Diabetes has become a global health concern, with its prevalence rapidly increasing from approximately 9.3% of the global population in 2019 (463 million people) to a predicted total of 578 million by 2030. An additional 122 million people globally could be affected by the disease by 2045.
Statistically, diabetes is more common in cities than in rural areas, being 3% higher in cities. Diabetes is more prevalent in higher-income countries than in lower-income ones by over 6%. The surprising fact is that many people living with the disease don’t know they have it! Roughly 1 in 2 people are unaware of it.1
Dragon fruit has been widely studied to show the link between consumption and diabetes management. Dragon fruit could benefit people who may be suffering from diabetes as it has the potential to influence inflammatory and oxidative processes involved in many diseases.2
What is diabetes?
Diabetes, in full form diabetes mellitus, is a metabolic disease in which blood glucose levels are abnormally raised. There are different types such as:3
- Type 1
- Type 2
- Maturity-onset diabetes of the young (type 2 diabetes in young people)
- Gestational diabetes(during pregnancy and often goes away after that period)
- Neonatal diabetes(diabetes that occurs within the first 6 months of life)
- Secondary causes (for example, endocrinopathies and steroid uses)
Type 1 and 2 diabetes are the most common forms. Type 1 diabetes typically occurs more in children or teens, while type 2 is seen in adults and the elderly who have had a prolonged experience with hypoglycemia. Both types have various symptoms and treatments.
Causes and risk factors
Type 1 diabetes is known as an autoimmune disease.4 This means your system is self-destructive in this process. Your pancreas, found near the stomach, contains pancreatic cells which produce insulin (a hormone which helps your body use sugar correctly).In type 1 diabetes, the pancreatic cells are destroyed by your immune system as it wrongly targets and kills those cells, thus no longer producing insulin.
The loss of insulin production means your blood sugar can no longer be controlled, hence leading to a type 1 diabetes diagnosis. Type 2 diabetes is usually characterised by insulin resistance, which is when body cells do not respond effectively to insulin and/or the pancreas does not produce enough insulin to compensate for high blood sugar levels after eating.
Risk factors for diabetes
- Risk increases with age
- Background – African Caribbean, Black African, Chinese or South Asian
- Genetics – two to six times more likely to get type 2 diabetes if a sibling or parent has it
- High blood pressure is a common risk factor
- High waist measurement
Importance of diabetes management
Managing your diabetes is very important as having your blood pressure and cholesterol under control means you can prevent further health complications and symptoms.5
About dragon fruit
Dragon fruit is also called strawberry pear or pitaya with a pink scaly outer and white flesh with black seeds on the inner. Dragon fruit is a tropical fruit.
The nutritional values in dragon fruit (1 cup serving) are the following:
- 103 calories
- 0g fat
- 27.4g carbs
- 5.6g fibre
Dragon fruit is also rich in antioxidants, which neutralise free radicals (damage-causing molecules).
The fruit was traditionally harvested in Latin America, including Costa Rica, Colombia, Mexico and Nicaragua.6 Within Chinese culture, good luck is brought to those who consume the fruit and evil spirits are thought to be warded off. The pink of the dragon fruit symbolises prosperity and so for these reasons, it is often exchanged to family and friends as gifts during special occasions. You may be thinking where the name comes from; it’s simply to do with the fact that the spikes and scales depict the characteristics of a dragon that is commonly shown in Chinese mythology.
Dragon fruit and diabetes
The speed at which a food raises blood sugar levels is measured by the glycemic index (GI)
- Foods with a high GI are rapidly digested and absorbed, creating a quick spike in blood sugar levels
- Foods with a lower GI are absorbed and digested slower hence a slower rise in blood sugar levels
In diabetes, repeated rapid spikes, known as hyperglycaemia, in blood sugar can be harmful and can cause long-term damage to hands and feet or create life-threatening conditions like diabetic ketoacidosis.
Dragon fruit contains a low GI, making it a good fruit for people with diabetes. High fibre in the fruit increases the time it takes for sugar in the bloodstream to be absorbed, so again, this is great news for people with diabetes. Dragon fruit is rich in antioxidants and is nutrient-dense. This means it can help in the reduction of inflammation and further prevent damage done by free radicals.
- Diabetes sufferers are often at risk of developing complications due to oxidative stress, so dragon fruit is beneficial in reducing it
- Contains vitamins C, B6, iron and Calcium to maintain health, especially as with diabetes, you become at risk of nutrient deficiencies
Ways of incorporating dragon fruit into your diet
Since dragon fruit can be eaten raw, frozen, fresh and dried, there’s a variety of ways you can incorporate it into your diet! You can enjoy it in these ways:
- As an everyday snack7
- In cocktails
- In a fruit bowl
The difference between fresh and dried dragon fruit just like any dried fruit, is that it undergoes a drying process in which the water is removed. This can be added to anything like cereals or enjoyed as a topping. If you are a diabetic, the best way to combine dragon fruit into your diet is in its raw form, unsweetened. Add it in any way as mentioned above, or you can get creative.
How much dragon fruit is excessive?
Serving size is always dependent on age and health status but generally, adults are recommended to consume 2-3 fruit servings daily. There is no limit as such to fruits, but in some cases, people experience diarrhoea, stomach upset or allergic reactions with excessive consumption.8 Studies have shown the red dragon fruit reduced blood sugar levels while also lowering systolic and diastolic blood pressure in respondents of the study.9
As mentioned previously, due to dragon fruit having a low GI index (being digested and absorbed slowly), energy release is slower and so individuals remain feeling fuller for longer. Consuming foods with a high GI index means you snack less and feel more satisfied for longer, hence contributing to weight loss. This is good news if you’re a diabetes patient since weight gain is a risk factor for health complications.
Cardiovascular disease is common within autoimmune patients, it is observed in diabetic type 1 and type 2 patients. Oxidative stress is an important trigger in these diabetes-associated complications.10 Antioxidants have been shown to be effective against cardiovascular issues due to the overproduction of reactive oxygen molecules. Dragon fruit being rich in antioxidants means regular intake can reduce the risk of cardiovascular disease.
Considerations and side effects
As with any informational guidance, this does not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions or interactions. It is recommended that you refer to this as guidance only, consulting a health professional if required and that you monitor any changes after a change in diet.
- Look out for any allergic reactions to the fruit, as this is possible, although uncommon
- Excessive consumption may lead to minor side effects such as upset stomach and diarrhoea
Since diabetic medications are used to lower blood sugar levels, consuming dragon fruit alongside it has the risk of dropping your blood sugar too low.
- With diet changes, it is important to monitor blood sugar closely and your doctor may advise altering the dose of medication given
- Medications used for diabetes include insulin, metformin, glimepiride, glyburide and others
Alongside your diet, another equally important factor in managing diabetes is a healthy lifestyle. This includes exercise and forms of physical activity.
Studies11 have shown that compared to individuals considered to have a less healthy lifestyle, the healthier individuals had a 75% reduced risk of diabetes.
The holistic aim of diabetes management is the balancing of multiple risk factors rather than concentrating on just one.
Stress management is also great for diabetics. Effective management of stress has been shown to have a positive impact on controlling diabetes.12 Also, sleep is another amazing tool for blood sugar control. Poor diabetes management and insufficient sleep quality have been linked.
The trial in this study is underway as of yet13 however it is obvious that good sleep provides the energy required to make day-to-day healthy choices such as going to the gym and eating consciously.
Dragon fruit is great for managing diabetes naturally, from its nutritional value to strengthening your immune system. Most significantly, it has a low GI index and is diverse in the way you can incorporate it into your diet, a great option for diabetic patients or even just those people who want to maintain good health!
Creating a personalised diabetes management plan with a healthcare professional will allow you to control your diabetes better while being able to pick what you enjoy eating or don’t. This way, you’re more likely to want to stick at it. Be sure to explore the many other dietary options available with professional guidance, as there are many other nutritional foods similar to dragon fruit for you to benefit from and manage your diabetes naturally.
- Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019 Nov;157:107843.
- Nishikito DF, Borges ACA, Laurindo LF, Otoboni AMMB, Direito R, Goulart R de A, et al. Anti-inflammatory, antioxidant, and other health effects of dragon fruit and potential delivery systems for its bioactive compounds. Pharmaceutics. 2023 Jan 3;15(1):159.
- Sapra A, Bhandari P. Diabetes. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Sep 19]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK551501/
- Lucier J, Weinstock RS. Type 1 Diabetes. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Sep 19]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK507713/
- Managing diabetes - niddk [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. [cited 2023 Sep 21]. Available from: https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes
- Paśko P, Galanty A, Zagrodzki P, Luksirikul P, Barasch D, Nemirovski A, et al. Dragon fruits as a reservoir of natural polyphenolics with chemopreventive properties. Molecules [Internet]. 2021 Apr 9 [cited 2023 Sep 21];26(8):2158. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070077/
- Can i eat dragon fruit every day? Nutrient chart, health benefits [Internet]. MedicineNet. [cited 2023 Sep 21]. Available from: https://www.medicinenet.com/can_i_eat_dragon_fruit_every_day/article.htm
- Lykins T. Overload: major side effects of eating too many dragon fruits [Internet]. Fischer Institute. 2023 [cited 2023 Sep 21]. Available from: https://fischerinstitute.com/side-effects-eating-too-many-dragon-fruits/
- Siti F, Adi S, Furaida K, Dedeniwa S, Nazwar Hamdani R. Dragon Fruit (Hylocereuspolyrhizus) Effectively Reduces Fasting Blood Sugar Levels and Blood Pressure on Excessive Nutritional Status. Pakistan Journal of Medical and Health Sciences. 2020 Jun;14(2).
- Anand Swarup KRL, Sattar MA, Abdullah NA, Abdulla MH, Salman IM, Rathore HA, et al. Effect of dragon fruit extract on oxidative stress and aortic stiffness in streptozotocin-induced diabetes in rats. Pharmacognosy Res [Internet]. 2010 [cited 2023 Sep 21];2(1):31–5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140125/
- Zhang Y, Pan XF, Chen J, Xia L, Cao A, Zhang Y, et al. Combined lifestyle factors and risk of incident type 2 diabetes and prognosis among individuals with type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. Diabetologia. 2020 Jan;63(1):21–33.
- Eshete A, Mohammed S, Deresse T, Kifleyohans T, Assefa Y. Association of stress management behavior and diabetic self-care practice among diabetes type II patients in North Shoa Zone: a cross-sectional study. BMC Health Serv Res. 2023 Jul 19;23(1):767.13.
- Martyn-Nemeth P, Duffecy J, Quinn L, Reutrakul S, Steffen AD, Burke L, et al. Sleep optimization to improve glycemic control in adults with type 1 diabetes: study protocol for a randomized controlled parallel intervention trial. Trials [Internet]. 2022 Aug 19 [cited 2023 Sep 21];23:686. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9389486/