Malaysia is confronting a quiet pressure that has grown beyond the familiar warning about sugar: Type 2 diabetes arises from the accumulation of excess energy, refined carbohydrates, inactivity and body weight, often without any visible sign. In Petaling Jaya, on World Diabetes Day, health specialists asked the public to see prevention as a patient, everyday discipline rather than a brief act of abstinence. With millions living with the condition and about half unaware of it, their message is that the earlier a person looks, and the more steadily they live, the more the future can still be sha
Beyond Sugar: Experts Urge Malaysians to Rethink Diabetes Prevention Through Lifestyle and Early Checks
Avoiding sugar completely does not guarantee protection.
Mark
The headline message is that it goes beyond sugar. Isn't that a strange thing to say about diabetes?
Mimi
It's a correction more than a contradiction. Prof Sharifah said excess calories matter too, including high-carbohydrate foods and sugary drinks, and Ng Kar Foo said avoiding sugar completely doesn't guarantee protection.
Mark
So what do they want people to do instead?
Mimi
Routines they can sustain: walking after meals, 150 minutes of moderate activity a week, less sweetness in teh tarik, plain water as the default.
Luke
Before we go further, the 4.75 million figure and the 2.4 million undiagnosed are International Diabetes Federation estimates, not a count of confirmed cases.
Mark
Fair. And the undiagnosed share, 50.4%, is that the part that worries people most?
Mimi
It's the reason for the push on early checks. Prediabetes and early diabetes may show no symptoms, so waiting for thirst or blurred vision means waiting too long.
Luke
Worth noting the drinks point is Ng's observation that freshly made drinks generally fall outside the excise duty. The article doesn't say how much sugar those drinks contain or how much they contribute to diabetes.
Mark
And the younger patients?
Mimi
The registry recorded 1,926 patients under 30 in 2024, with Type 2 found in some as young as 14.
Luke
That's registered patients, so it tells us who was recorded, not how common it is among young people overall. The article also doesn't say whether the number is rising.
Le Pouls
- Roughly 2.4 million Malaysians with diabetes do not know they have it, meaning the disease is advancing largely out of sight.
- Experts are pushing back against the belief that cutting sugar alone will protect people, revealing a gap between popular assumption and medical reality.
- Young patients, some as young as 14, are appearing in the national registry, unsettling the idea that this is a disease of later life.
- Specialists are steering people toward modest, repeatable steps such as walking after meals, smaller portions and less sweetened tea or coffee.
- A possible next move looms: wider screening and clearer guidance on freshly made drinks that currently sit outside the sugar excise duty.
Malaysia is confronting a quiet pressure that has grown beyond the familiar warning about sugar: Type 2 diabetes arises from the accumulation of excess energy, refined carbohydrates, inactivity and body weight, often without any visible sign. In Petaling Jaya, on World Diabetes Day, health specialists asked the public to see prevention as a patient, everyday discipline rather than a brief act of abstinence. With millions living with the condition and about half unaware of it, their message is that the earlier a person looks, and the more steadily they live, the more the future can still be shaped.
On World Diabetes Day, under the theme "Early action on diabetes," Malaysian health professionals offered a correction to a common belief. Preventing Type 2 diabetes, they said, is not only about cutting sugar. Speaking in Petaling Jaya, specialists called for lasting lifestyle changes, earlier health checks and better access to healthier food.
Public health specialist Prof Dr Sharifah Ezat Wan Puteh warned that excess calories matter as much as sweetness. High-carbohydrate foods and sugary drinks can lead to weight gain and insulin resistance. She advised against crash diets, favouring routines people can sustain: staying active, managing stress, sleeping well, eating more fibre and cutting back on white rice and processed foods. Because prediabetes often gives no warning, she urged people with high blood pressure, abnormal cholesterol or abdominal obesity to get regular glucose and HbA1c tests rather than waiting for symptoms.
The stakes are considerable. Malaysia has the highest diabetes prevalence in South-East Asia, with an estimated 4.75 million adults affected, and about half of them undiagnosed. Dietitian Ng Kar Foo added that the food environment shapes these outcomes, and that the difference between whole fruit and free sugars in drinks matters more than any single ingredient. For many, he said, the simplest start is the cup in hand: less sweetness in teh tarik or coffee, plain water as the default, and a daily walk after meals.
The warning also reaches the young, with 1,926 patients under 30 registered in 2024. What comes next will depend on whether screening expands and whether guidance on sweetened drinks extends to freshly prepared beverages now left outside the excise duty.
On World Diabetes Day, observed under the theme "Early action on diabetes," Malaysian health professionals made a point that cuts against a common assumption: preventing Type 2 diabetes is not only a matter of cutting sugar. The Star reported their comments from Petaling Jaya, where specialists called for lasting lifestyle changes, earlier health checks and better access to healthier food.
Public health medicine specialist Prof Dr Sharifah Ezat Wan Puteh said many people think diabetes is only about sugar, when excess calorie intake also matters. High-carbohydrate foods and sugar-sweetened drinks, she said, can lead to weight gain, obesity and insulin resistance. She cautioned against building prevention around crash diets or short bursts of effort. Her advice was to watch diet and weight, stay active through walking, cycling or regular exercise, manage stress and get enough sleep, favouring routines people can keep up. She also recommended cutting back on refined sugar, white rice, sugary drinks and highly processed foods, and eating more fibre.
Prof Sharifah, who is president of the Malaysian Society for Harm Reduction, described diabetes risk as a mix of genetics, family history, age, physical inactivity, unhealthy eating and excess body weight, particularly fat around the abdomen. People with high blood pressure, high cholesterol or triglyceride levels, or abdominal obesity should have regular blood glucose and HbA1c tests, she said. Prediabetes and early diabetes may produce no symptoms, so she urged people not to wait for constant thirst, frequent urination, tiredness or blurred vision before getting checked.
The scale of the problem explains the urgency. The International Diabetes Federation estimated that 4.75 million Malaysians aged 20 to 79 were living with diabetes in 2024. Based on the federation's 2024 country estimates, Malaysia has the highest diabetes prevalence in South-East Asia. About 2.4 million of those with diabetes, or 50.4%, are estimated to be undiagnosed.
Dietitian Ng Kar Foo said food environment and everyday eating patterns have to be part of the conversation. Type 2 diabetes, he said, is complex and has many causes, and is not simply the result of eating too much sugar. Avoiding sugar entirely does not guarantee protection; the larger issue is overall dietary pattern, excess energy intake, physical inactivity and weight gain. He urged consumers to tell apart naturally occurring sugars, as in whole fruit and plain milk, from free sugars in sweetened drinks, syrups and desserts.
For many Malaysians, Ng said, the most practical starting point is what they drink: gradually reduce the sweetness in teh tarik or coffee, eat smaller portions, and make plain water or unsweetened drinks the usual choice. He noted that freshly prepared drinks at kopitiam, mamak restaurants and cafes may be overlooked sources of sugar, since they generally fall outside the excise duty on sugar-sweetened beverages, which applies to selected ready-to-drink products. He also urged reading nutrition labels, choosing whole fruit over juice, and eating more vegetables and wholegrains. Small, consistent changes matter more than drastic restrictions, he said.
On activity, Ng recommended at least 150 minutes of moderate-intensity exercise a week, with a 10 to 15-minute walk after meals as a realistic first step.
The disease is also reaching younger people. Health Ministry data showed 1,926 patients under 30 were registered in the National Diabetes Registry in 2024, with Type 2 diabetes detected in patients as young as 14. What to watch next is whether early screening widens and whether guidance on sweetened drinks extends to the freshly prepared beverages the excise duty does not cover.
Citations marquantes
Prediabetes and early diabetes may not cause symptoms. Do not wait until you are constantly thirsty or experiencing blurred vision before getting checked.— Prof Dr Sharifah Ezat Wan Puteh, public health medicine specialist
Small, consistent changes in everyday choices matter more than drastic restrictions.— Ng Kar Foo, dietitian
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