INTERACTIVE: It's not sweet news for Malaysia as diabetes becomes more common

A diabetes patient taking his blood sugar level reading at his home in Bandar Puncak Alam, Kuala Selangor. – RAJA FAISAL HISHAN/The Star

PETALING JAYA: It's World Diabetes Day and here's the bitter truth - the disease has become more common in Malaysia, with its prevalence increasing by seven percentage points over the past decade.

We are also the country with the highest rate of cases in South-East Asia.

About 19% of our population was diabetic in 2021 - an increase from 12.1% in 2011. That means about one in every five Malaysians is diabetic.

This 6.9 percentage point jump was also the largest spike among the 10 countries in Asean, according to figures from the World Bank.

We are also in the top 20 in the world. Malaysia was ranked 16th among 226 countries and territories in the world.

Our closest neighbours are well-behind us, with Singapore having 11.6% prevalence, Brunei 11.1%, Indonesia 10.6% and Thailand 9.7%.

Taking top spot was Pakistan, where 30.8% of its population aged between 20 and 79 were living with the condition in 2021.

Second-placed French Polynesia and third-place Kuwait are well-behind on 25.2% and 24.9%.

Our diet and lifestyle must change

The numbers may be sobering, but it isn’t surprising that Malaysia has the highest prevalence of diabetes in South-East Asia, says Malaysian Medical Association (MMA) president Dr Azizan Abdul Aziz.

“An average adult in Malaysia consumes seven teaspoons of sugar a day.

“Of this, four teaspoons are table sugar while another three are from sweetened condensed milk added into beverages,” she said, citing such information from the Malaysian Adult Nutrition Survey 2002/2003.

Also, Dr Azizan pointed out that Malaysian food was mostly carbohydrate-based, including staples like white rice, noodles and flatbreads.

“A high carbohydrate diet can cause blood sugar levels to spike.

“It also doesn't help that food is available 24 hours in the country. Late night eating can also increase risk of diabetes,” she added.

Diabetes Malaysia vice-president Jong Koi Chong said the nation’s alarmingly high prevalence of the disease compared to neighbouring countries could be due to many factors.

“Dietary habits, sedentary lifestyles, genetic predispositions, and rapid urbanisation are key contributors.

“These factors, when combined, create an environment where diabetes can thrive.

“More comprehensive steps need to be introduced to address these issues and promote a healthier way of life,” he said.

One of the government’s proposed measures is to increase excise duty on sugary drinks from 40sen to 50 sen a litre, as announced in Budget 2024.

Such tax collected can then be channeled to treat diabetes and provide support to dialysis centres.

Jong said Diabetes Malaysia approved of this move and believed it has the potential to significantly deter Malaysians from excessive sugar consumption.

“While it may not entirely eliminate the problem, this measure aligns with global efforts to promote healthier dietary choices and reduce the consumption of sugar-laden beverages,” he added.

Calling the higher excise duty a step in the right direction, Dr Azizan said ultimately, it was the lifestyle changes among the Malaysian public that will truly make a difference.

“We need to address lifestyle and the daily food and beverage consumption habits of Malaysians,” she urged.

Selangor tops the list

Within Malaysia, Selangor is the state with the most number of patients with 242,464 people dealing with diabetes.

This number comprised 14.3% of the total 1.7 million people recorded in the National Diabetes Registry Report 2020 by the Health Ministry.

Almost all or 99% of the total number of people in the registry were diagnosed with Type 2 diabetes, which happens when the body doesn't use insulin properly, resulting in unusual blood sugar levels.

Following closely in second place was Johor with 240,445 people (14.2%) and Perak with 183,734 patients (10.8%). The majority - 57% of diabetes patients in the country - were women.

Women outnumbered men in all states and territories, except for Putrajaya where 51.5% of patients were male.

On the issue of most diabetics being women, Jong said a possible cause was hormonal factors, such as gestational diabetes which is a type of diabetes that develops in pregnancy.

“However, we would like to stress that there needs to be further research to gain a clearer understanding of this gender disparity,” he added.

Meanwhile, the bulk of diabetes patients were aged between 50 and 54, with this age group making up 17.2% of the total number of people in the registry.

The average age of a patient when diagnosed with diabetes was 53.

As they battle diabetes, some patients in Malaysia have to face other comorbidities too, with the most common complication being hypertension.

About 80% of patients in Malaysia have the condition, while 75.7% also had high cholesterol as of 2020.

Those with kidney problems made up 14.4% of patients while 11.5% had eye complications caused by diabetes.

As for amputations, less than 1% or 646 diabetics were found to have undergone such procedures from the report which audited 181,634 patients.

A bigger fight needed for diabetes

To encourage the public to make healthier choices, Dr Azizan said the Health Ministry should make it a requirement for all food outlets to display a nutritional guide for consumers.

“This will help the public keep track of their sugar intake when ordering food and beverages,” she suggested.

To prevent the onset of type 2 diabetes, Dr Azizan said it was crucial to proactively educate and nurture healthy lifestyle habits.

“This includes promoting balanced nutrition, regular physical activity and adequate rest among school-going children.

“By instilling these habits early on, we can empower them to carry these health-conscious practices into adulthood, significantly lowering the likelihood of developing the disease,” she said.

Achieving and maintaining healthy body weight is also important as obesity can also increase the risk of type 2 diabetes.

“Most people aren't aware that smoking too, can increase risk of diabetes,” she said.

In conjunction with World Diabetes Day, the MMA advised the public to cut down on their sugar intake and strive for moderation.

“Drink plain water after meals instead of sweetened beverages which should only be consumed in moderate amounts or better saved for special occasions.

“Avoid eating at irregular hours, exercise regularly and get proper rest every night.

“Visit a general practitioner for a scheduled medical check-ups to know your health status too,” she urged.

To combat the disease, Diabetes Malaysia urged the government to introduce educational programmes in schools and increase access to affordable, nutritious foods.

“Diabetes Malaysia also hopes the current healthcare infrastructure can be strengthened to improve diabetes prevention, early diagnosis, and effective treatment,” Jong urged.

With the world shining a light on diabetes today, he called upon Malaysians to place health as their top priority.

“While we try to lead a healthy lifestyle, I also hope the public will not stigmatise those living with diabetes as they cope with their illness,” Jong said.

With the key to preventing diabetes being a healthy lifestyle, eating a balanced diet should be part of our daily life.

It's tough to completely eliminate sugar from meals, but it will surely help to know the content of what we eat.

Here’s the sugar content in some of the local food and drinks we consume in Malaysia: