Editorial Note:
This article is an expanded and revised edition of a previously commissioned feature. It has been updated to sharpen the central message: Singapore’s diabetes challenge is not only about adults — risk is building earlier, and prediabetes in late teens is a warning sign that deserves prompt action. The piece also clarifies what families and young adults can do now, before “borderline” numbers turn into lifelong disease.
Key takeaways (quick read):
- Early-onset diabetes is higher-risk because the body is exposed for longer, raising the chance of kidney, heart and eye complications.
- Prediabetes is not harmless — it is a window where lifestyle changes can prevent or delay type 2 diabetes.
- The biggest levers are unglamorous: sugary drinks, sleep debt, inactivity, stress eating, and highly processed food patterns.
Quick action today: if you’re under 40 with a family history, weight gain around the waist, irregular sleep, or frequent sweet drinks/snacks, book a screening and ask specifically about HbA1c (and what your result means for the next 6–12 months).
A major international review published in Diabetologia has sounded the alarm on the rising tide of diabetes amongst young people worldwide. Singapore, often seen as a model for public health, is not immune to this trend. In fact, the city-state faces a unique set of challenges as diabetes increasingly affects its youth, with early-life factors playing a decisive role in shaping lifelong risk.
The Scale of the Problem in Singapore
Diabetes is a national health crisis in Singapore. As of 2024, there are nearly 700,000 adults (aged 20–79) living with diabetes, and this figure is projected to climb to over 780,000 by 2050. The prevalence rate amongst adults is about 11.6%, one of the highest in the developed world IDF Diabetes Atlas. More than 400,000 Singaporeans currently live with diabetes, and the number is expected to reach 1 million by 2050 if current trends persist CNA.
What is particularly concerning is the shift towards younger age groups. Doctors are seeing more patients under 40 with diabetes, and an estimated 14% of Singaporeans aged 18–19 are already diagnosed with pre-diabetes—a warning sign that full-blown diabetes could develop in early adulthood Diabetes Singapore.
Early-Life Factors: The Roots of Risk
The international review highlights that early-life factors—ranging from genetics and the intrauterine environment to childhood obesity and socioeconomic status—are critical in determining diabetes risk. In Singapore, these factors are particularly relevant:
- Obesity in Youth: Childhood and adolescent obesity rates have been rising, fuelled by sedentary lifestyles, high-calorie diets, and increased screen time. Obesity is a well-established risk factor for type 2 diabetes (T2D), and the hormonal changes of puberty can accelerate the shift from a healthy to an unhealthy metabolic state.
- Ethnic Disparities: Malays and Indians in Singapore have consistently higher rates of diabetes compared to Chinese, reflecting both genetic predispositions and cultural dietary patterns.
- Socioeconomic Factors: Youth from lower-income families are at higher risk, often due to limited access to healthy foods, safe spaces for physical activity, and healthcare resources. One in three individuals with diabetes in Singapore is unaware of their condition, and another third have poor control, increasing the risk of serious complications.
The Impact of Early-Onset Diabetes
Early-onset diabetes is associated with a longer duration of disease exposure, which increases the risk and severity of complications over time. In Singapore, diabetes is a leading cause of kidney failure, heart disease, stroke, and vision loss. The cost burden is immense: medical expenses and productivity loss from diabetes are expected to rise from $940 million in 2014 to $1.8 billion by 2050 Diabetes Singapore.
Children and adolescents with diabetes are also more likely to experience psychological stress, social stigma, and reduced quality of life. Complications such as retinopathy, nerve damage, and cardiovascular issues can begin developing even before symptoms appear.
Local Trends: A Closer Look
- Rising Youth Cases: Singapore's National Health Survey and local clinicians report a steady increase in diabetes amongst those under 40, with lifestyle factors such as unhealthy diets, sugary drinks, and lack of exercise being major contributors.
- Pre-diabetes Epidemic: The high rate of pre-diabetes amongst young Singaporeans is a red flag. Without intervention, many of these individuals will progress to T2D within a decade.
- Ethnic and Gender Differences: Malays and Indians are at higher risk, and adolescent girls with diabetes often face more severe insulin resistance and complications compared to boys.
Policy and Prevention: Singapore's Response
Singapore has declared a "War on Diabetes", launching a multi-pronged approach to tackle the crisis:
- Public Education: Nationwide campaigns promote healthy eating, regular exercise, and early screening. The Health Promotion Board (HPB) runs school-based programmes to instil healthy habits from a young age.
- Regulation and Labelling: The introduction of Nutri-Grade labelling for beverages and restrictions on advertising sugary drinks to children aim to reduce sugar consumption.
- Community Initiatives: ActiveSG and other community programmes encourage physical activity amongst youth, whilst healthier food options are promoted in schools and hawker centres.
- Screening and Early Intervention: The Ministry of Health (MOH) encourages regular screening for at-risk groups, including young people with a family history of diabetes or obesity.
- Support for Vulnerable Groups: Efforts are underway to address disparities, ensuring that lower-income families and ethnic minorities have access to resources, education, and affordable care.
The Way Forward
The evidence is clear: early-life factors, from genetics to environment and socioeconomic status, play a critical role in shaping lifelong diabetes risk in youth. In Singapore, the rising tide of youth diabetes demands bold, sustained action—starting early, focusing on prevention, and ensuring equitable access to care for all.
By addressing these factors head-on, Singapore can not only curb the rise of diabetes amongst its youth but also set an example for other nations facing similar challenges. The time to act is now—for the health of our young people and the future of our nation.
A Youth-Focused Prevention Plan (Realistic for School, NS, Uni and First Jobs)
The hardest part about preventing diabetes in young people is that the risk factors can look “normal” in modern life: long sitting hours, ultra-processed convenience food, sugary drinks, and chronic sleep debt. The plan below is designed to be practical, not perfect — and to work even when schedules are unpredictable.
1) The 4-screen questions (self-check)
- Do I drink sugary beverages most days (bubble tea, canned drinks, sweet coffee/tea, juice)?
- Do I sleep less than 7 hours often, or have very irregular sleep timing?
- Am I sitting for most of the day (classes/desk work/gaming) with little movement?
- Has my waistline increased in the last 6–12 months, or do I often feel hungry shortly after high-carb meals?
If you answered “yes” to two or more, consider screening and choose two behaviour targets for the next month.
2) The 30-day “two targets” method (more sustainable than a total overhaul)
- Target A (choose one): replace sugary drinks with water/unsweetened options on weekdays; or cap sweet drinks to 1–2 times/week.
- Target B (choose one): walk 10–15 minutes after 1 meal/day; or hit 8,000 steps on 4 days/week; or strength train 2 days/week.
These two changes alone can meaningfully improve insulin sensitivity and post-meal glucose trends over time.
3) Eating cues that reduce glucose spikes (without “diet culture”)
- Protein first: include eggs, fish, chicken, tofu/tempeh, yoghurt, or beans at meals.
- Fibre buffer: add vegetables and whole foods (fruit, nuts, oats) to slow digestion.
- Portion reality: if your day is mostly sitting, huge carb portions are more likely to overshoot your needs.
4) The “screening script” (what to ask at the clinic)
You can say: “I’m concerned about early diabetes risk. Can we check my HbA1c, fasting glucose and lipids, and help me interpret the results? If I’m in the prediabetes range, what should I change first, and when should we recheck?”
Frequently asked questions
If I’m young, can I just “wait and see”?
Waiting often means losing the easiest window for prevention. Early risk is exactly when small changes have the biggest payoff.
What if my numbers are “borderline”?
Borderline results are a useful warning, not a verdict. Treat them as a prompt to pick two sustainable targets for 30 days, then reassess.
Medical note: This article is for general education and is not a substitute for medical advice. Seek medical assessment if you have persistent excessive thirst, frequent urination, unexplained weight loss, blurred vision, or fatigue, or if you are unsure what screening is appropriate for your risk profile.
Editorial update: 22 February 2026 — expanded with a youth-friendly 30-day plan, a screening “script”, and practical eating cues for steadier glucose.
Note: This piece was written as a commissioned feature and has appeared in other health and lifestyle platforms.