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Can You Drink Orange Juice if You Have Diabetes?

Posted on January 23, 2023
Medically reviewed by
Robert Hurd, M.D.
Article written by
Joan Grossman

Healthy eating is a crucial part of controlling blood sugar if you have type 2 diabetes, and nutritious fruits and vegetables should be part of your diet. But what about fruit juices — in particular, orange juice, which is often considered a healthy beverage rich in vitamin C?

DiabetesTeam members have asked about whether it’s a good idea for people living with diabetes to drink fruit juice. One member wrote, “Hi team, just curious if there is any recommended fruit juice I can take for type 2 diabetes?”

Sugar occurs naturally in fruit in the form of fructose. As with other forms of sugar, consuming excess amounts of fructose is linked to serious medical risks, such as diabetes, high weight, and metabolic syndrome. Here are some important facts about the risks and health benefits of drinking orange juice if you are living with diabetes.

Orange Juice and Sugar

When fructose is metabolized (changed into a form the body can use), it’s largely converted to glucose (blood sugar). A hormone called insulin controls how much glucose is let into cells to be used for fuel and how much stays in the blood. In people with type 1 or type 2 diabetes, insulin is not able to properly regulate blood glucose levels, so they must be carefully monitored.

The glycemic index is 0-to-100 rating scale that indicates how quickly a food item causes a spike in blood glucose when it’s digested. High-ranking foods are high in carbohydrates, especially refined or simple carbohydrates, which break down into sugar and can rapidly raise blood glucose levels. If untreated, hyperglycemia (high blood glucose) can damage nerves, blood vessels, and other tissues, leading to serious health problems in people with diabetes.

Whole Fruits vs. Fruit Juices

Unsweetened orange juice has a moderately low value on the glycemic index, about 50 — not much higher than that of a raw orange (about 43). But health care professionals and researchers generally recommend that people with diabetes consume whole fresh fruits instead of fruit juices.

Here’s why: Even though their glycemic index values are close, orange juice has a much higher glycemic load, which is based on the volume of carbohydrates in a portion of the food. It takes multiple pieces of fruit to produce one serving of juice, which raises its glycemic load. A serving of orange juice has been found to have more than twice the glycemic load of one orange.

For example, you may need to squeeze four oranges to make a single glass of fresh OJ, which you could drink down in a couple of gulps. In contrast, you’d probably eat only a single orange in one sitting, and doing so would take longer than drinking the glass of four-orange juice. These two scenarios will result in very different blood glucose responses.

The experience of one DiabetesTeam member relates to this difference. “I somehow convinced myself that if I could eat the occasional orange, then I could drink orange juice. For the last couple of weeks, I’ve been drinking orange juice morning and night and not testing my BS [blood sugar],” they wrote. “But then tested BS … 22.5 — oooopppss.”

Another member described their surprise that drinking OJ had raised their blood sugar level. “I’ve been having too much pure orange juice with my sandwich in the afternoon, and I’ve been told to stop because I’m treating hypoglycemia [low blood sugar] that I’m not having, and that’s why my blood sugar levels have increased. Who knew? I didn’t, but now I’m strictly banned from having orange juice or any other pure juice.”

Juice Lacks Fiber To Slow Absorption of Sugar

Fiber helps slow digestion and allows sugar to be absorbed more gradually into the blood system. Whole fruits contain fiber, which is mostly lost when it’s made into juice. Fruit juices are digested more quickly than fruit, which can cause high blood glucose levels. Plus, rapid digestion means some healthy nutrients may pass through the body too quickly to be properly absorbed.

Because of processing, commercially sold orange juice — even with pulp — is very low in fiber. Fresh-squeezed orange juice has been found to have significantly more fiber than processed and packaged types. However, eating a whole orange will still provide your body with the most fiber and cause the slowest and lowest rise in blood glucose.

Orange Juice for Low Blood Sugar

People with diabetes occasionally need to quickly treat an incident of hypoglycemia, and some doctors recommend drinking orange juice as one way to rapidly raise blood sugar to more appropriate levels. Symptoms of low blood sugar include:

  • Headache
  • Fatigue or weakness
  • Dizziness
  • Shakiness
  • Increased heartbeat

A small amount of orange juice — one-half cup — can quickly raise blood sugar. But it’s important to get your doctor’s advice regarding the best treatment option and proper amount of sugar for you in case your blood sugar drops.

“My day started out with my blood sugar being 74 — way too low for me, I think. Had to take a glucose tablet and a small glass of orange juice to feel right,” a DiabetesTeam member wrote.

Importantly, consuming sugar-sweetened orange juice — or any other beverage sweetened with sugar — is a diabetes risk factor and is linked to other health risks, including tooth decay, unhealthy weight gain, high blood pressure, high blood triglycerides, and heart disease. Any fruit juice with added sugar should be limited — or avoided.

Talk to your doctor if you need help designing a diabetes-friendly, healthy diet. Your health care provider can give you a referral to a registered dietitian, who can develop a meal plan to help you manage blood sugar levels, portion sizes, and appropriate sweeteners.

Find Your Team

DiabetesTeam is the social network for people with diabetes and their loved ones. On DiabetesTeam, more than 127,000 members come together to ask questions, give advice, and share their stories with others who understand life with diabetes.

Do you have questions about orange juice and diabetes? Has your doctor given you advice on fruit juices? Share your experience in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Robert Hurd, M.D. is a professor of endocrinology and health care ethics at Xavier University. Review provided by VeriMed Healthcare Network. Learn more about him here.
Joan Grossman is a freelance writer, filmmaker, and consultant based in Brooklyn, NY. Learn more about her here.

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