Apples vs pears: which is better for diabetes?

The short answer

Neither is clearly better — pick the one you enjoy, and eat it whole. A medium apple and a medium pear weigh about the same and carry almost the same carbohydrate: roughly 21 g once the fibre is taken off. Both have a low glycaemic index, so they raise blood sugar slowly, and in large long-term studies both are linked with a lower risk of type 2 diabetes.

If you want a tie-breaker: pears have a little more fibre, which slows digestion and helps fullness; apples have more research behind them, including trials showing that an apple eaten before a meal softens the rise in blood sugar afterwards. For most people with diabetes, how much fruit you eat, when you eat it and whether it is whole or juiced matter far more than which of the two you choose.

This article is general information, not medical advice. If you take insulin or medicines that can cause low blood sugar, your diabetes team can help you fit fruit into your carbohydrate plan.

Apple vs pear: the numbers side by side

Per medium fruit	Apple (182 g)	Pear (178 g)
Calories	95 kcal	101 kcal
Total carbohydrate	25 g	27 g
Fibre	4.4 g	5.5 g
Net carbohydrate (total minus fibre)	20.6 g	21.5 g
Sugars	19 g	17 g
Glycaemic index	36 (low)	About 38 (low)
Glycaemic load, one fruit	About 7 (low)	About 8 (low)

Nutrients are from USDA FoodData Central for raw fruit with the skin. The glycaemic index figures come from the international GI tables, which average many tests; individual varieties and ripeness move them a few points either way. The glycaemic load, which combines how fast a food raises blood sugar with how much carbohydrate a portion contains, is our calculation from those figures.

The differences are small enough to be swamped by fruit size. A large apple can easily carry more carbohydrate than a small pear, and the other way round. Weighing or comparing sizes a few times is more useful than choosing between the two fruits.

Why both are good choices for blood sugar

Low glycaemic index and load

Foods with a glycaemic index of 55 or under are classed as low, and apples and pears sit well below that. Three things keep them there: their fibre, especially soluble pectin, slows digestion; a large share of their sugar is fructose, which raises blood glucose far less than glucose does; and the fruit has to be chewed and broken down. Their glycaemic load per fruit — about 7 to 8 — is also low, where 10 or under counts as low.

Fibre, and the skin

Much of the fibre in both fruits is in or just under the skin, so peeling them removes a good share of what slows the sugar down. Pears also contain gritty “stone cells”, which add insoluble fibre. Guidance around the world asks adults for 25 to 30 g or more of fibre a day, and people with diabetes are encouraged to aim at least as high.

They are linked with lower diabetes risk

In a 2013 analysis of three large US cohorts — more than 187,000 people followed for decades — eating more whole apples and pears was linked with a slightly lower risk of type 2 diabetes, while more fruit juice was linked with a higher risk. In a study of half a million adults in China, people with diabetes who ate fresh fruit more often had lower rates of death and of complications affecting the heart and blood vessels. These are observational studies: they show links, not proof that fruit caused the benefit, but none of them suggests whole fruit is harmful.

Where apples edge ahead: the evidence

Apples have been tested directly for their effect on blood sugar after meals. In a 2019 randomised crossover study, eating an apple before a rice meal roughly halved the rise in blood sugar compared with the rice meal on its own, and a 2023 follow-up found an apple first lowered the peak by about a third at breakfast, lunch and supper. Both studies were small and in people without diabetes, so they suggest a strategy rather than prove it — but pears have not been tested this way at all.

Apples also have a longer-term trial behind them: in a 2020 study, two apples a day for eight weeks lowered LDL cholesterol a little in adults with mildly raised cholesterol. Heart health matters in diabetes, because the condition raises the risk of heart disease.

Where pears edge ahead

Pears have about a quarter more fibre per fruit and slightly less sugar. Their main trial, a 2019 study in adults with metabolic syndrome — a cluster of risk factors that often comes before type 2 diabetes — found that two pears a day for 12 weeks lowered systolic blood pressure from where it started, while a calorie-matched drink did not. Blood pressure control is one of the most important parts of diabetes care.

Pears also contain more sorbitol, a sugar alcohol with little effect on blood glucose. It helps keep bowels regular, but it can cause wind and loose stools in some people.

Do you need to cut back on fruit?

Usually not. In a 2013 randomised trial, 63 adults with newly diagnosed type 2 diabetes were advised either to eat at least two pieces of fruit a day or no more than two. After 12 weeks, HbA1c — the main measure of long-term blood sugar — fell by the same amount in both groups, and weight and waist size did not differ. The researchers concluded that fruit should not be restricted in type 2 diabetes.

Both the American Diabetes Association and Diabetes UK encourage fruit as part of a healthy diet for people with diabetes, favour whole fruit over juice, and suggest spreading fruit through the day rather than eating a lot at once.

How to eat apples and pears with diabetes

• Count it as carbohydrate. A small apple or pear is about 15 g of carbohydrate; a medium one about 20 to 25 g; a large one more. If you count carbohydrates for insulin, weigh a few to learn your usual sizes.
• Eat it whole, with the skin. The skin holds much of the fibre. Wash the fruit well instead of peeling it.
• Pair it with protein or fat. An apple or pear with a handful of nuts, some cheese or plain yoghurt raises blood sugar more gently than the fruit alone and keeps you fuller.
• Try it before or with a meal. The apple studies suggest fruit eaten first can soften the rise after a starchy meal. Check your own response with your meter or sensor.
• Spread it out. One piece at a time, across the day, rather than several at once.
• Skip the juice, and go easy on dried and tinned fruit. Juice has lost the fibre and its sugars count as free sugars. Dried fruit concentrates the sugar into a small portion, and tinned fruit in syrup adds more — choose fruit tinned in juice or water, drained.

Who should take extra care

• People on insulin or sulfonylureas. Fruit is carbohydrate and should be counted in your plan; ask your diabetes team if you are unsure how.
• People treating a low. Apples and pears are too slow to treat hypoglycaemia. Use fast-acting glucose as your team advises.
• People with IBS. Both fruits are high in fructose and sorbitol and are common triggers. Smaller portions, or lower-FODMAP fruit such as oranges, kiwi or berries, may suit you better.
• People with kidney disease. Apples and pears are relatively low in potassium, but if you have been told to limit potassium, check portion sizes with your dietitian.

The bottom line

For diabetes, apples and pears are close to a tie: similar carbohydrate, both low glycaemic index and load, and both linked with better outcomes. Choose pears for a little more fibre, apples for the stronger evidence on after-meal blood sugar — or, better, eat both. Keep them whole, count them in your carbohydrate plan, and pair them with protein.

To see how apples and pears compare with other fruits, read fruit and diabetes: the glycaemic index and load of 12 common fruits. For more on each fruit, see what happens when you eat two apples a day for a week and two pears a day for a week.