Turns out mangosteens have a unique interaction with insulin in the body:
· Mangosteens affect insulin resistance (and thus glucose intake) when consumed.
· When consumed with sugar by a diabetic or pre-diabetic, the biological result of that consumption could be manifestly changed by the combinatory effects of the mangosteen and the sugar together, as opposed to taking both separately. It would also be different than eating any other fruit with sugar.
· Were there to be a biological response, it would likely be acute (shock, dehydration, low/high blood sugar spikes) rather than any sort of chronic condition.
· Many Cambodians lack proper medical knowledge and facilities to treat diabetic emergencies which would be less severe in the states, meaning a case of abnormally high- or low-blood sugar could be life-threatening.
· Cambodia has a high and rising rate of diabetes, perhaps
partially attributable to the Khmer Rogue. A 2004 study found that up to
25% of adults in Cambodia had some sort of glucose intolerance, and two thirds were unaware of their condition.
So. It seems that in most cases, eating a mangosteen with sugar will not result in death. However, given the fragile balance of insulin and glucose that most diabetics must maintain in order to have good health, and given the high rate of diabetes, particularly undiagnosed diabetes, in Cambodia, it may not be such a good idea for a Cambodian to try it. In fact, it doesn't seem so strange that an undiagnosed diabetic eating a mangosteen with a heap of sugar on top could result in a medical emergency requiring treatment that may not be easily accessible in most parts of Cambodia.