Most people with type 2 diabetes know that they can't indulge in a daily chunk of chocolate cake for dessert or sip sugar-laden drinks. But is all sugar off limits in a type 2 diabetes diet, even the natural sugar found in fruits?
"In general, for most patients, all kinds of fruit are fine," says dietitian Nora Saul, MS, RD, a certified diabetes educator at the Joslin Diabetes Center in Boston. Fruit is a healthy snack, packed with the fiber, vitamins, and nutrients essential for good health.
But that doesn't mean that people with type 2 diabetes can eat all the fruit they want — fruit will affect their blood sugar levels. "Every single fruit has carbohydrates," says Lorena Drago, a certified diabetes instructor and consumer adviser for the American Association of Diabetes Educators. Following a few simple guidelines will help you make the right choices.

Diabetes and Fruit: The Glycemic Index

If you have diabetes and fruit is on your preferred menu, you’ll need to pay attention to its glycemic index ranking.
The glycemic index is a numerical rating assigned to carbohydrate foods and indicates how quickly a food will affect blood sugar levels. Low-glycemic-index foods raise blood sugar levels at a slower rate than higher glycemic index foods, says Saul. So low-glycemic-index foods will help you keep your blood sugar levels more stable — the goal for everyone with diabetes.
Apples, oranges, and pears are some of the fruits with a low glycemic index and may be a good choice if you need to limit your carbohydrates on a particular day.

Diabetes and Fruit: Go for the Berries

If you're looking for the most nutritional bang for your carbohydrate buck, opt for berries, says Drago. Strawberries, blackberries, blueberries, and other berries are nutrition powerhouses in terms of nutrients.
But just because they're healthy, remember not to overdo it on the carbohydrates, as carbs will affect blood sugar levels. It's important to stay within your daily carbohydrate budget, which is specific to every individual with diabetes. When you're selecting your fruit, it's also good to go for variety.
"Different fruits provide different vitamins and minerals," says Saul. "You just have to watch the portions and not eat too much at once." If your favorite fruits have a very high glycemic index, eat them in smaller portions or include them in a meal that has an overall low glycemic index, she suggests.
A wide variety of fruits is the best choice for a type 2 diabetes diet, says Saul, but she suggests being sure to include fruits high in vitamin A and C and rich in fiber.

Diabetes and Fruit Juice

Drinking juice doesn't not provide the same nutritional benefits of the whole fruit, Saul says, so tread carefully around fruit juices.
"Most juices don't have any protein, any fiber, or any fat,” Saul says. And because they’re liquid, they leave the stomach very quickly. With "nothing to slow down absorption, they tend to spike blood sugar levels very quickly," she points out.
Saul explains that fruit juice isn't totally off limits, but moderation is key for any type 2 diabetes diet. If you do choose juice, "it should be small quantities, 4 ounces or less," she says. You'll get the same vitamins that you’d get from eating the whole fruit, but you will miss out on the more complete nutrition provided by whole fruit.
You don't have to skip nature's sweet treats when you have diabetes. You can, and should, enjoy fresh fruit as part of a healthy type 2 diabetes diet. Just remember that moderation rules when you’re factoring in these carbs.