Kencing manis (diabetes) is a condition where your blood sugar (glucose) level is too high because your body cannot make enough insulin or cannot use it properly. In Malaysia, the National Health and Morbidity Survey 2023 found that about 1 in 6 people surveyed (15.6%) had diabetes, and younger adults were more likely to be undiagnosed. Common signs are peeing more, constant thirst, tiredness and weight loss without trying, but many people have no symptoms, so a blood test is the only way to know. Type 2 diabetes can often be prevented or improved with weight loss, a healthy diet and exercise, and medicine helps keep blood sugar under control to prevent complications such as heart disease, kidney problems, eye damage and foot ulcers.
What is kencing manis? Type 1, type 2 and gestational diabetes
Insulin is a hormone that helps your body use glucose (sugar) from food for energy. Without enough working insulin, glucose builds up in the blood. The name kencing manis ("sweet urine") comes from the sugar that spills into the urine when blood sugar is high.
- Type 2 diabetes is the most common type. The body cannot make enough insulin, or the insulin does not work properly (insulin resistance). It may be prevented, and it can be managed with diet, exercise and medicines.
- Type 1 diabetes is caused by a problem with the immune system that stops the body making insulin. It usually develops more quickly and is more common in younger people, and it is treated with insulin.
- Gestational diabetes is high blood sugar that develops during pregnancy, most often in the second or third trimester, and usually goes away after birth. Women who have had it have a higher risk of type 2 diabetes later.
According to the National Health and Morbidity Survey (NHMS) 2023, 15.6% of the population surveyed had diabetes, down from a peak of 18.3% in 2019 but still high. Younger people were more likely to have undiagnosed diabetes.
Tanda kencing manis: what are the signs?
According to the NHS, the most common symptoms of type 2 diabetes are:
- peeing more than usual (see our guide to kerap kencing);
- feeling thirsty all the time;
- feeling very tired;
- losing weight without trying.
Other symptoms can include:
- blurred vision;
- cuts or wounds taking longer to heal;
- itching around the genitals, or getting thrush again and again (see our guide to vaginal yeast infection).
Symptoms are the same in adults and children, and they may develop gradually. Not everyone gets symptoms, which is why it is important to be checked if you are at risk. Type 1 diabetes symptoms are similar but usually come on much faster.
Bacaan kencing manis: what blood sugar levels mean
Diabetes is diagnosed with a blood test. The HbA1c test shows your average blood sugar over the last 2 to 3 months. According to Diabetes UK:
| HbA1c result | What it means |
|---|---|
| Below 42 mmol/mol (below 6.0%) | Normal |
| 42 to 47 mmol/mol (6.0% to 6.4%) | Prediabetes (borderline): high risk of type 2 diabetes |
| 48 mmol/mol (6.5%) or above | Type 2 diabetes range |
Doctors can also use glucose tests. Under a UK NHS diagnostic guideline, diabetes can be diagnosed with a fasting blood glucose of 7.0 mmol/L or higher, or a random blood glucose of 11.1 mmol/L or higher. If you have no symptoms, the test is repeated to confirm. Cut-off points can differ slightly between countries and guidelines, so ask your doctor to explain your own results.
If you already have diabetes, an HbA1c of 48 mmol/mol (6.5%) or below is a common target, but your healthcare team will set an individual target with you. A blood sugar below 4 mmol/L is too low (a hypo).
Punca kencing manis: who is at risk?
According to the NHS, you are more likely to get type 2 diabetes if:
- you are over 25 and of South Asian or Chinese background (or over 40 if you are white), groups that make up much of Malaysia's population;
- a parent, brother or sister has diabetes;
- you are overweight and not very physically active;
- you have a condition that increases your risk, such as high blood pressure (see our guide to darah tinggi).
Women who have had gestational diabetes are also at higher risk, and polycystic ovary syndrome is linked to insulin resistance; see our guide to PCOS symptoms.
Prediabetes means your blood sugar is higher than normal but not yet in the diabetes range. It is a warning sign and the best time to act.
Cara kawal kencing manis: diet and lifestyle
The NHS says lifestyle changes can lower blood sugar and, for some people, bring it back to a normal level without medicine (remission):
- eat a healthy diet with fruit, vegetables, wholegrains such as oats and wholemeal bread, and pulses such as chickpeas and lentils;
- cut down on processed foods high in salt and sugar, such as sweets, biscuits and fried snacks;
- be active for at least 2.5 hours a week, such as brisk walking or any activity that leaves you out of breath;
- lose weight if you are overweight;
- stop smoking and limit alcohol;
- make changes gradually; a small change each week is easier to keep.
Malaysian-style tips: choose plain water or unsweetened teh O kosong instead of sweet drinks (see our guide to Malaysian drinks), watch your rice portions and fill half your plate with vegetables (see our guide to nasi putih calories), and limit kuih and sweet desserts to small portions.
Prevention works. In the large US Diabetes Prevention Program trial of people at high risk, a lifestyle programme focused on weight loss and regular activity reduced the number of people who developed diabetes by 58% over about 3 years, which was more effective than metformin (31%).
Do not start a very strict, low-calorie diet without speaking to your doctor first, especially if you take insulin or other diabetes medicines, because your doses may need to change.
Ubat kencing manis: medicines and check-ups
If lifestyle changes are not enough, the NHS describes these common treatments for type 2 diabetes:
- Metformin, which improves the way your body handles insulin;
- SGLT2 inhibitors, which help remove extra sugar through your urine;
- GLP-1 agonists, weekly injections that may be added for people with heart disease or obesity;
- insulin, if other medicines do not control blood sugar.
Take your medicines as prescribed and do not stop them unless your doctor tells you to. If you are unwell with vomiting, diarrhoea or a high fever while taking diabetes medicine, contact your doctor urgently, as some medicines may need to be paused. Herbal products and supplements cannot replace diabetes medicine; check that any product is registered (see how to verify KKM registration) and tell your doctor about anything you take.
Regular check-ups help catch problems early. According to the NHS, these include:
- an HbA1c test every 3 to 6 months;
- checks of weight, cholesterol, blood pressure and kidneys at least once a year (see our guide to kolesterol tinggi);
- regular foot checks and eye screening;
- regular dental check-ups, as diabetes raises the risk of gum disease.
If you have diabetes and are planning a pregnancy, talk to your doctor early, as some medicines need to be changed.
Complications and luka kencing manis
Over time, high blood sugar can damage blood vessels and nerves. The NHS lists these long-term complications:
- heart disease and stroke;
- foot problems such as ulcers and infections, which can sometimes lead to amputation;
- eye problems (diabetic retinopathy) and blindness;
- kidney problems;
- gum disease.
Luka kencing manis (diabetic wounds). Nerve damage can stop you feeling small cuts or blisters on your feet, and poor circulation slows healing, so a small wound can become a serious ulcer. Check your feet every day, keep them clean and dry, and see a doctor or diabetes nurse if you notice blisters, cracked skin, or pain, tingling or numbness. Fungal infections of the feet are also more serious with diabetes; see our guide to kurap and kutu air.
Managing your blood sugar, blood pressure and cholesterol, eating well, exercising and not smoking lowers the risk of all these complications.
Low and very high blood sugar: when to get help
Low blood sugar (hypo) is usually below 4 mmol/L and mainly affects people taking insulin or some other diabetes medicines. According to the NHS, symptoms include hunger, sweating, shaking, dizziness, feeling anxious or irritable, tingling lips, palpitations, tiredness, blurred vision and confusion. To treat it:
- have something sugary straight away, such as a small glass of fruit juice or a sugary fizzy drink, or glucose tablets;
- check your blood sugar again after 10 to 15 minutes, and repeat if it is still below 4 mmol/L;
- once you feel better, eat something more filling, such as biscuits, bread or your next meal.
If someone with a hypo is unconscious, do not give them food or drink, put them in the recovery position and call 999.
Very high blood sugar can rarely cause dangerous conditions called diabetic ketoacidosis (DKA) or hyperosmolar hyperglycaemic state (HHS). Call 999 or go to the emergency department if someone with diabetes is peeing a lot, feels very thirsty, feels sick, is confused, very sleepy or drowsy, or is short of breath.
Frequently asked questions (FAQ)
What are the signs of kencing manis (tanda kencing manis)?
The most common signs of type 2 diabetes are peeing more than usual, feeling thirsty all the time, feeling very tired and losing weight without trying. Other signs include blurred vision, cuts or wounds that take longer to heal, and itching around the genitals or repeated thrush. Many people have no symptoms at all.
What is a normal blood sugar reading (bacaan kencing manis normal)?
An HbA1c below 42 mmol/mol (6.0%) is generally normal, 42 to 47 mmol/mol (6.0% to 6.4%) is prediabetes, and 48 mmol/mol (6.5%) or above suggests diabetes. Diabetes is also diagnosed with a fasting blood glucose of 7.0 mmol/L or above, or a random glucose of 11.1 mmol/L or above. A doctor usually repeats the test to confirm.
What causes kencing manis?
Type 2 diabetes happens when the body cannot make enough insulin or the insulin does not work properly, so blood sugar stays too high. Your risk is higher if you are overweight, not very active, have a parent or sibling with diabetes, have high blood pressure, or are over 25 and of South Asian or Chinese background.
What is the best ubat kencing manis?
Treatment starts with lifestyle changes. If medicine is needed, metformin is commonly used, often together with other medicines such as SGLT2 inhibitors; some people need injections such as GLP-1 agonists or insulin. Your doctor will choose what suits you. Do not stop your medicine or replace it with herbal products.
Can kencing manis be cured?
Type 2 diabetes cannot always be cured, but some people can bring their blood sugar back to a normal level without medicine (remission) by losing weight and improving their diet. For people with prediabetes, a lifestyle programme reduced the chance of developing diabetes by 58% in a large trial.
Why do diabetes wounds heal slowly (luka kencing manis)?
High blood sugar can damage nerves and blood vessels, so cuts and blisters, especially on the feet, may not be felt and can heal slowly or become infected. This can lead to foot ulcers and, in severe cases, amputation. Check your feet every day and see a doctor about any blister or cracked skin.
What are the symptoms of low blood sugar (hypo)?
A hypo is usually a blood sugar below 4 mmol/L. Symptoms include hunger, sweating, shaking, dizziness, feeling anxious or irritable, palpitations, tingling lips, blurred vision and confusion. Take something sugary straight away, such as a small glass of fruit juice, then check your sugar again after 10 to 15 minutes.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor or pharmacist. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- What is type 2 diabetes? — NHS
- Symptoms of type 2 diabetes — NHS
- Treatment for type 2 diabetes — NHS
- Complications of type 2 diabetes — NHS
- Type 1 diabetes — NHS
- Gestational diabetes — NHS
- Low blood sugar (hypoglycaemia) — NHS
- Diabetes — World Health Organization
- What is HbA1c? — Diabetes UK
- Prediabetes — Diabetes UK
- Screening and diagnosis of type 2 diabetes — NHS Highland
- Mat Rifin H, Mohd Yusoff MF, Abd Hamid HA. Conducting the National Health and Morbidity Survey 2023 in Malaysia with focus on methodology and main findings on non-communicable diseases. Sci Rep. 2025;15(1):25531.
- Knowler WC, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
