose test. This is because your abdomen has fewer nerve endings as compared with your fingers which have more.

Further, a regular series of insulin shots will not make a patient'€™s life excessively complicated. Your endocrinologist will start you on one injection, first thing in the morning or before bedtime.

If you'€™re traveling, insulin pens are easy to carry and they don'€™t need any refrigeration. These pens are easily stored and last for up to a month. They are easy to pack and use when you travel. Most people learn to give their own injections easily.

For those afraid of hypoglycemia '€” well, for most,'€œhypos'€ don'€™t usually occur and when they do occur, too much insulin has been injected.

Hypos don'€™t happen much in type 2 diabetes, but more among those who suffer from type 1.

Ask your endocrinologist about the mechanism of your insulin and how best to manage hypos when it happens so you can prepare and take precautions.

The writer, who has worked as a consultant endocrinologist at Changi General Hospital, is also an assistant adjunct professor in Research at Duke-NUS, the region'€™s premier graduate medical school. He specializes in diabetes mellitus and thyroid disease and is vice president of the Diabetic Society of Singapore.