More obese children are developing 'adult' diabetes

The Star

17 hours ago

Twelve-year-old Adam loves his toasted bread coated with condensed milk and a sprinkle of chocolate rice for breakfast.
At school, he often grabs fried chicken rice for lunch and a sweet drink on the way home.
In the evening, he's glued to his mobile games, snacking on chocolate biscuits.
His parents notice he has gained weight and recently tires easily, wakes up at night to pee frequently and constantly asks for water.
A visit to the doctor and a simple blood test confirms their fears: Adam has type 2 diabetes.
His parents are shocked: 'But he's just a child! Isn't diabetes something only adults get?
'Did we do something wrong?'
If these thoughts sound familiar, you're not alone.
Unhealthy lifestyle patterns
In Malaysia, nearly one in three children is either overweight or obese, according to a 2022 review in the Malaysian Journal of Nutrition.
Globally, the World Health Organization (WHO) estimates that around one in five children and adolescents aged five to 19 years are overweight, with 8% classified as obese.
With this rising trend comes a worrying increase in young patients presenting with prediabetes or full-blown type 2 diabetes – a condition once considered exclusive to adults..
So why is this happening?
Type 2 diabetes tends to run in families due to a combination of shared genetic factors and lifestyle habits, such as eating patterns and physical activity levels, that increase the risk among close relatives.
The main lifestyle contributors are: Unhealthy diets Processed, sugary, and fried foods are often more accessible and cheaper than healthy alternatives. Many children exceed the recommended daily sugar limit.
Sedentary lifestyle In previous generations, walking to school or playing outside was normal. But children today spend hours indoors on screens: YouTube, mobile games and social media. Outdoor play and physical activities have become rare in their daily routine.
Poor sleep routines
Staying up late while staring at a screen affects melatonin and cortisol levels, increasing cravings for sugary or fatty foods, which leads to weight gain and insulin resistance.
Causing insulin resistance
Obesity, especially central obesity (fat stored around the abdomen), plays a key role in the development of type 2 diabetes. Preventing type 2 diabetes can involve steps as simple as cutting back on sugary drinks and getting children used to drinking plain water as their default beverage.
This excess adiposity causes the body to become resistant towards the actions of insulin, which is being produced normally by our body.
The result is that glucose (sugar) builds up in the blood.
Our pancreas then tries to compensate by producing more insulin to overcome this 'resistance'.
Over time, the pancreas becomes 'exhausted', and blood sugar levels start to rise.
This is the beginning of type 2 diabetes.
Many people think diabetes only becomes dangerous later in life, but in reality, children with type 2 diabetes are at risk of both acute and long-term complications.
Acutely, they may develop life-threatening conditions like diabetic ketoacidosis (DKA) or hyperosmolar hyperglycaemic state (HHS).
Both these conditions can lead to severe dehydration, organ failure, and even coma, if not treated promptly.
Long-term complications, once seen mostly in older adults, can also appear earlier in young people living with type 2 diabetes, including: Nerve damage (neuropathy) – causing tingling, numbness or burning pain.
Eye problems – such as diabetic retinopathy, which may lead to blindness.
Kidney damage – diabetic nephropathy, which can lead to kidney failure.
Heart disease and high blood pressure – increasing risk of heart attacks and strokes, even from a young age.
Predisposition to infections.
Spotting the warning signs
Unlike type 1 diabetes, which develops quickly and dramatically, type 2 diabetes in children often develops silently and gradually, making it harder to detect.
Watch for these red flags: Frequent thirst and urination
Tiredness, even with adequate sleep
Weight changes – either rapid gain or unexplained loss
Dark velvety patches on the neck, armpits or elbows – this is a sign of insulin resistance known as acanthosis nigricans
Recurrent infections or slow-healing wounds
Mood swings or irritability.
A simple fasting blood sugar test and HbA1c test at your clinic can reveal whether your child is at risk.
Further blood tests such as diabetes antibodies will be done to differentiate between type 1 and type 2 diabetes.
Lower your child's risk
Type 2 diabetes is manageable, but prevention is best.
This doesn't mean forcing your child into a strict diet or intense workouts.
Small, sustainable lifestyle changes can make a big difference – and they work best when the whole family gets involved.
These can include: > Cutting back on sugary drinks gradually
Instead of a complete ban (which may cause rebellion), start by reducing the frequency of consuming such drinks.
Swap syrupy drinks or juices for infused water with lemon or mint if your child wishes for a more 'flavourful' drink.
Encourage water as the default drink during meals.
Gradually limit sweet drinks like bubble tea, iced chocolate or malted drinks, and fruit-flavoured milk to special occasions only. > Tweak their favourite meals
Healthy eating doesn't mean abandoning Malaysian favourites; it's about smart swaps.
Choose grilled or baked chicken over deep-fried.
Replace white rice with brown rice.
Add more vegetables to family dishes like fried rice, curry and soups.
Avoid ultra-processed snacks like chips and opt for fruit, yoghurt or nuts. > Encourage active play, not just exercise
Many children dislike the idea of 'exercise', but love to play.
Try dancing games, cycling, hula-hooping or treasure hunts.
Let them choose a weekend activity: sports, hiking or swimming.
Revive traditional games like batu seremban, congkak or galah panjang. > Limit screen time without battles
You don't have to ban gadgets altogether, but balance is key.
Create 'tech-free' zones (e.g. during meals and before bedtime).
Use parental controls or timers to limit passive screen time.
Pair screen use with movement. > Make it a family affair
Children learn by example with a supportive family.
When the whole family makes healthier choices, kids follow naturally.
Encourage positively.
Cook together and let your child choose a veggie to try each week.
Go to the market together and teach them about fresh produce.
Present food creatively, e.g. use colourful bento boxes or cut fruit into fun shapes.
Start small today
If your child is overweight or has been diagnosed with prediabetes, don't panic and don't blame yourself.
Parenting doesn't come with a manual, and lifestyle changes are often shaped by environment, availability and awareness.
What's most important is what you choose to do today.
Start small and be consistent.
Keep it fun: Movement should be enjoyable, not a punishment.
Do it together: When families act as a team, progress is faster and more sustainable.
As a paediatric endocrinologist, I've seen how easily type 2 diabetes can creep up.
But I've also seen how families who take proactive steps early can turn their child's health around.
Let's give our children the best chance at a healthy, happy life one small step at a time with no blame or shame.
Worried about your child's weight or risk of diabetes?
Talk to your doctor or a paediatric endocrinologist.
Early intervention is the best prevention.
Dr Jeanne Wong Sze Lyn is a consultant paediatrician and paediatric endocrinologist. For more information, email [e-mail]. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.