Diet and lifestyle for diabetes and pre-diabetes

In brief

• In pre-diabetes, losing 5 to 10% of body weight, eating better and moving more can cut the risk of Type 2 diabetes by 31 to 37%.
• Lose weight slowly, about 0.5 to 1 kg a week; even 3 to 5% improves blood sugar.
• Fill half your plate with vegetables, a quarter with lean protein and a quarter with whole grains, and cut the sugar in drinks.
• Aim for at least 150 minutes of moderate activity a week, plus resistance exercise twice a week.
• Alcohol can cause low blood sugar if you take insulin or a sulfonylurea, especially without food.

We help you plan diet, activity and weight changes that fit your life at our Punggol clinic. See our chronic disease care.

Diabetes series: 1. What is diabetes · 2. Diet and lifestyle · 3. Oral medications · 4. Injectables · 5. Preventive care

A note on weight

In people with pre-diabetes, losing 5 to 10% of body weight, eating better and moving more can reduce the risk of Type 2 diabetes by 31 to 37% over a few years. In people who already have diabetes, the same habits lower HbA1c, reduce medication needs and prevent complications.

For most adults with pre-diabetes or early Type 2 diabetes, gradual weight loss of 5 to 10% is the single most effective lifestyle change. For most of our patients, that is 3 to 8 kg.

• Use Asian BMI cut-offs. Chinese, Malay and Indian people develop metabolic complications at lower body weights than Western populations. In Singapore, a healthy BMI is generally below 23 kg/m², not the Western cut-off of 25. Waist size matters too: below 90 cm for men and below 80 cm for women.
• Slow and steady wins. Losing 0.5 to 1 kg a week is sustainable and most likely to stay off. Crash diets usually rebound.
• Weight is not everything. Some people will never be slim, and that’s okay. Even modest weight loss (3 to 5%) brings meaningful blood-sugar improvements. People who become fitter without losing much weight also do better on average.

The plate — a simple template

You don’t need to count calories or track macros. Start with:

• Half your plate: vegetables (cooked or raw), with a small portion of fruit
• A quarter: lean protein, such as fish, skinless poultry, eggs, tofu, low-fat dairy, or lean red meat (sparingly)
• A quarter: whole grains, such as brown rice, wholemeal bread, wholemeal noodles or oats

Eating out in Singapore — practical swaps

Most of us eat out several times a week. Avoiding hawker, food court and restaurant meals isn’t realistic, and we don’t recommend it. What works:

Rice and noodles

• Choose brown rice where available. Many hawker stalls now offer it, so ask.
• Ask for less rice. “Less rice, more vegetables” is one of the highest-impact swaps: fewer carbs, the same protein and fibre.
• Watch noodle dishes. Soup bases are often high in sodium, though the broth isn’t usually the main carb source. Fried noodles (mee goreng, char kway teow, fried mee) are very high in both carbs and oil. Share a plate or have them less often.
• White rice isn’t forbidden. Just take a smaller portion, with more vegetables and protein.

Hawker and food court favourites

• Chicken rice: less rice, less skin, more cucumber and tomato.
• Economic rice (cai fan, caifan): very flexible. Aim for two vegetable dishes and one meat, with less rice.
• Yong tau foo: a good choice, as you control the fillings: more tofu, fish balls and vegetables, fewer fried items, and no thick soup or sweet sauce.
• Laksa, curry noodles, mee siam: high in sugar and coconut milk. Fine once in a while, not for every lunch.
• Kway chap, bak kut teh, fishball noodles: not bad in moderation; watch the portion size and the salt.
• Western / zichar: avoid deep-fried items and creamy sauces. Choose steamed or grilled fish, stir-fried vegetables and rice in moderation.

Drinks

• Kopi and teh: a standard kopitiam cup has roughly 3 teaspoons of sugar plus a generous amount of condensed or evaporated milk. Three cups a day easily add 100+ extra calories of sugar.
• Ask for “kosong” (no sugar) or “siew dai” (less sugar). It takes a few weeks to adjust, but most people stop missing it.
• Bubble tea, fruit juice and soft drinks are the biggest sugar offenders. A large bubble tea can contain 10 to 15 teaspoons of sugar. Fruit juice, even “100%” unsweetened, is essentially liquid sugar without the fibre of whole fruit.
• Water, and tea or coffee without sugar, are always the safest choice. “Zero-calorie” fizzy drinks are okay occasionally but shouldn’t replace water as a habit.

Fruit

Whole fruit is fine, and its fibre slows sugar absorption. Most adults can have two portions of fruit a day. A portion is roughly one medium apple, one orange, a small banana or a cup of cut fruit.

• Watch: durian (very calorie-dense), mango, longan, lychee, dried fruit and fruit juice.
• Fresh cut fruit with meals is better than juice or smoothies on their own.

Cooking oils

At home, use oils higher in unsaturated fats:

• Good: olive oil, rice bran oil, canola oil, sunflower oil, peanut oil (in moderation)
• Use less of: butter, ghee, lard, coconut oil, palm oil
• Use less oil overall. Air fryers and steaming help.

Alcohol

If you drink, men should have no more than 2 standard drinks a day, and women no more than 1. A standard drink is a can of beer (330 ml), half a glass of wine (100 ml) or one nip of spirits (30 ml). Alcohol can cause low blood sugar (hypos) if you take a sulfonylurea or insulin, especially without food. If you do, talk to us before a heavy night out or a wedding dinner.

Physical activity

The clearest targets for most adults with diabetes or pre-diabetes:

• At least 150 minutes of moderate-intensity aerobic activity a week, or
• At least 75 minutes of vigorous-intensity activity a week
• No more than two days in a row without exercise

Moderate intensity means you can talk but not sing: brisk walking, leisure cycling, steady lap swimming, gardening or doubles tennis. Vigorous means you can only say a few words at a time: jogging, fast cycling, stair climbing or football.

Add resistance exercise twice a week. Building and keeping muscle improves how your body handles glucose. You don’t need a gym. Bodyweight exercises (squats, wall push-ups, planks), dumbbells or resistance bands at home, or a basic routine with a personal trainer once a fortnight all count.

What we tell every patient:

• Start where you are. If you walk 10 minutes after lunch now, make it 15 next week.
• Build it into your day. Get off the bus one stop early, take the stairs, walk the children to school.
• Count steps if it helps. 7,000 to 10,000 steps a day is a reasonable target for most adults. A fitness tracker or phone step counter is enough.
• If you have heart, joint or balance problems, talk to us before starting a new programme. We may refer you for a supervised start.

Sleep

Poor sleep is well established to drive insulin resistance and increase cravings for carbs and processed food the next day.

• Most adults need 7 to 9 hours. Regularly getting five or six hurts blood sugar, weight and mood.
• Keep regular sleep and wake times, including weekends where possible.
• Phones and bright screens before bed disrupt sleep more than most people realise.
• Tell us if you snore heavily, wake up gasping or feel exhausted despite enough time in bed. Obstructive sleep apnoea (OSA) is very common in Type 2 diabetes, and treating it often improves blood sugar and blood pressure.

Stress

Stress hormones (cortisol, adrenaline) push up glucose, and stress drives comfort eating and short sleep. What helps, according to the evidence:

• Brief regular practices: 10 minutes of walking, stretching, breathing exercises or a meditation app (Headspace, Calm, Insight Timer)
• Social connection: regular time with family and friends
• Treating mood problems: depression and anxiety both push blood sugar up. If you have felt low or anxious for more than two weeks, tell us. It is common and treatable, and treating it often helps diabetes control too.

Smoking cessation

If you smoke, stopping is the most effective change you can make after weight loss. Smoking worsens insulin resistance, impairs blood-sugar control and multiplies cardiovascular risk in people with diabetes.

We can help with effective treatments (nicotine replacement therapy, varenicline, bupropion) and counselling through the national I Quit programme. Ask us at your next visit.

Making lifestyle changes stick

Long-term change is hard, especially in Singapore, where food is both a national pastime and a social currency. We help you make changes that fit your life, not a generic template. What helps:

• Pick one or two changes, not everything at once. “This month I will cut sugar in my kopi and walk 30 minutes four times a week” beats a complete diet overhaul that collapses by week three.
• Track one thing, such as steps, weight or a simple food log. The point is awareness, not the numbers.
• Plan for rough weeks. When you slip, and you will, return to the routine rather than giving up.
• Tell someone: family, a friend, or us at a follow-up. Accountability helps.
• Reward progress that isn’t weight: better sleep, easier stairs, a better HbA1c, a smaller waist.

When lifestyle alone isn’t enough

For many people with pre-diabetes or early Type 2 diabetes, lifestyle change is the whole treatment. For others, it works alongside medication.

For pre-diabetes, lifestyle comes first. Medication may be added if blood sugar doesn’t improve after a period of solid effort, or if lifestyle change isn’t practical for you, particularly if you:

• Have a BMI of 23 kg/m² or higher
• Are younger than 60 years of age
• Have a history of gestational diabetes

For established Type 2 diabetes, the question isn’t whether to start medication, but which and when. The next two parts cover this:

→ Oral medications for diabetes (and what about supplements?) → Injectables — insulin and GLP-1 medications

Get in touch

Punggol — 658 Punggol East, #01-04, Singapore 820658 · Tel 6312 4589

Joo Chiat — 172 Joo Chiat Road, #01-01, Singapore 427443 · Tel 6920 1952

Email — admin@ktmc.sg

References

• Agency for Care Effectiveness (ACE). Managing pre-diabetes — a growing health concern. Updated July 2021. ace-hta.gov.sg
• Health Promotion Board Singapore. My Healthy Plate — dietary guidelines for the Singapore population.
• American Diabetes Association. Standards of Care in Diabetes — 2026.
• Ministry of Health Singapore. I Quit programme — smoking cessation support. healthhub.sg

This information is for general education only and is not a substitute for medical advice. Lifestyle advice must be individualised — please speak with our team if anything here isn’t workable for your circumstances. v1.1 · October 2026 (v1.0 April 2026) · Review due April 2028.