Yet many Malaysians only realise the threat when complications such as heart disease or kidney failure appear. While medication remains central to diabetes care, experts say one of the most powerful – and often overlooked – defences is nutrition.
Beyond simply avoiding sugar, good nutrition is now recognised as a form of medical therapy. It can help prevent or delay diabetes and support better outcomes for those already diagnosed.
Without early intervention, dietitians warn, Malaysia will continue to face both rising healthcare costs and worsening health outcomes.
“Diabetes is a very serious disease, yet many people don’t treat it as such because symptoms may not cause immediate pain,” said Malaysian Dietitians Association (MDA) vice-president Prof Dr Winnie Chee Siew Swee.
“The good news is that, with early nutrition intervention, we can take meaningful steps to prevent complications and support healthier outcomes in the long run.”
Lifestyle changes can deliver impressive results, but sticking to them is often the hardest part. This is why Chee emphasises the need for meal plans that fit local eating habits and everyday routines.
To support this, Malaysian researchers have adapted an international guideline called the Transcultural Diabetes Nutrition Algorithm (tDNA). The framework helps dietitians create personalised nutrition plans based on cultural background, food preferences and lifestyle – all while keeping Malaysian favourites like rice, noodles and traditional dishes in the picture.
Rather than prescribing a rigid, one-size-fits-all diet, the tDNA allows for familiar foods prepared with healthier methods and controlled portions.
“Our research showed that when patients followed a personalised plan based on the tDNA and included diabetes-specific formula (DSF) as a partial meal replacement, adherence to the programme improved by up to 90%,” Chee said.
“Many achieved significant weight loss, better HbA1c levels (reflecting average blood sugar over two to three months), and reduced medication needs.”
She added that strong clinical evidence supports the use of DSF in structured nutrition therapy. One study by global healthcare company Abbott – conducted among 235 adults in Malaysia and Thailand with type–2 diabetes – found that DSF used as a partial or full meal replacement led to improvements in blood sugar control, body composition, and cardiometabolic risk factors.
Participants recorded up to double the reduction in weight and body fat compared to the control group after 90 days, while blood pressure also improved. Chee said this was the first study in Asia to show such significant changes when DSF was combined with standard care.
For overweight or obese individuals, she recommends reducing overall calorie intake by using one to two servings of DSF as a meal or snack replacement, paired with fruits, vegetables and lean protein.
For example, a 1,200-calorie plan might start with a DSF serving and a banana for breakfast. Lunch could include another DSF serving with a non-fried popiah and an apple. Dinner could feature brown rice, stir-fried vegetables, spinach soup and grilled ikan kembung.
A 1,500-calorie plan might include a DSF serving with a piece of kuih for breakfast, followed by kuey teow soup and fruit for lunch. Snacks such as guava or a wholemeal tuna sandwich can help maintain fullness.
With support from a dietitian and at least 150 minutes of exercise a week, such customised plans help patients achieve a calorie deficit while still meeting nutritional needs.
But even the best nutrition plans face challenges in the real world: Malaysia’s food culture is rich, comforting – and often unhealthy for those with diabetes.
White rice, fried favourites and sugary drinks are everyday staples. Social habits like late-night suppers and festive feasts can also derail well-intentioned diets.
“Food is tied to our identity, family and traditions,” Chee noted, acknowledging that telling people to give up rice entirely is impractical. “What works better is portion control, healthier cooking methods and gradual changes.”
She noted that swapping out high-glycaemic breakfasts like roti canai and teh tarik for grilled sandwiches, fruit, or structured local meal plans can significantly reduce blood sugar spikes.
Chee concluded that consistent, culturally tailored nutrition therapy not only improves personal health outcomes but could also help slow Malaysia’s rising diabetes burden. Her message is simple: nutrition is as important as medication.