Diet and lifestyle for diabetes and pre-diabetes

About this guide

Medication gets most of the attention in diabetes — but lifestyle changes are what carry the most weight over a lifetime. Good research has shown that losing 5 to 10% of your body weight, eating better, and moving more can reduce the risk of developing Type 2 diabetes by 31 to 37% over a few years in people with pre-diabetes. And for people who already have diabetes, the same habits help lower HbA1c, reduce medication needs, and prevent complications.

This is the second of five short guides we give our diabetes patients:

1. What is diabetes and pre-diabetes? — the basics
2. Diet and lifestyle for diabetes and pre-diabetes (you are here)
3. Oral medications for diabetes (and what about supplements?)
4. Injectables — insulin and GLP-1 medications
5. Preventive care for diabetes

We won’t pretend this is easy. Long-term lifestyle change is hard — especially in Singapore, where food is both a national pastime and a social currency. What we can do is help you make changes that fit your actual life, not a generic template.

A note on weight

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

A few things are worth knowing:

• Asian-specific BMI cutoffs: Chinese, Malay, and Indian populations tend to develop metabolic complications at lower body weights than Western populations. In Singapore, a healthy BMI is generally considered below 23 kg/m² (not 25, which is the Western cutoff). Waist circumference matters: for men, below 90 cm; for women, below 80 cm.
• Slow and steady wins: 0.5 to 1 kg per week is sustainable and most likely to stay off. Crash diets usually rebound.
• Weight is not everything: some patients will never be slim — and that’s okay. Even modest weight loss (3 to 5%) produces meaningful blood-sugar improvements, and people who become more physically fit without losing much weight also do better on average.

The plate — a simple template

You don’t need to count calories or track macros. A practical starting point:

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

That’s the foundation. Everything below is about adapting it to Singapore food culture.

Eating out in Singapore — practical swaps

Most of us eat out several times a week. Completely avoiding hawker, food court, or restaurant meals isn’t realistic, and we don’t recommend it. What does work:

Rice and noodles

• Choose brown rice where available. Many hawker stalls now offer brown rice as an option — ask.
• Ask for less rice. “Less rice, more vegetables” is one of the highest-impact swaps. You save carbs, keep protein and fibre.
• Watch noodle soups: the soup base is often high in sodium; the broth itself isn’t usually the main carb source, but fried noodles (mee goreng, char kway teow, fried mee) are very high in both carbs and oil. Consider sharing a plate or having them less often.
• White rice isn’t forbidden — just smaller portions, with more vegetables and protein alongside.

Hawker and food court favourites

• Chicken rice: ask for less rice, less chicken skin, more cucumber and tomato.
• Economic rice (cai fan, caifan): a very flexible meal. Aim for two vegetable dishes and one meat; take less rice.
• Yong tau foo: a good choice — you control the fillings. More tofu, fish balls, vegetables; less fried items; avoid the thick soup or the sweet sauce.
• Laksa, curry noodles, mee siam: high in sugar and coconut milk. Once in a while is fine; 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. Steamed or grilled fish, stir-fried vegetables, and rice in moderation.

Drinks

This is where many people lose the battle without realising.

• Kopi and teh at a kopitiam: a standard cup has roughly 3 teaspoons of sugar and a generous amount of condensed/evaporated milk. Over a day, three cups easily add up to 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, soft drinks — these 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 the whole fruit.
• Water, plain tea (without sugar), black coffee (without sugar) are always the safest choice. Carbonated “zero-calorie” drinks are okay occasionally but don’t replace water as a habit.

Fruit

Whole fruit is fine — and the fibre in fruit actually slows sugar absorption. Most adults can have two portions of fruit a day without issue. 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 fruits, fruit juice.
• Fresh cut fruit with meals is better than juice or smoothies on their own.

Cooking oils

If you cook at home, use oils that are 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 are your friend.

Alcohol

If you choose to drink: men no more than 2 standard drinks per day; 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 sugars (hypos) in people on sulfonylureas or insulin — especially when drunk without food. If you take any of those medications, please discuss with us before a heavy night out or a wedding dinner.

Physical activity

The single clearest target for most adults with diabetes or pre-diabetes:

• At least 150 minutes of moderate-intensity aerobic activity per week, OR
• At least 75 minutes of vigorous-intensity activity per week
• No more than two consecutive days without exercise

Moderate-intensity means you can hold a conversation but not sing — brisk walking, leisure cycling, swimming laps at a steady pace, gardening, or doubles tennis. Vigorous means you can only say a few words at a time — jogging, fast cycling, stair climbing, football.

Plus resistance exercise twice a week. Building and preserving muscle improves how your body handles glucose. This doesn’t require a gym membership: bodyweight exercises (squats, push-ups against a wall, planks), simple dumbbells or resistance bands at home, or a basic routine with a personal trainer once a fortnight all count.

A few things we tell every patient:

• Start where you are. If walking 10 minutes after lunch is your current baseline, make it 15 next week.
• Build it into your day. Get off the bus one stop earlier. Take the stairs. Walk the kids to school.
• Count steps if it helps. 7,000 to 10,000 steps a day is a reasonable general target for most adults.
• A fitness tracker or a phone step counter works. Nothing fancy is needed.
• If you have existing heart, joint, or balance issues, please discuss with us before starting a new programme — we may refer you for a supervised start.

Sleep

Poor sleep drives insulin resistance and increases appetite for carbs and processed foods the next day. This is now well-established.

• Most adults need 7 to 9 hours. Five or six on a regular basis hurts blood sugar, weight, and mood.
• Keep a regular sleep and wake time, even on weekends where possible.
• Phones and bright screens before bed disrupt sleep more than most people realise.
• If you snore heavily, wake up gasping, or feel exhausted despite enough hours in bed, please tell us — obstructive sleep apnoea (OSA) is very common in people with Type 2 diabetes, and treating it often improves blood sugar and blood pressure at the same time.

Stress

Stress pushes up glucose through stress hormones (cortisol, adrenaline), and drives comfort-eating and under-sleeping. We won’t tell you to “reduce stress” — that’s easier said than done. What does help, in the evidence:

• Brief regular practices — 10 minutes of walking, stretching, breathing exercises, or meditation apps (Headspace, Calm, Insight Timer) are all shown to help
• Social connection — regular time with family and friends
• Treating underlying mood problems — depression and anxiety both push blood sugar up. If you’ve been feeling low or anxious for more than two weeks, please let us know. It is common, it is treatable, and treating it often helps diabetes control too.

Smoking cessation

If you smoke, stopping is the single highest-impact thing you can do beyond weight loss. Smoking worsens insulin resistance, impairs blood-sugar control, and multiplies cardiovascular risk in people with diabetes.

We can help — there are effective treatments (nicotine replacement therapy, varenicline, bupropion) and counselling support through the I Quit programme run nationally. Ask us at your next visit.

Making lifestyle changes stick

The hardest part isn’t knowing what to do — it’s keeping it going when life gets in the way. A few things from our experience:

• Pick one or two things, 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. Steps, weight, or a simple food log. Not for the numbers — for the awareness.
• Plan for the rough weeks. When you slip — and you will — come back to the routine rather than giving up on it.
• Tell someone. Family, a friend, or us at a follow-up. Accountability helps.
• Reward progress that isn’t weight. Better sleep, easier stairs, better HbA1c, a smaller waist — these are all wins.

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 becomes part of the treatment alongside medication.

The starting point for most people with pre-diabetes is lifestyle. If blood sugars don’t improve after a period of solid effort — or if lifestyle change isn’t practical for you given your circumstances — medication can be added, particularly if you have one or more of these factors:

• BMI of 23 kg/m² or higher
• Younger than 60 years of age
• History of gestational diabetes

For established Type 2 diabetes, the question isn’t whether to start medication — it’s which medication and when. That’s covered in the next two parts:

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

Get in touch

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

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

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. v1.0 · April 2026 · Review due April 2028.