Juices in type 1 and type 2 diabetes: benefits and harms

A healthy diet, regular physical activity, and often drug therapy are key components of diabetes care. The position of the American Diabetes Association (ADA) is that there is no one-size-fits-all diet for people with diabetes. The ADA also recognizes the integral role of nutrition therapy in the overall care of diabetes and has historically recommended that everyone with diabetes actively participate in self-management, education, and treatment planning with their healthcare provider, which includes developing a personalized diet plan. [ 1 ], [ 2 ], [ 3 ]

Everyone knows that diabetes occurs due to insufficiency or lack of insulin production by the pancreas, which is necessary for the absorption of glucose. It plays an important role in human metabolism and is the main source of energy. Overcoming problems with carbohydrate metabolism is carried out by supplying cells with insulin and regulating the uniform flow of carbohydrates, which directly depends on nutrition. Diet therapy is the main part of treatment, so the question arises: is it possible to drink juices with diabetes?

What juices can be drunk with diabetes type 1 and 2?

We position juices as a healthy drink, saturated with many nutrients necessary for the full functioning of the body. And this is really so, because they contain all the components inherent in the fruits from which they are made.

At the same time, they also contain double the amount of easily digestible carbohydrates (sucrose, fructose), which greatly increase blood glucose levels. [ 4 ] What to do in this case?

There are a lot of juice packages from different manufacturers on the shelves of shops, but the technology of their preparation is such that diabetics should not drink them at all. First, water is evaporated from them and a concentrate is prepared, then they are restored, pasteurized and cooled. In the final product that reaches the consumer, there is little useful and a lot of sugar.

Freshly squeezed juices are allowed provided that their volume is obtained from the recommended amount of raw materials with a low glycemic index (GI) for diabetics, for example, two apples, one orange, etc. [ 5 ] Moreover, a recent study showed that consumption of green leafy vegetables and fruits was associated with a lower risk of developing diabetes, while consumption of fruit juices may be associated with an increased risk of developing diabetes among women. [ 6 ]

Tomato juice

Tomatoes are a low-calorie vegetable, they contain a lot of water and little sugar. Tomatoes are very useful for this disease, because they contain useful minerals: iron, magnesium, phosphorus, calcium, chromium; B vitamins, ascorbic acid; carotenes, antioxidants.

There is growing evidence that tomato consumption reduces the risk of cardiovascular disease due to its antioxidant, anti-inflammatory and hypotensive effects. [ 7 ]

The juice from them, which has not undergone heat treatment, has a beneficial effect on health due to its composition:

• the bright pigment lycopene counteracts cardiovascular diseases;
• phytoncides counteract inflammation and bacteria;
• serotonin regulates the functions of the nervous system;
• vitamins B1, B2, C improve metabolism;
• Calcium makes the walls of blood vessels more elastic and helps reduce blood pressure.

In addition, tomato juice cleanses the liver, reduces cholesterol, and saturates well. The recommended daily intake of tomatoes for patients is 300 g, and this is the amount from which the drink should be made.

Pomegranate juice

Natural pomegranate juice from ripe seeds-berries is rich in polyphenols with high antioxidant capacity, due to which its antidiabetic properties are manifested - it regulates the glycemic index. Observing patients, it was found that when drinking a drink with food with a high GI, blood sugar drops by a third. Limited studies on human and mouse models have shown that pomegranate juice has significant antiatherogenic, antioxidant, antihypertensive and anti-inflammatory effects. [ 8 ]

In addition, pomegranate contains many other substances that can support the body of a diabetic and prevent complications. It contains 15 types of amino acids, its tannins are an excellent disinfectant, it fights anemia, atherosclerosis, hypertension, and increases the elasticity of vascular walls. [ 9 ]

Drink it through a straw so as not to damage tooth enamel. It can be harmful to people with hyperacid gastritis, stomach ulcers, and constipation. It is important to listen to yourself and try small portions not on an empty stomach.

Carrot juice

Everyone knows from childhood about the role of carrots on visual acuity. Due to its low energy value and low carbohydrate content, carrot juice is the best choice for diabetics.

This drink has a beneficial effect on the immune and nervous systems, slows down the absorption of glucose, improves the digestive tract, and helps cleanse the body of toxins. The fruit contains a large group of vitamins B, A, K, PP, alpha- and beta-carotene, and a significant mineral composition. Drinking carrot juice can protect the cardiovascular system by increasing overall antioxidant status and reducing lipid peroxidation, regardless of any markers of cardiovascular risk. [ 10 ]

However, diabetics need to know their limits, and they should not exceed 200-250 ml of juice per day.

Apple juice

There are many different varieties of apples in nature. They are classified by ripening time, sweetness, hardness, juiciness and many other parameters. To obtain juice that is useful for diabetics, sour juicy and ripe fruits are suitable, and there is no need to peel them, because it contains many useful nutrients.

Freshly prepared apple juice will provide the need for vitamins A, C, B1, B2, B5, B6, folic acid, as well as iron, sodium, potassium, phosphorus, magnesium. The drink improves the condition of the skin, hair, nails, strengthens the heart muscle, blood vessels, activates the body's defenses, regulates bowel function, removes harmful substances, increases hemoglobin.

Although apple juice generally contains lower levels of phenols than whole apples, it is still a widely consumed source of dietary antioxidants.

The main class of phytochemicals commonly found in fruits and vegetables are flavonoids. Apples are a very important source of flavonoids in the diet in the United States and Europe. They are also a good source of antioxidants. Several studies have definitely linked apple consumption to a reduced risk of cancer, especially lung cancer, [ 11 ] a reduced risk of heart disease, [ 12 ] a reduced risk of asthma, and overall lung health. [ 13 ] The high content of quercetin, the main component of apple peel, has been shown to reduce the risk of type II diabetes. [ 14 ] Eating apples and pears has been shown to promote weight loss in middle-aged women. [ 15 ] Part of the protective effect of apples against heart disease may be due to their potential to lower cholesterol. [ 16 ]

Apples, and especially apple peels, have strong antioxidant activity and can significantly inhibit the growth of liver cancer and colon cancer cells. The antioxidant activity of 100 g of apples (about one serving of apple) is equivalent to about 1,500 mg of vitamin C. [ 17 ] Several studies have shown that apples have strong antiproliferative activity. [ 18 ]

Different apple varieties have different effects on liver cancer cell proliferation. At a dose of 50 mg/mL, Fuji apple extracts inhibited Hep G2 cell proliferation by 39%, while Red Delicious extracts inhibited cell proliferation by 57%. Unpeeled apples were significantly less effective in inhibiting Hep G2 cell proliferation compared to peeled apples, suggesting that apple peel has significant antiproliferative activity.[ 19 ]

Recently, crude extracts from unripe apples were found to actually inhibit the enzymatic activity of cholera toxin in a dose-dependent manner.[ 20 ]

You should refrain from it in the acute phases of gastritis, pancreatitis, and peptic ulcers.

Pumpkin juice

It contains several phytocomponents belonging to the categories of alkaloids, flavonoids and palmitic, oleic and linoleic acids. It has antidiabetic, antioxidant, anticarcinogenic, anti-inflammatory and other properties. [ 21 ]

Pumpkin is sweet in taste and has a high glycemic index. It would seem that this circumstance prohibits its consumption, but it turns out that the orange fruit stimulates the production of beta cells involved in the production of its own insulin.

Pumpkin juice has a general health effect on the body as a whole, and in particular, it burns fat and promotes weight loss, thanks to pectins it activates intestinal peristalsis and accelerates the cleansing of waste products, reduces the risk of atherosclerosis, stimulates the functions of the pancreas, removes fluid from the body, and is a preventative measure against cardiovascular pathologies.

Beetroot juice

The percentage of carbohydrates in beets is second only to dietary fiber (6.9% and 12.5%, respectively). This is undesirable, but on the other hand, the root vegetable contains a lot of silicon, chromium, manganese, cobalt, potassium, vitamins C, B, and other useful components in small quantities.

It is recommended for low hemoglobin, to normalize stool, and to reduce blood pressure. And fresh beetroot juice also has anti-cancer properties, so diabetics do not need to completely give it up, but only observe moderation (50 ml at a time).

Beetroot is also considered as a promising therapeutic agent for the treatment of several clinical pathologies associated with oxidative stress and inflammation. Its components, primarily betalain pigments, exhibit strong antioxidant, anti-inflammatory and chemopreventive activity. Beetroot consumption has beneficial physiological effects that may lead to improved clinical outcomes in several pathologies, such as hypertension, atherosclerosis, type 2 diabetes and dementia. [ 22 ]

Beetroot juice increases nitric oxide (NO), which has multiple functions related to increased blood flow, gas exchange, mitochondrial biogenesis and efficiency, and increased muscle contraction. These improvements in biomarkers suggest that beetroot juice supplementation may have an ergogenic effect on cardiorespiratory fitness.[ 23 ]

Immediately after receiving the drink, do not drink it, but let it sit in the refrigerator for 1-2 hours, since it contains volatile substances that cause nausea and vomiting.

Potato juice

Boiled potatoes are also considered a high glycemic index food due to their high content of rapidly digestible starch, long-term consumption of which will increase the risk of cardiovascular disease and type 2 diabetes. [ 24 ] White potatoes are also a concentrated source of vitamin C and potassium. [ 25 ] Although cooked potatoes are not recommended for diabetics due to their high starch content, raw potato juice is a healing remedy for many ailments.

In folk recipes it is prescribed to patients with gastritis, ulcers, pancreatitis, cholecystitis, helps with constipation, flatulence, treats pharyngitis and tonsillitis. Its effect on the body of a diabetic is healing, anti-inflammatory, with the exception of severe forms and low acidity of the stomach.

Take it in the morning on an empty stomach in a volume of a quarter of a glass for 2 weeks.

Jerusalem artichoke juice

Jerusalem artichoke or earth pear is a beneficial product for this endocrine disease, practically requiring no restrictions in consumption, it can replace potatoes in the diet. And all thanks to the inulin in it. Inulin consumption does not affect blood sugar levels and stimulation of insulin secretion, so it is suitable for the treatment of type 2 diabetes, obesity and other health conditions associated with high blood sugar. [ 26 ] Inulin is considered a prebiotic, which can affect both the composition and / or activity of the gastrointestinal tract microflora. [ 27 ]

Systemic consumption of Jerusalem artichoke juice reduces the load on the pancreas, increases the immune system, accelerates carbohydrate and lipid metabolism, and gradually reduces glycemic indices.

Before preparing the drink, the fruit is peeled, ground with a meat grinder or grated, then squeezed through cheesecloth. You can immediately prepare a glass, which will last for the whole day, and store in a cool place. 15 minutes before eating, drink a third of the volume. The treatment course lasts at least a month.

Grape juice

Recently, considerable interest has been focused on the bioactive phenolic compounds in grapes, as they have many biological properties such as antioxidant, cardioprotective, anti-cancer, anti-inflammatory, anti-aging, and antimicrobial. Research shows that consumption of polyphenol-rich foods improves vascular health, thereby significantly reducing the risk of hypertension and cardiovascular disease. [ 28 ]

Grapes are a sweet berry that does not meet the task of reducing sugar-containing products. Its GI, depending on the variety, ranges from 40 to 60 units, which is quite a lot for such patients. Despite all its benefits for healthy people, diabetics are best off giving up this drink.

An exception is red grapes, but it is recommended to eat no more than 12 berries per day. Dark grape juice has been shown to suppress platelet activity, have antiplatelet and antioxidant properties, and improve vascular endothelial function, [ 29 ] and improve immunity in healthy middle-aged people. [ 30 ] The flavonoids found in dark grapes, particularly Concord, are powerful antioxidants that can protect against oxidative stress and reduce the risk of free radical damage and chronic disease. [ 31 ]

Cabbage juice

Cabbage juice is a well-known healer of gastrointestinal pathologies. And it owes its reputation to a multitude of nutrients necessary for the body, including the rare vitamin U, which is a source of the amino acid methionine - an excellent protector from toxins and free radicals. Vitamin U prevents the development of histamine-induced peptic ulcers. [ 32 ]

Red cabbage, among various vegetables, is one of the main sources of anthocyanins, known for its protective role against oxidative stress of the heart and liver, has hypocholesterolemic, neuroprotective, nephroprotective and hepatoprotective activity. [ 33 ], [ 34 ] Reduces oxidative stress and increases the expression of endothelial NO synthase in blood vessels, ensuring vascular homeostasis. [ 35 ]

In addition, without this vitamin, B4 (choline) is not synthesized - a hepatoprotector, a substance that improves brain activity, the lack of which causes fatty liver, an increase in "bad" cholesterol, hypertension, fatigue, and irritability. The chemoprophylactic activity of cabbage against breast cancer has been proven. [ 36 ]

For diabetes, cabbage juice is also useful because it lowers blood sugar, has a diuretic effect, fights constipation, and promotes wound healing.

Drink freshly prepared juice 20-30 minutes before meals, three times a day, 200 ml at a time. It is not suitable for those suffering from colitis, spasms of the bile ducts and intestines. Fermented cabbage juice can serve as a healthy drink for vegetarians and consumers with lactose allergies. [ 37 ]

Burdock juice

Burdock is a common weed in our area, so it won't be difficult to improve your health with the help of the juice of its giant leaves in the summer season. Its use in cosmetology is more common; women use the roots to strengthen and beautify their hair.

Pharmacologically, it has been established that burdock has hepatoprotective, desmutagenic, antibacterial, gastroprotective, antihypoglycemic, antihypolipidemic, anti-inflammatory, antioxidant effects. It relieves fatigue, controls body weight, and is used as an aphrodisiac. [ 38 ]

Burdock root has been found to contain antidiabetic compounds, active ingredients, antioxidants that help improve blood circulation to the skin surface, improving skin health and treating skin conditions such as eczema. Burdock seeds have been found to contain active compounds that have anti-inflammatory effects and strong antiproliferative effects. Leaf extracts have been found to contain active compounds that can inhibit the growth of oral microorganisms. [ 39 ] Drinking burdock root tea can affect markers of inflammation and oxidative stress. [ 40 ]

Its positive role in diabetes is very high, especially type II, because it has the property of reducing blood glucose levels. Inulin improves the pancreas, accelerates the metabolism of fats and carbohydrates, fatty acids and oils promote skin regeneration, phytosterols reduce cholesterol, tannins have an antimicrobial and astringent effect, vitamin P has a beneficial effect on the peripheral circulatory system, carotene minimizes the risk of eye damage.

The juice is prepared from both leaves and roots, or they can be combined. Drink a tablespoon on an empty stomach 3 times a day. It should not be used by pregnant women, during breastfeeding, or combined with diuretics.

The most useful juice for diabetes

From all of the above it follows that the most useful juices for diabetes are homemade, freshly squeezed. Many diabetics share their experience and recommend making combined compositions, including greens: cilantro, dill, parsley, basil, celery, etc.

So-called green smoothies have reduced sugar levels and provide vitamins, fiber, micro- and macroelements.

Another option suitable for diabetics is a combination of fruit and vegetable juices; cucumbers, zucchini, and tomatoes can be used as raw materials for the latter, and they should predominate.

You need to experiment with different products, determining the appropriate taste qualities, while not forgetting to control glucose.