If I had a penny for every time I was asked this I’d…. well I’d have more money. Can I eat fruit with diabetes is a question I’m asked time and time again in my role as diabetes specialist dietitian and thank you for sending me this question via Facebook. If you have a question, it’s very likely others will too and I’m more than happy to blog about them.
To begin answering this there a few variables we first need to unpick.
Why are we worried about fruit in the first place?
Fruit is a carbohydrate containing food. Carbohydrates increase glucose levels. Therefore, fruit might push up glucose levels. It is the natural sugar in fruit that some say has a bad impact on your diabetes control. Hopefully over the course of this article/video I’ll explain why that might not necessarily be the case.
Fruit in the hierarchy of carbohydrate food
Most fruits don’t actually have much carbohydrate compared to the big players in the carbohydrate world. Starch and processed sugar usually contain between 60-90g of carbohydrate per 100g. That can be a lot of carbohydrate if you eat too much. This means an average 75g (uncooked) or about 180g (cooked) plate of rice gives about 50g of carbohydrates at a meal.
Natural sugars in fruit vary much more in their carbohydrate content. Dried fruit is king of the carbs when it comes to fruit. It has around 40g/100g. Due to the fruit being dehydrated it leaves us with a concentrated form of sugar. Therefore, these a best eaten in small amounts.
The old culprit bananas are number 2 on the list. These average around 22.5g/100g with the average banana containing about 30g per banana.
Grapes rank at number 3 with about 15g/100g. The problem with grapes isn’t their carbohydrate content. It is because no one stops at one handful and instead eats the entire punnet.
After this most other fruits are below 15g/100g. Considering a portion of fruit is 80g or about one handful hopefully you can start to see most fruits don’t provide much carbohydrate at all. Especially when we stack fruit up against the other carbohydrate containing foods.
If someone is telling you to avoid bananas or grapes but makes no reference to any other carbohydrate containing food group they probably do not understand this very well.
The type of diabetes
Your type of diabetes will play a big part on how I advise around fruit intake. In type 1 diabetes the name of the game is injecting insulin for carbohydrate entering your body.
Fruit is carbohydrate so all fruit needs injecting for right? Wrong. As a rule of thumb we say only take rapid insulin for anything over 20g in one sitting. This is because anything below 20g will not have a significant impact on your glucose levels and therefore the injection is almost for the sake of it.
Some people will still inject because they do not want to see any rise in their glucose levels. In the grand scheme of things though, eating below 20g of carbohydrate isn’t going to do much. For example, 20g of carbohydrate will not cause a spike in your glucose levels from 6mmol/l to 21mmol/l. It will more than likely be 6 to 7 or 8mmol/l if at all.
In type 2 diabetes it starts to make more of a difference. We try to aim for a carbohydrate intake of 150g per day in these patients. The normal intake would be around 200-280g (including fruit and vegetables). This doesn’t mean carbohydrates are bad. It means people with type 2 diabetes cannot digest and absorb them properly due to what’s happening in their body. To help fix this, check out my blood glucose recovery programme or go to the type 2 blog section on this blog.
If you eat a banana with 30g of carbohydrate in it this is quite a big hit for a snack. Does it mean bananas are bad? No. It just means you need to regulate your intake throughout the rest of the day. If you have 2 bananas in the day then you will likely need to cut back at breakfast, lunch or dinner. If you have big portions of starch at your main meals, it means you might need to have a lower carbohydrate snacks during the day. This is the way to think about it.
To answer the question, yes you can eat fruit with diabetes. It’s encouraged. Fruit is healthy. If you have type 1 diabetes it might just mean you need to take some rapid insulin. In type 2 diabetes just watch how much you’re having. A good rule is to aim for no more than 3 handfuls a day and spread these out over the day.