Is Beet Juice Bad for Diabetics? Risks and Benefits

Beet juice is not bad for most people with diabetes, but the evidence that it actively helps blood sugar control is surprisingly inconsistent. A 2024 systematic review of 20 human studies found that red beetroot products “may help maintain the blood sugar levels of humans under different health conditions,” yet the overall results were conflicting enough that researchers could not draw firm conclusions about glycemic management.¹ The real picture involves trade-offs between beet juice’s natural sugar content, its nitrate-driven cardiovascular effects, and a handful of genuine risks that depend on your individual health profile.

The Blood Sugar Evidence Is a Mixed Bag

If you search for beet juice and diabetes, you will find bold claims in both directions. Some trials report genuine improvements in blood sugar markers, while others find no effect at all. The disagreement is not just internet noise; it shows up in the peer-reviewed literature itself, and it matters for understanding what beet juice can and cannot do for glycemic control.

On the positive side, a study of people with type 2 diabetes found that consuming raw red beetroot for eight weeks led to a meaningful drop in fasting blood sugar (about 13.5 mg/dL) and a small reduction in HbA1c of roughly 0.3 percentage points.² A separate pilot study found that a single dose of beetroot juice reduced total glucose exposure during an oral glucose tolerance test, suggesting an acute benefit on how the body processes a sugar load.³ Another small study echoed that finding, showing improved glucose responses at the 60-, 90-, and 120-minute marks after sugar intake.⁴

On the other hand, a 24-week randomized, double-blind trial giving inorganic nitrate to people with type 2 diabetes found no significant difference between the supplement group and placebo for any glycemic or lipid measure.⁵ A randomized trial using concentrated beetroot juice similarly came up empty: fasting plasma glucose, insulin, HbA1c, and insulin resistance all showed no significant change compared to control.⁶

Why the contradictions? Differences in dosage, duration, form of beetroot product (raw beets vs. juice vs. concentrated shots vs. nitrate capsules), and the health status of participants all play a role. The 2024 systematic review pointed to exactly these design variations as the likely reason the literature has not converged on a clear answer.¹ At this stage, the honest read is that beet juice is unlikely to worsen blood sugar in meaningful amounts, and it might modestly help, but it is nowhere near proven enough to treat as a glucose-lowering tool on its own.

How Much Sugar Is Actually in Beet Juice

This is the question that concerns most people with diabetes, and it is a practical one. A 100-milliliter serving of beetroot juice contains about 22.6 grams of carbohydrates, of which roughly 12 grams are sugars. The sugar breaks down to about 8.8 grams of sucrose, 2.5 grams of glucose, and under a gram of fructose.⁷ That is roughly comparable to what you would get from the same volume of apple juice, so beet juice is not a “free” drink if you are counting carbs.

In practice, though, most beet juice supplements designed for health benefits come in concentrated shots of 60 to 70 milliliters, not full glasses. At those smaller volumes, the carbohydrate load drops to about 13 to 16 grams per serving, which for most people with diabetes is manageable as long as it is counted into your daily carb budget. Where it gets trickier is with large servings of commercially sweetened beet juice blends, which can stack extra fruit sugars on top of the natural content. If you are buying beet juice off a shelf, check the label for added sweeteners.

The review literature suggests that despite this sugar content, persistent consumption of beetroot juice can delay the postprandial glycemic response and reduce the blood sugar peak after eating.⁷ In other words, the other compounds in beet juice, particularly nitrates, may partially counterbalance the sugar it contains. That is not a license to drink unlimited amounts, but it does mean a measured serving is unlikely to cause a dramatic spike for most people with type 2 diabetes.

Where Beet Juice Looks More Promising for Diabetics Is Heart Health

People with type 2 diabetes face roughly double the risk of cardiovascular disease compared to those without it, so any food that reliably improves heart-related markers is worth paying attention to. This is where beet juice has its strongest evidence, and the mechanism is better understood than its effects on blood sugar.

Beet juice is one of the richest dietary sources of inorganic nitrate. When you drink it, bacteria on your tongue convert nitrate to nitrite, which your body then converts to nitric oxide, a molecule that relaxes and widens blood vessels. A trial in people with type 2 diabetes found that dietary nitrate supplementation reduced both peripheral systolic blood pressure and central systolic blood pressure, while placebo had no effect.⁸ Central blood pressure, which reflects the pressure your heart and brain actually experience, is considered a better predictor of cardiovascular events than the number you see at the doctor’s office, so that finding carries real weight.

A systematic review and meta-regression looking more broadly at beetroot nitrate supplementation found that it reduced arterial stiffness (measured by pulse wave velocity, which dropped about 0.27 m/s) and improved blood vessel function (flow-mediated dilation increased by about 0.6 percentage points).⁹ These are modest-sounding numbers, but arterial stiffness is a strong independent predictor of heart attacks and strokes, and even small improvements accumulate over time.

The pilot study that showed improved glucose response in people with type 2 diabetes also found that beetroot juice reduced systemic vascular resistance, which is essentially how hard the heart has to push against the blood vessel walls. The effect size was large enough that researchers described it as meaningful.³ For someone with diabetes, that combination of lower blood pressure, better vessel flexibility, and reduced vascular resistance could matter more in the long run than any modest blood sugar effect.

It Does Not Appear to Help with Exercise Performance in Diabetes

Beet juice has a strong reputation in the athletic performance world, where studies in healthy young people show it can reduce the oxygen cost of exercise and improve endurance. You might reasonably expect that benefit to extend to people with diabetes, who often struggle with exercise tolerance. Unfortunately, that does not seem to be the case.

A randomized, double-blind crossover trial in people with type 2 diabetes found that beetroot juice supplementation did not reduce the oxygen cost of moderate-paced walking and did not improve distance covered in a six-minute walking test.¹⁰ The researchers concluded that dietary nitrate supplementation simply does not modulate the exercise response in people with type 2 diabetes the way it does in healthy individuals. This may be because the nitric oxide pathway is already impaired in diabetes, so providing more raw material (nitrate) does not fully overcome the bottleneck. Whatever the reason, if you are drinking beet juice expecting to feel more energetic during workouts, the evidence suggests you will be disappointed.

Oxalate Content and Kidney Risk

This is the risk that gets the least attention but matters the most for a specific group of people with diabetes. Beetroot juice is high in oxalates, compounds that bind with calcium in the body and can contribute to kidney stone formation. Measured concentrations in commercial beetroot juices range from about 60 to 70 milligrams of total oxalate per 100 milliliters.¹¹ That puts beet juice among the highest-oxalate beverages commonly consumed, second only to rhubarb nectar in the same analysis.

Why does this matter more for people with diabetes? Diabetes is one of the leading causes of chronic kidney disease. If your kidneys are already under strain, adding a concentrated oxalate load can increase the risk of kidney stones and potentially worsen kidney function over time. For someone with healthy kidneys, the oxalate in a daily shot of beet juice is unlikely to cause problems. But if you have diabetic nephropathy or a history of calcium-oxalate kidney stones, beet juice is one of the dietary sources worth discussing with your doctor before adding to a daily routine. This is not a blanket reason to avoid it; it is a context-dependent risk that applies to a subset of people with diabetes.

Mouthwash Can Block Beet Juice’s Benefits

This is one of the more surprising findings in the beet juice research, and it has direct practical implications. The nitrate-to-nitric-oxide conversion that drives most of beet juice’s cardiovascular benefits depends on bacteria that live on the surface of your tongue. If you kill those bacteria with antibacterial mouthwash, you short-circuit the entire process.

A study comparing obese and non-obese adults found that rinsing with antibacterial mouthwash before consuming beet juice with carbohydrates reduced insulin sensitivity in the obese group. The Matsuda Index, a measure of insulin sensitivity, dropped from about 5.7 to 4.9 in obese adults who used mouthwash, while non-obese adults were not significantly affected.¹² The implication is that the oral bacteria are not just important for blood pressure effects; they may also influence how your body handles the glucose that comes with beet juice.

For someone with diabetes who is already overweight (which describes a majority of people with type 2 diabetes), using chlorhexidine-based mouthwash regularly might be undermining both the blood pressure and the metabolic effects of dietary nitrate. This does not mean you should stop using mouthwash for dental health, but it is worth being aware that the timing matters. If you drink beet juice for its health effects, doing so right after gargling with antibacterial mouthwash is likely counterproductive.

Antioxidant Compounds in Beets and What We Know from Animal Studies

Beyond nitrates, beet juice contains betanin, the pigment responsible for that deep red color. Betanin belongs to a family of antioxidants called betalains, and there is growing interest in whether these compounds have anti-diabetic effects independent of the nitrate pathway.

In animal research, betanin has shown real promise. A study in diabetic rats found that betanin treatment activated a cellular energy-sensing pathway (AMPK and SIRT1) while dialing down an inflammatory signaling molecule (NF-κB).¹³ In practical terms, those pathways control how cells use glucose and how much inflammation they produce, both of which are central to type 2 diabetes. The raw beet study that found reduced fasting blood sugar and HbA1c in humans also reported a significant increase in total antioxidant capacity, suggesting that betalains may be doing real work in people too.²

The caution here is that animal studies often do not translate cleanly to humans, and the doses of purified betanin used in rat studies do not map neatly onto what you get from drinking a glass of beet juice. Still, the combination of nitrate-driven vascular effects and betalain-driven antioxidant effects gives beet juice a more interesting biochemical profile than most vegetable juices. The science has not caught up to the hype, but the mechanisms are plausible enough that continued research is warranted.

Practical Considerations for Including Beet Juice in a Diabetic Diet

If you have type 2 diabetes and want to try beet juice, a few practical points are worth keeping in mind. Concentrated beet juice shots (typically 60 to 70 milliliters) deliver meaningful amounts of nitrate with a lower carbohydrate load than drinking a full glass. Count the carbs into your meal plan the way you would count a small piece of fruit. Avoid commercially sweetened beet juice blends that add apple, grape, or cane sugar on top of what is already a moderately sugary vegetable juice.

Monitor your blood sugar more closely for the first few days after adding beet juice. The studies showing improved glucose tolerance and the ones showing no effect are hard to reconcile at the population level, which means individual responses may vary significantly. Your glucose meter will tell you more about how your body handles it than any study can.

If you take blood-pressure-lowering medication, be aware that beet juice’s blood-pressure-reducing effects could add to what your medication is already doing. This is usually a mild effect, not dangerous, but if you are already prone to dizziness or low blood pressure, it is worth mentioning to your doctor. The same goes for anyone on anticoagulants, since beet juice is high in vitamin K, which can affect blood-clotting dynamics.

One harmless but startling side effect worth knowing about: beet juice can turn your urine and stool a deep red or pink color, a phenomenon called beeturia. It is completely benign and affects roughly 10 to 14 percent of the population, but if you are not expecting it, it can look alarming enough to prompt an unnecessary trip to the emergency room. Now you know.

Raw Beets vs. Juice vs. Supplements

The form of beetroot you consume likely matters. The study that found the most consistent metabolic improvements, including reduced fasting blood sugar, lower HbA1c, and improved antioxidant capacity, used raw red beetroot rather than juice.² Raw beets retain their fiber, which slows sugar absorption and reduces the glycemic impact compared to juice, where the fiber has been removed. That roughly one gram of dietary fiber per 100 milliliters of juice is not much to buffer the 12 grams of sugar it accompanies.⁷

Concentrated nitrate supplements (capsules or powders) strip out most of the sugar while preserving the nitrate content. If your primary goal is the cardiovascular benefit, these may be a better option for blood sugar management than drinking juice. However, they also strip out the betalains and other whole-food compounds that may contribute additional anti-inflammatory and antioxidant effects. There is no head-to-head trial comparing nitrate capsules to whole beet juice in a diabetic population, so the choice comes down to what trade-off you prefer: lower sugar with fewer accessory compounds, or a full-spectrum food with a carb cost attached.

Roasting or boiling beets changes the equation again. Cooking reduces some of the nitrate content but retains fiber and betalains. Pickled beets, popular in some diets, often come loaded with added sugar, making them a poor choice for diabetes management despite looking like a vegetable serving. As with most nutritional questions, reading the label matters more than following a blanket rule about beets being “good” or “bad.”