Malaysians Getting Diabetes In Their 20s, Delay To 50s Possible By Managing Prediabetes: Expert

An endocrinologist says Malaysians are getting diabetes before age 40, unlike diabetes onset in one’s 50s in other countries. One can delay diabetes to middle age by managing prediabetes. Diabetes isn’t just about sugary drinks, but eating excessive carbs. 

Prof Emeritus Dr Chan Siew Pheng, an endocrinologist at Subang Jaya Medical Centre (SJMC), says people with prediabetes have an opportunity to get back to normal blood sugar levels. 

An expert has sounded the alarm over the extremely early onset of diabetes in Malaysians before the age of 40 years, three decades earlier than middle age in other countries.

Prof Emeritus Dr Chan Siew Pheng, an endocrinologist at Subang Jaya Medical Centre (SJMC), stressed that diabetes can be prevented or delayed.

“In the rest of the world, they are developing diabetes in their 50s, but in Malaysia, we have people developing diabetes in their 20s or 30s,” Dr Chan said.

“You can delay it and perhaps, instead of becoming diabetic at age 20, you may develop diabetes at age 50.”

She explained that those with prediabetes have an opportunity to get back to normal blood sugar levels. Prediabetes is characterised by a fasting blood sugar level of between 5.6 and 7.0 mmol/L and can progress to type II diabetes, where fasting blood sugar is above 7.0 mmol/L.

Evidence proves that the following strategies have been successful in preventing progression to diabetes:

1. Gradual weight loss: Aim for at least a 7 per cent reduction in body weight over a period of three to six months. This gradual approach is more sustainable and less likely to result in a yo-yo effect on weight.
2. Reduce calorie intake: A 20 per cent reduction in daily calorie consumption can significantly impact weight and blood sugar levels. This doesn’t mean drastic dieting, but rather, making smarter food choices and being mindful of portion sizes.
3. Eliminate unnecessary snacks: Many people underestimate the impact of casual snacking on their overall calorie intake. Cutting out unnecessary snacks, especially those high in calories, sugars, and unhealthy fats, can make a big difference.
4. Increase physical activity: Regular exercise is crucial in preventing prediabetes and its progression to full diabetes. Health experts recommend at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week.

According to the National Health and Morbidity Survey (NHMS) 2023, about 3.6 million adults, or 15.6 per cent of Malaysia’s adult population, have diabetes. 

Similarly, obesity is steadily rising in Malaysia, with NHMS 2023 indicating that over half of Malaysian adults (54.4 per cent) were overweight or obese. This trend is closely linked to the rise in prediabetes cases, as excess body weight is a primary risk factor for developing insulin resistance, the hallmark of prediabetes and type 2 diabetes.

Besides rising overweight and obesity rates, Dr Chan also attributed the increase in prediabetes and diabetes prevalence to Malaysia’s ageing population.

The endocrinologist stressed the importance of cutting the number of people with diabetes as the basic solution to reduce the country’s dependence on diabetes medications including insulin. 

Under Budget 2025 that was recently tabled in Parliament, the government is providing an additional allocation for the procurement of SGLT2 inhibitors to treat diabetes. The medication eventually reduces the need for insulin as it enables the kidneys to remove sugar from the body through urine.

In the government’s “War on Sugar”, the government also proposed a raise in the excise duty rate for sugar-sweetened beverages (SSB) in phases from January 1, 2025, by 40 sen per litre under Budget 2025.

Diabetes Not Just About Sugary Drinks, But Excessive Carbs

Dr Chan countered public misperception that diabetes is caused only by consuming sugary drinks.

“That doesn’t make me diabetic. But taking too many calories – whether in the form of sugar or carbs – will increase the risk of someone developing diabetes; it doesn’t have to be sugar,” she said.

“Unfortunately, we are brought up to enjoy the sweetness in the food that we eat. Of the three ethnic groups, the one with the highest consumption of sugar is the Malay ethnic group. That is difficult to manage; they need to shift from wanting that sweetness.”

While prediabetes affects individuals across all social strata, it’s becoming increasingly clear that lower-income groups bear a disproportionate burden of this health challenge. The socioeconomic divide in prediabetes rates highlights the complex interplay between economic status and health outcomes, Dr Chan noted.

“The lower socio-economic class choose less healthy food. They also don’t emphasise or have the opportunity to focus on increasing physical activity, staying fit and healthy. 

“Also, much of their food consists of large quantities of carbohydrate, rather than eating healthy options that may be slightly more costly,” Dr Chan told CodeBlue. 

At Engage Life’s Wellness @ the Parc event in Subang Jaya, Selangor, on September 7, 2024, Prof Emeritus Dr Chan Siew Pheng, an endocrinologist at Subang Jaya Medical Centre (SJMC), counters public misperception that diabetes is caused only by consuming sugary drinks.  

Create ‘Default Environments’ For Physical Activity

Dr Chan noted the lack of accessible spaces in all neighbourhoods, especially in lower-income areas that could be used for physical activity. Parks, gyms, and recreational facilities are often scarce or poorly maintained in these areas, discouraging regular exercise. 

This combination of poor diets and sedentary lifestyle can significantly increase the risk of developing prediabetes among the bottom 40 per cent (B40) community.

As such, there is a need for these spaces to be turned into “default environments” that would encourage people to increase their physical activity, Dr Chan said. These places can include playgrounds for children or clean and well-lit staircases in apartments that are safe for use.

The endocrinologist pointed to Western countries where bicycle lanes cut across housing estates, allowing mobility for the community and opportunities to increase their physical activity as part of their everyday lifestyle.

“I believe that once you have default environments that encourage an increase in healthy activities, that will surely help those who are prone to prediabetes and diabetes.”  

How Prediabetes Affects The Workplace

With obesity and diabetes reaching epidemic levels in Malaysia, posing significant health risks to the population, SJMC has partnered with Engage Life, a company that creates workplace wellness programmes for corporations, to tackle this growing crisis. 

Paresh Subramaniam, CEO and founder of Engage Life, highlighted the impact of prediabetes on employee performance and overall well-being is a key reason for the collaboration with SJMC in developing corporate wellness solutions.

He said energy management is vital in a corporate setting, as both managers and employees will struggle to maintain consistent energy levels throughout their workday.

Paresh also shared a personal experience that changed his dietary needs. “I found out that cabbage was my main killer,” he said, explaining how certain foods can cause bloating and discomfort for some individuals.

SJMC, a multidisciplinary tertiary hospital, is widely recognised for its innovative approach to diabetes care, including its pioneering use of Continuous Glucose Monitoring (CGM) technology. 

This approach has earned the hospital numerous accolades, such as being named one of Newsweek’s Best Specialised Hospitals in APAC 2024 for Endocrinology and receiving the GlobalHealth Asia-Pacific Award 2024 for Diabetes Service Provider of the Year.

This commitment to enhancing community health aligns closely with Engage Life’s vision, resulting in a strategic partnership between the two. Together, they have launched the nationwide wellness initiative, the Growing Well Together (GWT) programme, aimed at providing comprehensive health care solutions and promoting healthier lifestyles among Malaysians.

The GWT programme kicks off with a 30-day in-app initiative, offering participants personalised guidance, tracking and assessment tools, and a supportive community to improve their health. Available through the Engage Life app, the programme focuses on weight management, nutrition, and physical activity, with the aim of fostering long-term behavioural change. 

As the official health care partner, SJMC supports the programme by offering expert medical advice, e-learning materials, and health screening offers to empower the public in preventing and managing chronic diseases, particularly obesity and diabetes.

“This collaboration aligns with our commitment to enhancing the health and well-being of our community, where healthy habits and screenings are essential. We look forward to creating a comprehensive approach to address the pressing health challenges facing Malaysia and together build a healthier nation for generations to come,” said SJMC chief executive officer Bryan Lin. 

As part of its efforts, SJMC is also adopting a more holistic approach to employee wellness, empowering its staff to take charge of their health by pledging 50 passes to the GWT programme, further reinforcing its commitment to the initiative.

Source: Code Blue

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