Diabetes in Malaysian Children: A Growing Concern

In Malaysia, type 2 Diabetes, once considered an adult disease, is now being diagnosed in children as young as 14, according to a recent statement by Yang Berhormat Datuk Seri Dr Dzulkefly bin Ahmad, Health Minister of Malaysia[i]. 

According to Dr Ch’ng Tong Wooi, Consultant Paediatrician & Paediatric Endocrinologist at Sunway Medical Centre, Sunway City (SMC), the trend is one that paediatricians have been witnessing for years. “This is more than an alarming statistic. It signals a growing public health crisis because type 2 diabetes that develops during adolescence is often far more aggressive than when it develops later in adulthood,” she continues. 

For teenagers, the implications are also greater as they may live with the disease for decades, increasing the risk of kidney disease, heart disease, nerve damage and vision loss. This is why early detection and intervention are crucial.  

Why are Children at Risk of Developing Type 2 Diabetes?

Obesity remains the biggest risk factor, but it is only parts of the picture. According to National Health and Morbidity Survey (NHMS) 2024 data, two in three adolescents consume more than 7.5 teaspoons of free sugar daily[ii], exceeding the recommended maximum of 6 teaspoons[iii]. Diets low in fruits, vegetables and dairy products, sedentary lifestyles and excessive screen time are also driving obesity and insulin resistance among children. 

Family history also matters. In one major study, nearly 59.6% adolescents with type 2 diabetes had a parent or sibling with diabetes, while almost 89% had an affected grandparent[iv]. "Asian children can develop insulin resistance and type 2 diabetes at lower body weight than Western populations. Some children who appear healthy may be vulnerable if they have a family history or other metabolic risk factors, hence it’s important to speak to doctors promptly," Dr Ch'ng explains.

The Warning Signs Parents Should Not Ignore

Type 2 diabetes can develop quietly, with some children showing few or no symptoms until the condition is detected through screening. Dr Ch’ng advises parents to watch for persistent thirst, frequent urination, excessive hunger, unexplained tiredness, blurred vision or recurring skin infections. Another warning sign is acanthosis nigricans, the dark, velvety patches around the neck, underarms or groin, which may indicate insulin resistance and are sometimes mistaken for dirt or poor hygiene[v]. 

Children who are overweight or obese with additional risk factors should begin screening from age 10 or after the onset of puberty, with repeat screening if risks persist[vi]. “The window for intervention is narrower than in adults so identifying the condition early gives children the best opportunity to control their blood sugar, reduce long-term complications and potentially achieve remission,” she continues. 

Healthy Habits Start at Home 

While the rise of type 2 diabetes among teenagers is worrying, Dr Ch’ng says parents should remember that the disease is largely preventable, and prevention works best when the whole family is involved.

“A family-centred approach is essential. Healthy habits are much easier to sustain when everyone makes changes together, rather than singling out one child.” 

That starts with simple but consistent changes like filling the plate with more fruits, vegetables, whole grains and legumes, cutting back on sugary drinks and ultra-processed foods, encouraging at least 60 minutes of physical activity every day, limiting recreational screen time and making sure children get enough sleep. Shared meals and family activities can also help children develop healthier habits that last into adulthood.

Lifestyle and Treatment Go Hand in Hand

For children with type 2 diabetes, lifestyle changes remain the cornerstone of treatment. Dr Ch’ng urges families not to lose hope, as advances in treatment, healthier habits, and proper medical support now enable many children to manage their condition and lead healthier, more active lives. 

While oral medication such as metformin may be first-line treatment for youth-onset type 2 diabetes[vii], newer treatments such as GLP-1 receptor agonists are now available for selected young patients, alongside with other approved medications. These are used together with healthy eating, regular physical activity and behavioural support to improve blood sugar control and reduce the risk of long-term complications. 

“Lifestyle changes and medication are complementary, not competing strategies. Medication helps control the disease while families work towards sustainable changes in eating habits, physical activity and other healthy behaviours,” she adds. With the right treatment and unwavering family support, children with type 2 diabetes can still reclaim their health, protect their future and grow up with every chance to live full, active lives.