MUNICH - The promise of better equipment to treat diabetes spells a future in which there will be fewer amputations, less blindness and fewer kidney failures.

Companies have been working on equipment that offers greater control of insulin for diabetics with less pain - a major reason why more than 50 per cent of diabetics in Singapore do not have their disease well controlled is a fear of needles and the pain involved in daily insulin injections.

Dr Stanley Liew, an endocrinologist with the National University of Singapore, estimates about 70,000 patients - more than 25 per cent of the nation's diabetics - need regular insulin boosts to control their blood glucose levels.

Still, many resist going on insulin therapy because of the pain and bother of daily injections.

Dr Daphne Khoo, head of endocrinology at Singapore General Hospital, said many patients did not have their disease well controlled and that led to complications such as blindness, heart problems and strokes.

But with the introduction of several painless ways to monitor and deliver insulin, many such problems could soon be a thing of the past, according to Professor David Klonoff of the University of California, San Francisco.

Speaking at a four-day European Association on the Study of Diabetes meeting here which attracted more than 12,000 delegates, Dr Klonoff described the latest developments.

One of the most exciting is an artificial pancreas. The palm-size machine will be attached to a patient's abdomen and will continuously check glucose levels.

When the glucose drops below a preset level, the device will automatically administer the right amount of insulin.

Thus, monitoring and regulation of insulin levels can be achieved round the clock, even when a patient is sleeping.

Dr Liew said such a device would prevent damaging fluctuations of a patient's insulin levels.

Such peaks and troughs, if severe, could lead to brain damage and death, he said.

Less sophisticated equipment includes inhalable insulin packs to replace the twice-daily injections. Instead of painful jabs, diabetics will only need to breathe in the insulin particles.

Dr Klonoff said the first inhalable insulin could be on the market as early as next year.

Other ways of delivering insulin with little or no pain include the use of micro-needles - which are so small that their tiny pin-prick can hardly be felt - ultrasound and laser delivery of insulin without the need to puncture the skin.

Insulin-monitoring devices that alert patients when their levels are too high or too low could come in the shape of a watch.

Dr Khoo said the success of such equipment in Singapore would depend on price.

'If they are affordable, many more patients will be able to control their diabetes adequately.

'This would considerably decrease the incidence of blindness, kidney failure and possibly amputation and heart disease. It will certainly improve the quality of life for them,' she said.

Diabetes is the leading cause of blindness among Singaporeans.