Misunderstandings a hurdle in disease management

In my medical practice, I have noticed that patients have certain misunderstandings which can hinder the treatment and management of ailments such as diabetes, asthma and food allergy.

In the case of diabetes ("S'pore 'has 2nd-highest proportion of diabetics'"; Dec 2), there seems to be the misunderstanding that refraining from taking sugar can cause one to be weak.

Sugar is consumed in complex carbohydrates as well, and the taking of simple sugar makes the management of diabetes a difficult task.

Drinking fruit juice means taking in fructose, which will be converted to glucose and, thus, affect the sugar level in the blood. Patients insist that fruits are good for them, but it is not so in this scenario.

The treatment of diabetes may involve the use of multiple medications and even the injection of insulin as the disease progresses.

But many patients are averse to adding more medications and object to the idea of injections.

However, improved insulin medications with better pens/needles cause very little pain, and the problem of hypoglycaemia is almost eliminated.

Poor control of diabetes eventually leads to more complications and more pain.

As for asthma ("Night-time asthma attacks? Nose may be cause"; Dec 2), some patients feel that the use of inhalers is addictive. Also, they are put off by steroids and associate it with severe side effects.

But inhalers are effective and give quick relief when used correctly. They are definitely not addictive and may even stop a serious attack.

The use of steroid inhalers does not cause as many side effects as oral steroids. At times, oral steroids may be needed for life-threatening situations. But when administered properly for a short period, they are generally safe.

The prevention and management of asthma may require the long-term use of inhalers and adequate use of medications; this is safer and better than to depend on ad-hoc treatments when faced with sudden attacks.

With regard to food allergies ("Baby steps in the food allergy battle"; Dec 4), it is becoming fashionable for parents to send their children for blood tests and concluding that they are suffering from a long list of food allergies.

The tests can point only to the possibility of a certain allergy.

It may be prudent for parents to refer their children to doctors specialising in food allergies rather than keep them from a long list of food and affect their proper nutrition.

Quek Koh Choon (Dr)