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Apples are a nutritious snack, but are the sugars and carbohydrates in an apple good or bad for blood sugar and insulin levels if a person has diabetes?

According to the American Diabetes Association (ADA), although they contain sugars and carbohydrates, eating apples and other fruit is not a problem for a person with either type 1 diabetes or type 2 diabetes.

Apples contain a different kind of sugar to foods with added sugar, and they also contain fiber and nutrients. A person with diabetes should be aware of how apples affect them in order to include this fruit in a diabetes-healthy diet.

In this article, we look at how consuming apples and other fruit might affect people with diabetes.

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The fiber in apples may help to slow the absorption of sugars in the body.

People with diabetes must watch their carbohydrate intake to make sure their blood sugar levels stay stable throughout the day. It makes sense, then, to monitor any foods that contain carbs and sugars.

According to the US Department of Agriculture (USDA), there are about 25 grams (g) of carbs in total in a medium-sized apple, and around 19 g of that is sugar.

Most of the sugar in an apple is in the form of naturally occurring fructose, however, and this may have a different effect on the body than other sugars. Fructose is different to the refined and processed sugars that occurs in packaged foods such as chocolates and biscuits.

A review posted to the American Journal of Clinical Nutrition in 2017 found that replacing glucose or sucrose with fructose led to less sugar and insulin in the blood stream after a meal.

The USDA report that a medium apple contains around 4 g of dietary fiber, and this fiber may help slow the absorption of sugars in the body, which could help prevent spikes in sugar and insulin.

In addition, pairing fruits with a healthy fat or protein can also lower the spike in blood sugar and leave a person feel full for longer.

Apples and the glycemic index

The glycemic index (GI) compares foods according to the likelihood of them causing blood sugar spikes. Foods score between 0–100, with water having the lowest and glucose the highest score.

The body absorbs carbohydrates and sugars quickly from foods with a high GI score, such as candies. The carbs from foods with a low GI score enter the bloodstream more slowly, and so there is a lower risk of a blood sugar spike.

Cornflakes, for example, score around 81 on the GI, depending on the brand and type. This is a high score. Apples score around 36. This is a low score.

Altogether, apples may have a relatively low impact on the insulin and blood sugar levels in the body. This makes them a suitable fruit for people with diabetes, in moderation.

Apples and counting carbs

In the past, some doctors advised people to count their carbs as a way of managing blood sugar levels. However, current guidelines for diabetes management focus on individual needs and no longer recommend any specific carb intake.

It is still essential for someone to monitor any changes they have after eating an apple, so they know what to expect in their body when they do so. A person with diabetes needs to test their blood sugar levels regularly.

A doctor will advise on how often and what targets a person should aim for, as it will depend on the individual.

Blood glucose monitors are available for purchase online.

Many people love apples for their simplicity, but they are also very nutritious.

One medium apple, weighing around 182 g, contains around:

  • water: 155.72 g
  • energy: 95 calories
  • protein: 0.47 g
  • fat: 0.31 g
  • carbohydrate: 25.13 g, including 18.91 g of sugar
  • fiber: 4.4 g
  • calcium: 11.00 milligrams (mg)
  • iron: 0.22 mg
  • magnesium: 9.00 mg
  • phosphorus: 20 mg
  • potassium 195 mg
  • sodium: 2 mg
  • zinc: 0.07 mg
  • vitamin C: 8.4 mg
  • vitamins A, E, and K
  • various B vitamins, including 5 micrograms (mcg) of folate.

The Dietary Guidelines for Americans 2015–2020 recommend that adults consume 22.4–30.8 g of fiber a day, depending on age and sex. A person can feel full after eating an apple due to the combination of fiber, water, and nutrients.

Vitamins A and C are antioxidants. These may help reduce inflammation.

Specific flavonoids, such as quercetin, are present in apples. These may help improve blood glucose levels. A review from 2011 found a link between eating apples and a lower risk of diabetes.

All these factors make apples a good choice as a quick snack between meals.

Eating a varied diet rich in vegetables and fruit, including apples, is good for everyone but maybe even more important for a person with diabetes or prediabetes, when there is a high risk for the disorder.

Learn more here about suitable foods for people with prediabetes.

A diet rich in vegetables and fruits is beneficial for everyone, and certain fruits provide more benefits than others, particularly for a person with a chronic health condition.

Eating fruits in their whole, raw form provides the most benefits because processing fruits can reduce the fiber, antioxidant, and other nutritional content.

Berries and cherries

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Compared to many other fruits, berries have a lower level of sugar.

Berries have lower levels of sugar than some other fruits. They are naturally high in antioxidants, flavonoids, and nutrients which helps boost the body's immune system and overall health.

Like apples, cherries contain quercetin, which may be beneficial for a person with diabetes.

Rich-colored berries may make for healthful choices, including:

  • strawberries, raspberries, and blackberries
  • grapes and currants
  • blueberries
  • cranberries
  • tart cherries

It is possible to buy berries fresh or frozen. Dried versions may be less filling but are also a healthy option. However, anyone with diabetes should check the labels for added sugar, as this is not always obvious.

Other fruits

A person with diabetes can eat any fruit in moderation, as long as they do not have an allergy.

The ADA recommend the following fruits for people with diabetes, based on their GI score:

  • avocado
  • banana
  • mango
  • papaya
  • kiwi
  • pineapple
  • cantaloupe, watermelon, and honeydew melons
  • citrus fruits, such as grapefruit, oranges, and tangerines
  • stone fruits, including apricots, plums, and peaches

Most fruits have a low GI score, according to the ADA, but the following have a medium score:

  • melon
  • pineapple
  • some dried fruits, for example, raisins, dates, and sweetened cranberries

A person should monitor how different fruits affect their symptoms and blood sugar, as each person's sensitivities may be different.

Some may find they need to limit or avoid fruits that have a higher sugar content, depending on how they affect the person's blood sugar.

A person with diabetes should be able to consume fruit juices that contain 100 percent real fruit.

However, depending on how their blood glucose levels react, the individual may need to limit their intake, as fruit juices may contain a higher concentration of sugar and less fiber than fresh fruits.

This can cause a higher spike in blood sugar.

Four ounces of fruit juice contains about 15 g of carbohydrates. Being mindful of total carbohydrate intake during the meal is important for managing diabetes. A person should include fruit juice in their carbohydrate tracking.

Fruit juices with added sugars are not suitable. Some fruit juices may start as fruit, but the process of turning them into juice may remove much of the fiber and nutrients. What is left after processing is often higher in both sugar and calories than the fruit itself.

Other "fruit juices" contain little to no real fruit. Reading the ingredients and focusing on 100 percent real juices is crucial to ensure a higher nutrient intake.

Click here to get some ideas on tasty and satisfying fruit-based and other drinks that are suitable for people with diabetes.

Apples are a highly nutritious food choice and can be a satisfying and healthful snack. They should have a minimal effect on blood sugar and insulin levels, making them a good option for people with diabetes.

Regular monitoring of blood sugar and insulin levels after eating apples can help let a person know how apples will affect them. People should always eat a variety of fresh, healthy foods.

Fresh apples and other apple products are available for purchase online. People should opt for fresh apples rather than apple-derived products, as they contain more nutrients and fiber and do not have added sugar.