Dr. Chooi Kheng Chiew, Consultant Physician, Endocrinologist and Diabetologist, Ampang Puteri Specialist Hospital

The rising trend of diabetes among Malaysian children is becoming an urgent public health concern. According to the Ministry of Health National Diabetes Registry Report 2023, 289 individuals under the age of 18 are recorded as living with diabetes in Malaysia¹. Although this represents only 0.01 per cent of the total registry, it is medically significant because the registry primarily captures adult Type 2 diabetes cases. Paediatric cases, especially Type 1 diabetes, are often not captured in adult-focused systems, which means the real number of affected children is likely higher.

Additional data referenced from the International Diabetes Federation notes that 977 Malaysian children and teenagers under 18 have been diagnosed with diabetes². The National Heart Institute has also reported treating one of the youngest registered diabetic patients in the country, an eight-year-old child³. These findings reflect a concerning shift. Diabetes can now begin in childhood, not only adulthood.

Diabetes Can Start Much Earlier Than Expected

Type 2 diabetes was traditionally seen as a condition of middle age. Today, however, children and adolescents are increasingly showing signs of insulin resistance, the earliest stage of abnormal sugar regulation. This suggests that the pancreas is under strain long before adulthood begins.

Childhood in Malaysia has changed dramatically. Many children grow up in environments shaped by:

• Sweetened drinks and processed snacks are easily available at home, in school canteens and in convenience shops. These foods cause sharp spikes in blood sugar and force the pancreas to work harder.
• Long hours of screen time reduce physical play. Less movement slows down metabolism, weakens muscle activity and raises the risk of insulin resistance.
• Irregular meal patterns and fast-food habits due to busy family routines. High-calorie, low-nutrient meals disrupt the body’s natural metabolic rhythm.

These factors do not harm the body immediately. Instead, they accumulate quietly over the years until the body begins to struggle with glucose control.

Common Contributors to Diabetes in Children

• Sugary drinks and processed snacks
• Too much screen time, too little movement
• Irregular meals and fast food habits

Why Early Habits Matter

Childhood is a critical phase for metabolic learning. The body is still developing its ability to manage insulin, regulate hunger and establish long-term eating patterns. What children eat and how they live during these early years strongly influence their lifelong health.

Clinical observations show that:

• Eating habits formed before the age of 10 have a powerful impact on later diabetes risk. When children grow up drinking sugary beverages or eating processed snacks regularly, their baseline glucose and insulin levels may shift permanently.
• Childhood obesity is now one of the strongest predictors of early-onset Type 2 diabetes. Excess weight, particularly around the abdomen, reduces the body’s sensitivity to insulin.
• Frequent snacking and skipped meals disrupt the body’s internal metabolic rhythm. When the body cannot anticipate when glucose is coming, insulin responses become less effective, and resistance develops over time.

These early patterns become the metabolic blueprint that continues into adulthood.

Parents Shape the Foundation Quietly but Powerfully

Parents remain the strongest influence on a child’s relationship with food and activity. This influence does not come from strict control but from daily consistency and example. Children observe more than they are told. When healthy habits feel normal at home, those habits follow them into their teenage years and adulthood.

Small, steady habits to implement at home:

• Choosing water or milk instead of sweet drinks
• Serving whole foods such as fruits, vegetables, lean proteins and whole grains
• Eating together as a family encourages slower, healthier eating
• Encouraging daily movement through outdoor play, cycling or sports
• Keeping screen time balanced with physical activity

Recognising Early Warning Signs

Type 2 diabetes in children is still less common than in adults, but early signs are often subtle.

Parents and caregivers should look for:

• Persistent tiredness
• Excessive thirst or frequent urination
• Sudden or unexplained weight loss
• Slow healing or recurring infections
• Dark patches of skin around the neck or armpits, a typical sign of insulin resistance

If these symptoms appear, early medical evaluation can reverse the progression and prevent long-term complications.

A Life Course Approach to Diabetes

Preventing diabetes is not a single step. It is a journey that begins in childhood and continues throughout adult life.

• In childhood, the focus is on building healthy foundations through food choices, activity and balanced routines.
• In adulthood, prevention relies on regular screening, early detection of metabolic changes and maintaining an active lifestyle.
• In older age, coordinated care helps prevent complications, especially for those who developed diabetes young age.

Supporting children early means protecting their health far into the future.

“The habits formed in childhood leave a lifelong imprint. When we guide our children toward healthier choices, we protect a future they will only understand when they are older.” – Dr. Chooi Kheng Chiew

References:

1. Ministry of Health Malaysia — National Diabetes Registry Report 2023. Primary source for national diabetes statistic,s including age group data showing 289 individuals under age 18. https://www.moh.gov.my/moh/resources/Penerbitan/Laporan/Umum/NDR_Report_2023_Final.pdf
2. International Diabetes Federation (IDF) Data on Malaysian Children Reported in peer peer-reviewed study citing 977 Malaysian children and adolescents diagnosed with diabetes (Type 1 and Type 2 combined). Article: Is Misdiagnosis of Type 1 Diabetes Mellitus in Malaysian Children a Common Phenomenon https://pmc.ncbi.nlm.nih.gov/articles/PMC7982891/
3. National Heart Institute (IJN) — Young Diabetics Feature Report. PDF: Heart 2 Heart Young Diabetics on the Rise https://www.ijn.com.my/wp-content/uploads/2025/05/7.-Heart-2-Heart-Young-Diabetics-on the-Rise_compressed.pdf 

Other sources:

• Medical Channel Asia — Diabetes in Malaysian Children and Teenagers Media analysis referencing International Diabetes Federation data on child and adolescent diabetes. https://medicalchannelasia.com/diabetes-in-malaysia-affecting-children-teenagers/

• Ministry of Health Malaysia — National Diabetes Registry Report 2020: Additional background figures and trend comparisons from earlier registry years. https://www.moh.gov.my/moh/resources/Penerbitan/Rujukan/NCD/Diabetes/National_Diabetes_Registry_Report_2020.pdf