The Diabetes Time Bomb in Singapore’s Youths

A major international review published in Diabetologia has sounded the alarm on the rising tide of diabetes among 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 among 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 among 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 among 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 among youth, while 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 among its youth but also set an example for other nations facing similar challenges.

The Diabetes Time Bomb in Singapore’s Youths