The last National Health and Morbidity Survey (NHMS) of 2015 reported a national prevalence of 17.5% among adults above 18 years, representing 3.5 million adult Malaysians, an increase from 15.2% (NHMS 2011). Current projection for prevalence in 2019 is 22.1% estimating 4.5 million adults. There were no apparent differences between gender or among urban rural population. There are almost half a million young adults < 30 years with diabetes, with majority undiagnosed. The ethnic differences in prevalence is apparent with Indians 22.1%, Malays 14.6% and Chinese 12.0%. Majority of persons with diabetes attend government-based health care services, 60% attend primary care and 20% public hospitals. Overall glycaemic control is still poor with 30% in primary care and 20% in hospital care attaining optimal glycaemic control. In the previous Diabcare Asia studies, Malaysia was found to have the highest HbA1c and postprandial hyperglycaemia. Access to newer anti-diabetic agents in public care is restricted. Insulinisation rates are increasing, with 28.7% insulin-treated in primary care and 65% in hospital-based diabetes care. There needs to be better use of SMBG to guide insulin dose adjustment and enable better glycaemic control. The annual national audit shows improvement in complication screening practices though not maximally covered. Malaysia has an exceptionally high rate of dialysis for diabetic nephropathy. Multidisciplinary care with diabetes educator nurses, dieticians and pharmacists is commonly practised. Group based patient education, patient support groups and community programmes to enhance overall wellbeing and quality of life of those with diabetes are not well utilised. Use of diabetes technology with insulin pumps, continuous glucose monitoring or remote glucose monitoring is still very much limited.