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, a total of 289 individuals under the age of 18 are recorded as living with diabetes in Malaysia. 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 diabetes.

The National Heart Institute has also reported treating one of the youngest registered diabetic patients in the country, an eight-year-old child.

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 that 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 that 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 years until the body begins to struggle with glucose control.

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 influences 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.

Small, steady habits at home make a lasting difference:

• 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 to encourage slower, healthier eating.

• Encouraging daily movement through outdoor play, cycling or sports.

• Keeping screen time balanced with physical activity.

Children observe more than they are told. When healthy habits feel normal at home, those habits follow them into their teenage years and adulthood.

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.

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

Closing message

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.

This World Diabetes Day, the message is clear. Prevention begins young, and protection lasts a lifetime.

-- BERNAMA

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