Malaysia finds itself confronting a diabetes epidemic of alarming proportions, with the burden escalating rapidly over recent decades. Recent figures and data suggest that the prevalence has more than doubled, now affecting one in five adults, and projections indicate that these numbers are set to climb further.

This growing crisis brings with it a host of challenges, including a vast undiagnosed population, increasing impact on younger Malaysians, and significant strain on both public health and the economy. Diabetes is closely tied to other non-communicable diseases such as cardiovascular disease, further amplifying its effects across the healthcare system.

Direct healthcare costs for diabetes alone reach approximately RM 4.4 billion each year, accounting for nearly 45% of all spending on non-communicable diseases (NCDs) in Malaysia. The money spent on diabetes each year—enough to build about ~53 new schools every year

The numbers outline a stark reality. In 2015, diabetes affected around 13.4% of the adult population. By 2019, the prevalence jumped to 18.3%, and the most recent reports put that number at 21%. Malaysia now ranks 13th globally for diabetes rates and holds the highest prevalence in Southeast Asia.

In NHMS 2024 report, Malaysia’s overweight rates hit 30.5 percent with obesity affecting 23.1 percent of respondents. Perhaps most concerning is abdominal obesity, which has reached 52.1 percent—a figure that signals heightened risk for metabolic syndrome and cardiovascular complications. The NHMS 2023 on the other hand revealed that nearly 7.5 million adults—33.3 per cent of the population—have high cholesterol levels. Alarmingly, half of these individuals are unaware of their condition

Then lately, it was reported that Health Minister Datuk Seri Dr Dzulkefly Ahmad had said about 3.6 million adults in Malaysia were living with diabetes, while nearly 1.9 million people were unaware of their condition. Many Malaysians may live for years unaware of their condition, only seeking treatment once complications arise. This delay in diagnosis complicates management and often leads to worse outcomes.

Primary care and outpatient management of diabetes alone amounted to RM 3.1 billion in 2017, more than triple the hospitalisation costs for cancer (RM 728 million), and over three times higher than those for cardiovascular disease (RM 753 million)

The rise is driven by several factors: an ageing population, urban lifestyles that encourage sedentary behaviour, and increasing obesity rates. These changes have made diabetes a widespread issue, not just for older adults but for younger generations as well.

The financial implications are staggering. Direct healthcare costs for diabetes alone reach approximately RM 4.4 billion each year, accounting for nearly 45% of all spending on non-communicable diseases (NCDs) in Malaysia. The money spent on diabetes each year—enough to build about ~53 new schools every year, assuming an average cost of RM83 million per school.

Diabetes management requires frequent primary care visits, regular outpatient treatments, and ongoing diagnostic and monitoring tests—especially for adults at risk of heart disease. Hospitalisation costs for complications add another layer to these expenses.

A closer look at healthcare spending reveals the scale of the problem. In 2017, the total direct costs for the top three NCDs—diabetes, cardiovascular disease, and cancer—was RM 9.65 billion. Diabetes carried the largest share at RM 4.38 billion (45.38%), exceeding spending on cardiovascular disease (RM 3.93 billion) and dwarfing costs for cancer (RM 1.34 billion).

Primary care and outpatient management of diabetes alone amounted to RM 3.1 billion in 2017, more than triple the hospitalisation costs for cancer (RM 728 million), and over three times higher than those for cardiovascular disease (RM 753 million).

This immense financial burden falls not only on government subsidies but also on individuals and families trying to manage the disease long-term. The government’s commitment to subsidised care remains strong, yet the rising tide of diabetes presents a major expense that threatens to outpace resources.

Prevention has become a key focus in policy efforts to curb costs and improve outcomes. The introduction of the sugar-sweetened beverage tax represents one measure aimed at discouraging excessive sugar consumption—a major contributor to obesity and diabetes risk. The tax was increased in the 2024 Budget, reflecting the urgency felt at policy levels to address the root causes of the epidemic.

Despite these efforts, challenges persist. Malaysia’s Nutri-Grade system is being developed to rate beverages based on sugar content, starting with ready-to-drink products before expanding to freshly prepared drinks at eateries. Yet health experts warn that stopping at beverages misses a major source of sugar—processed foods and meals from restaurants or food delivery services.

Advocates call for nutrition rating systems to be extended beyond drinks. Transparent labelling on restaurant menus and food platforms could help Malaysians make better choices and motivate eateries to improve recipes. Clear information on sugar, calories, and other nutrients allows individuals to understand what they are consuming, which is especially important as eating habits shift towards convenience and delivery options.

The Malaysian Medical Association pushes for mandatory calorie and nutrition labelling on food menus, arguing that transparency combined with education can change behaviour. The Federation of Malaysian Consumers Associations recommends expanding the ‘Healthier Choice’ logo to food delivery platforms so healthier options can be identified quickly.

Experts agree that tackling diabetes demands more than just information—it requires cultural change, support for healthier school environments, and policies that encourage physical activity from a young age. The rise in childhood obesity highlights gaps in current strategies, as more young people are diagnosed earlier than ever before.

Prof Dr Muhammad Yazid Jalaludin from Diabetes Malaysia stresses that small shifts in daily habits could make a meaningful difference over time but warns that education and support for both consumers and food operators is essential. Focusing solely on sugar is not enough; reducing excessive carbohydrate intake is also critical to combat obesity and abdominal fat—both risk factors for diabetes.

Improved primary care has led to earlier detection, which may have contributed to a decrease in deaths from diabetes over recent years—from 2,792 in 2021 down to 1,975 in 2023 according to government statistics. Early intervention offers hope, but much work remains.

Mohideen Abdul Kader from the Consumers’ Association of Penang suggests bans on junk food sales in schools and removing vending machines selling sugary snacks from hospitals, airports, and educational institutions. He proposes providing water dispensers instead and restricting food hawkers near schools.

Educators highlight the need for stronger nutrition and health education within school curricula with schools providing healthier food as an example to students.

Malaysia’s diabetes story is marked by high prevalence rates, rapid increases over time, staggering costs, and a massive undiagnosed population. The disease’s ripple effect throughout society touches families, schools, workplaces, and hospitals. It challenges policymakers to address not just symptoms but underlying causes—from diet and physical activity to urbanisation and ageing demographics.

Change will require sustained collaboration between government agencies, healthcare providers, educators, and communities. With clear labelling, effective prevention strategies, early intervention and ongoing education at every level of society, Malaysia can look towards reversing this trend and reducing the heavy toll diabetes exacts on its people.