For many diabetics, the reduction in fruit consumption is a limitation experienced as a severe food deprivation and restriction.
Diabetics, especially those with type 2 diabetes mellitus, need more accurate blood glucose control than healthy people.
For the control of glycaemia, it is essential that diabetics pay attention not to exceed in the glycemic load, limiting the portions of foods with high glucose density; among these: pasta, bread, fruit and some vegetables. Obviously, analyzing the nutritional characteristics of these products it is clear that the derivatives of cereals are more difficult to manage, and by comparison, fruit and vegetables appear less problematic. This could be a mistake! For the clinicians it is certainly not a novelty, but it is opportune to specify that often the dysmetabolic diabetics possess absolutely out of the ordinary food behaviors; it is not unusual to come across portions of potatoes, carrots and peppers that reach 400g, associated with a daily consumption of fruit that can reach 1000g / day. Moreover, the quantity of carbohydrates introduced with these foods should be added to that deriving from cereals; in this case, hyperglycemia is inevitable.
To prevent diabetics from reaching high levels of blood glucose, but without depriving them of fruit and some vegetables, it is necessary to reduce the frequency of consumption and the portions of all the foods mentioned above.
Cereals and refined derivatives must be reduced and can be replaced by whole or rather whole leguminous foods, just as fruit with a high index and glycemic load must be replaced (even if not entirely) by foods of the same category but less hyperglycemic ; the same applies to vegetables.
Fruit (like vegetables, except potatoes) contains both fructose and dietary fiber; soluble fiber reduces nutrient absorption speed and fructose needs to be converted into glucose. Both of these two characteristics give the fruit a good glycemic index, but does this apply to ALL fruits? Let's see ...
Glycemic load of fresh fruit; LARN sources:
| Food | carbohydrates per 100g of edible portion | Food | carbohydrates per 100g of edible portion |
| Locust beans | 49.9 | Kiwi | 9 |
| Mandarins | 17.6 | Pears without peel | 8.8 |
| Kaki | 16 | Clementine | 8.7 |
| Pomegranates | 15.9 | Blackberry | 8.1 |
| Grapes | 15.6 | oranges | 7.8 |
| Bananas | 15.4 | Summer melon | 7.4 |
| Prickly pears | 13 | Apricot | 6.8 |
| clementines | 12.8 | Grapefruit | 6.2 |
| figs | 11.2 | Quince | 6.3 |
| apples | 10 (average quality) | peaches | 5.8 |
| Plums | 10.5 | strawberries | 5.3 |
| Sour cherries | 10.2 | Watermelon | 3.7 |
| Pineapple | 10 | lemons | 2.3 |
| cherries | 9 |
From the list of fruit, little-consumed fruit and dried fruit (which does not provide significant amounts of carbohydrates) were voluntarily omitted, as well as dehydrated and syruped fruit due to their ABSOLUTE contraindication in the treatment of diabetics.
As regards the glycemic index of fruit, the most significant values reported by the international tables are:
| Food | Glycemic index referring to glucose |
| Ripe banana | 70 |
| Apricot | 57-64 |
| Pineapple | 59 |
| Kiwi | 53 |
| Grapes | 46-59 |
| Orange | 31-51 |
| Apple | 28-44 |
| cherries | 22 |
It is quite clear that among the most consumed fruit, that with a high glycemic load ALSO possesses a rather significant glycemic index; the use of bananas and grapes must be kept under control, but personally, for diabetics I would not recommend eating frequently even mandarins and khaki.
An interesting application of fruit with a low index and glycemic load could be to serve as a mid-morning or mid-afternoon snack, so as not to weigh significantly on the glycemic load of the main meals; obviously, this is a strategy that must be well tolerated by the diabetic. As for the more energetic and fast metabolizing fruit, taking care to reduce the portions, it should be placed mostly in post-exercise. In this way, the anabolic window (even if small in size) can facilitate recovery processes, prevent hyperglycemia and give diabetics the possibility of moderately inserting each type of fruit in their diet.
Bibliography:
- Guidelines for diabetes mellitus - European Diabetes Working Party for Older People 2001-2004 - Congress of Verona 12-14 May 2005.
- Food composition tables INRAN - L. Marletta E. Carnovale
