Type 2 diabetes is striking Malaysian teenagers. Here’s what parents need to know

 

IN Malaysia, type 2 diabetes, once largely associated with adults, is now being diagnosed in children as young as 14, according to Health Minister Datuk Seri Dr Dzulkefly Ahmad.

For Dr Ch’ng Tong Wooi, consultant paediatrician and paediatric endocrinologist at Sunway Medical Centre, Sunway City (SMC), this is a worrying trend that paediatricians have been observing 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 said.

The consequences can be particularly serious for teenagers, who may live with the condition for decades.

Youth-onset type 2 diabetes is associated with an increased risk of complications, including kidney disease, heart disease, nerve damage and vision loss. Early detection and intervention are therefore crucial.

Why are children at risk of developing type 2 diabetes?

Obesity is a major risk factor, but it is only part of the picture. National Health and Morbidity Survey (NHMS) 2024 findings show that two in three adolescents consume more than 37.5g, or 7.5 teaspoons, of free sugar daily.

The survey also found that average adolescent consumption was 11.5 teaspoons a day.

Diets low in fruits and vegetables, sedentary lifestyles and excessive screen time can contribute to excess weight and insulin resistance, increasing the risk of developing type 2 diabetes.

Family history also matters. In the TODAY study, 59.6% of adolescents with type 2 diabetes had a parent or sibling with diabetes, while 89% had an affected grandparent.

“Some Asian children can develop insulin resistance and type 2 diabetes at lower body weights than people of other ethnic backgrounds.,” Dr Ch’ng noted.

“A child who does not appear overweight may still be vulnerable, particularly if there is a family history or other metabolic risk factors. Parents should speak to a doctor if they have concerns.”

The warning signs parents should not ignore

Type 2 diabetes can develop gradually, and some children may show few or no obvious 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 and recurring skin infections.

Another warning sign is acanthosis nigricans, which appears as dark, velvety patches of skin around the neck, underarms or groin. It can be associated with insulin resistance and is sometimes mistaken for dirt or poor hygiene.

Children who are overweight or obese and have additional risk factors should be considered for screening from age 10 or after the onset of puberty, whichever comes first. Screening may need to be repeated if the risk persists.

“Identifying the condition early gives children the best opportunity to control their blood sugar, reduce the risk of long-term complications and potentially achieve better disease control,” she stressed.

Healthy habits start at home

While the rise in youth-onset type 2 diabetes is concerning, Dr Ch’ng said prevention and early intervention should involve the whole family.

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

Practical steps include eating more fruits, vegetables, whole grains and legumes, cutting back on sugary drinks and highly processed foods, encouraging at least 60 minutes of physical activity daily, limiting recreational screen time and ensuring children get sufficient sleep.

Shared meals and family activities can also help children develop healthier habits that last into adulthood.

For children diagnosed with type 2 diabetes, lifestyle changes remain an important part of treatment. However, they may not be sufficient on their own, and medical treatment should not be delayed when needed.

Depending on the child’s condition, metformin may be prescribed as initial treatment. Other options, including certain glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT2) inhibitors, are also available for eligible young patients.

The choice of medication depends on clinical needs, age approvals and the treating specialist’s assessment.

“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,” Dr Ch’ng added.

With appropriate medical care and family support, children with type 2 diabetes can manage their condition, reduce their risk of complications and lead active, fulfilling lives. ‒  Focus Malaysia