Are Malaysians’ getting too sweet?

health

Are Malaysians’ getting too sweet?

By Alpro Clinic

March 14, 2025

It has been discovered that every 1 in 5 adults in Malaysia has diabetes

According to the National Health and Morbidity Survey (NHMS) 2019, this makes us one of the highest in Asia for diabetes prevalence. The number of Malaysians living with diabetes has increased dramatically over the past few decades.

In 2011, the prevalence rate was 15.2%, but by 2019 it had risen to 18.3% of adults aged 18 years and above. Around 50% of the people with diabetes in Malaysia are unaware they have the condition.

The good news is that with easy access to information via the internet and social media, we have seen an increase in awareness of the importance of early health screening. As a family doctor myself, I see that more and more Malaysians are taking the initiative to do their regular blood tests at their regular GP clinics and this has led to a large number of individuals being diagnosed with pre diabetes but they are not too sure what it means.

What is Diabetes & Pre Diabetes?

In order to understand diabetes and pre diabetes better, we need to first learn how our body processes glucose. Think of your body as a car and the pancreas as the car’s engine control system, managing how fuel (glucose) is used to power the car. After you eat, the food you consume is broken down into glucose, which is like putting fuel in the car. When glucose enters your bloodstream, it’s like filling up the gas tank.

The pancreas, like the engine’s control system, detects the amount of fuel (glucose) in the system and releases insulin, the “key,” to unlock the doors of your cells and allow the glucose to enter. This provides the energy your body needs to run, much like fuel powers a car.

Diabetes & Your Body: When the Engine Fails to Run

In a healthy system, the pancreas is quick and responsive, making sure glucose (fuel) is delivered efficiently to the cells for energy. But in diabetes, the system malfunctions.

In type 1 diabetes, the pancreas is like an engine that’s completely broken down. It is unable to produce insulin at all, so the glucose just stays in the bloodstream, like a car without fuel reaching its engine.

In type 2 diabetes, the pancreas still produces insulin, but the body’s cells become resistant to it, like a car with a faulty ignition where the key does not work properly, preventing the glucose from entering the cells. Without proper function, the glucose cannot get used correctly, leading to high blood sugar levels and eventually, system breakdowns.

A Warning Light You Shouldn’t Ignore

Now, imagine your car’s engine is starting to wear down. The key does not turn the engine as easily as it used to, meaning the fuel is not used as efficiently. As a result, there is a buildup of fuel in the system (high blood sugar), but the engine is not broken yet. This is like pre diabetes. Your body is not managing blood sugar as well as it should, but it is not yet out of control like in full-blown diabetes.

If you do not fix the engine, it could eventually fail completely, causing more damage (diabetes). But if you catch it early, and make adjustments (like changing the oil, or in the case of pre diabetes, eating healthier and exercising), you can prevent further damage and get your engine running smoothly again.

There are three main types of screening tests for pre diabetes:

HbA1C Test:

This test measures the average blood sugar levels over the past 3 months. It’s also known as the glycated haemoglobin test. This test can be done at any time and does not require any fasting. According to the CDC, normal HbA1C is below 5.7%, pre diabetes is from 5.7-6.4% and diabetes is 6.5% and above. However, these figures may slightly vary according to the lab the test is done at.

Fasting Plasma Glucose (FPG):

This test requires you to fast overnight and measures your blood sugar level after fasting.

Oral Glucose Tolerance Test (OGTT):

In this test, you will fast overnight and then drink a sugary solution. Your blood sugar levels are tested at intervals afterward to see how your body processes the sugar. This test is usually done when you have symptoms of diabetes but your fasting/random blood sugar is normal or when you have no symptoms and your fasting/random blood sugar is higher than normal but not high enough to diagnose diabetes.

Your doctor can decide which test is most suitable for you based on your symptoms and previous results if you have already taken any other glucose test.

Pre-Diabetes: Silent Signs You Shouldn’t Ignore

Pre-diabetes often has no obvious symptoms, making it difficult to detect without testing. However, some people may notice subtle signs that could indicate higher blood sugar levels. These can include increased thirst, frequent urination, unexplained fatigue, and blurred vision. You may also experience slow-healing cuts or frequent infections.

People with pre-diabetes may notice dark, velvety patches of skin, especially in areas like the neck, armpits, or groin, a condition known as acanthosis nigricans. While these signs can be mild or overlooked, they can be warning signals that blood sugar levels are higher than normal. If you experience any of these symptoms, it is important to get checked by a healthcare provider to prevent the progression to type 2 diabetes.

According to the American Journal of Preventive Medicine (Volume 62, Issue 4) in April 2022, although several pharmacological approaches can reverse pre diabetes, lifestyle modification provides the strongest evidence of effectiveness and it remains the recommended approach to address this condition.

Pre-diabetes is not a permanent condition, it is a wake-up call. With early detection and simple lifestyle changes, such as improving your diet, increasing physical activity, and managing your weight, you can reverse pre-diabetes and prevent the onset of type 2 diabetes. The power is in your hands to take control of your health today. Note: Remember to bring your car (body) for regular service to prevent future breakdowns and make sure it stays reliable in the long run.