Fructose: The “different” sugar that confuses diabetics

Fructose does not raise blood sugar levels and has been used as an energy source for patients with diabetes. Confusion about fructose in fruits that are sweet can cause confusion for diabetics. We all know fruits are healthy and should be consumed regularly. Blueberries for instance might even help with weight loss and help to control diabetes, shown in a study presented April 2009 at the Experimental Biology convention.

Fructose in fruits, some fruit juices, and honey does not stimulate insulin release, nor does it acutely raise blood sugar levels – but high fructose consumption from foods with high fructose corn syrup and added sugar can cause weight gain and a host of other problems for diabetics and non diabetics

According to an editorial published in the Journal of Clinical Nutrition, November 2008, an article published by Livesey and Taylor concluded that “fructose intake up to 90 g/d may actually be beneficial because of its effects of lowering HbA1c concentrations, despite the potential countering effects of increases in plasma triglycerides. However, it is probably misleading to conclude that this amount of fructose consumption is safe by examining only the effects of fructose on plasma triglycerides, weight, and HbA1c.

The authors point out that high fructose intake can also “raise blood pressure, decrease insulin sensitivity, lower glucose tolerance, increase apolipoprotein-B concentrations, and cause microvascular disease, glomerular hypertension, renal injury, fatty liver, systemic inflammation, endothelial dysfunction, oxidative stress, and activation of the renin angiotensin system” – reported in animal studies. No wonder fructose consumption for diabetics is confusing.

Patients with diabetes can and should eat fruits, but must avoid foods with added sugar (sucrose). It is important to avoid high fructose corn syrup and other processed foods with added sugar that affect the glycemic index (GI) and lead to poor diabetic control. Most fruits do not affect the glycemic index even though fruit contains fructose.

Here are some tips from the American Diabetic Association,

For Carb counters
“A small piece of whole fruit or about ½ cup of frozen or canned fruit has about 15 grams of carbohydrate. Servings for most fresh berries and melons are from ¾ – 1 cup. Fruit juice can range from 1/3 -1/2 cup for 15 grams of carbohydrate. Only 2 tablespoons of dried fruit like raisins or dried cherries contains 15 grams of carbohydrate so be cautious with your portion sizes! Fruit can be eaten in exchange for other carbohydrates in your meal plan such as starches, grains, or dairy.

For Plate Method
If using the plate method, having a small piece of whole fruit or a ½ cup of fruit salad for dessert is a great compliment to the non-starchy vegetables, small portion of starch and protein foods that are on your plate.

For using the Glycemic Index
Most fruits have a low glycemic index because of their fructose and fiber content. Melons and pineapple have medium GI values as do some dried fruits such as dates, raisins, and sweetened cranberries. Overall, fruit is encouraged when using the glycemic index to guide food choices—so enjoy.” It is important to choose fresh fruits, canned in light syrup, or dried fruits.

High fructose corn syrup can also lend to confusion, but it is sugar. For diabetics it boils down to watching how much sugar you consume in all forms and by watching your food portions. Pure fructose from fruits, honey and fruit juices is not as harmful as the kind that sneaks into everyone’s diet from high fructose corn syrup and sugar(sucrose) that converts to glucose and is then stored in the body. Fructose found naturally in fruits and honey quickly converts into energy and is used. It is also important to note that fructose metabolism is extremely complicated. Fructose is rapidly metabolized by the liver. You can also benefit from reading “Sugar defined”, explaining how to find hidden sugar in foods.

Kathleen Blanchard RN

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2 Responses to “Fructose: The “different” sugar that confuses diabetics”

  1. Diabetes Doctor 20. Jan, 2010 at 1:25 pm #

    Best ever post – I will give 10/10 for the way you explained this very sensitive and difficult topic! keep it up Kathy! I am glad to have you as a author!

  2. the poor diabetic 20. Jan, 2010 at 8:22 pm #

    Carb control is at the cornerstone of effective diabetes management and sugar substitutes are to be used for that purpose. There is always confusing information when it comes to substitutes however and recent discoveries have questioned the validity of some of the sugar substitutes we as diabetic's used to use in the past.
    Frutose at its purest and natural levels is good for the body, the problem comes when we take it and start deconstructing in the name of commercialism.

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