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People with diabetes often hear that they should not eat sweet foods because these can cause spikes in blood sugar. Could honey be a healthful alternative to the sugar in sweets and snacks?

A person's glucose, or blood sugar, level refers to how much sugar is in their bloodstream. Sugar is the body's primary source of energy.

The pancreas secretes insulin, a hormone, to keep blood sugar at safe levels. In a person with diabetes, the body either cannot use insulin correctly or it cannot produce enough.

How honey affects people with diabetes remains unclear. Some studies suggest that, in moderation, it may be useful for those with type 2 diabetes.

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Honey is a natural sweetener that may offer health benefits for people with diabetes.

Raw honey starts out as flower nectar. After bees collect the nectar, it naturally breaks down into simple sugars, which bees store in honeycombs.

The honeycombs cause the nectar to evaporate, creating a thick, sweet liquid. This is honey.

Honey, like other types of sugar, is a dense source of carbohydrates. Most of these carbs are in the forms of glucose and fructose, which are simple sugars.

Unlike refined white sugar, honey also contains vitamins, minerals, and antioxidants.

Processed vs. raw honey

Most of the honey available today is processed, which means that the manufacturer has heated and filtered it. This strips away some of the honey's nutritional value and potential health benefits.

However, raw honey retains these properties. Raw, local honey may, for example, help with seasonal allergies.

According to a 2018 review published in Oxidative Medicine and Cellular Longevity, switching from refined sugar to honey may help keep blood glucose levels down.

The researchers attribute this to honey's lower glycemic index (GI) score and its ability to reduce inflammatory markers and improve levels of cholesterol.

Doctors are not likely to recommend switching to honey as a person's only diabetes management tactic. It will not replace medications or healthful lifestyle practices.

Babies younger than 1 year should not eat raw honey. Doing so can put them at risk of botulism, a kind of food poisoning that can be life-threatening.

Raw honey, much like white sugar, is a sweetener that contains carbohydrates and calories.

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Honey is a type of sugar, so people should use it in moderation.

A tablespoon of honey, weighing about 21 g, has about 64 calories, while 21 g of granulated white sugar contains 80 calories.

This amount of honey also contains:

  • 3.59 g of water
  • 17.25 g of sugar
  • 11 milligram (mg) of potassium
  • 1 mg of calcium
  • 1 mg of phosphorus
  • 1 mg of sodium
  • 0.05 mg of zinc
  • 0.1 mg of vitamin C

It also contains some B vitamins.

Sugar contains almost no other nutrients.

Another big difference between white sugar and honey concerns digestion. The body breaks down honey using enzymes that exist in the honey, while digesting sugar requires enzymes from the body.

An additional difference relates to the GI. This index measures the extent to which a particular carbohydrate raises blood sugar levels. Foods with high GI scores tend to elevate levels quickly and significantly but contain little nutritional value.

According to a study published in 2018, honey has a GI score of 58, while sugar's GI score is 60.

Several studies have found that eating honey may increase insulin levels and decrease levels of blood sugar.

Possible hypoglycemic impact

A small study from 2004 investigated honey and sugar's effects on blood glucose levels.

The researcher found that a solution containing 75 g of honey raised blood sugar and insulin levels in people with and without type 2 diabetes within 30 minutes. An equivalent solution containing dextrose raised blood sugar levels slightly higher.

Within 2 hours, the levels fell, and they fell lower and remained lower in the honey group, compared with the dextrose group.

The researcher suggested that honey may increase insulin levels. This would explain why, although blood sugar levels rose in both groups, they fell further in the honey group.

Improved measurements of diabetes

A review published in 2017 also explored the connection between honey and blood glucose in people with diabetes.

The authors found that honey had the following effects:

  • Honey decreased fasting serum glucose, which a doctor measures after a person has fasted for at least 8 hours.
  • It increased levels of fasting C-peptide, which helps the pancreas know how much insulin to secrete and plays a crucial role in keeping blood sugar levels stable in a healthy range.
  • It increased 2-hour postprandial C-peptide levels, which indicate the amount of peptide after a person eats.

Future therapeutic effect

In 2012, a study involving 50 people with type 1 diabetes found that, compared with sucrose, honey was less likely to raise blood sugar levels. The research team concluded that honey might, one day, have a role in treating the beta cells of the pancreas, which are responsible for producing insulin.

In 2018, a review of studies concluded that honey may be useful for treating type 2 diabetes, as it may have a hypoglycemic effect. In other words, it may help lower blood sugar.

However, the researchers caution that confirming these effects and establishing the beneficial dosages will require more studies in humans and long-term investigations.

Effect on long-term blood glucose levels

An 8-week study involving 48 people in Iran found that consuming honey did not appear to raise fasting blood sugar levels. Participants who ate honey also lost weight and had lower blood cholesterol levels.

The researchers also tested the participants' hemoglobin. Hemoglobin is a protein that carries oxygen to the body's cells. When glucose enters the cells, it joins with hemoglobin.

By measuring how much hemoglobin is combined with glucose, in a hemoglobin A1C test, a doctor can estimate a person's average blood glucose levels over the last few months.

A person with more hemoglobin A1C has a higher risk of diabetes and is likely to be receiving poor blood glucose management.

The researchers noted that participants in the honey group had an increase in hemoglobin A1c, suggesting a long-term rise in blood glucose levels. For this reason, the team recommended "cautious consumption" of honey among people with diabetes.

Antimicrobial and anti-inflammatory properties

Other studies have suggested that honey may have additional benefits because it contains antimicrobial, antioxidant, and anti-inflammatory properties.

A review published in 2017 looked at the potential roles of honey in healing. The authors noted that, in people with type 2 diabetes, doctors may one day use honey to lower blood sugar levels, reduce the risk of complications related to diabetes and metabolic disease, and help heal wounds.

In 2014, researchers in Greece published similar findings, noting that honey might help to fight the inflammatory processes that occur with diabetes, atherosclerosis, and cardiovascular disease, all of which are features of metabolic syndrome.

Complementing diabetes medication

Authors of another study from 2014 reported that combining diabetes medications with honey could be beneficial, and they called for further studies to confirm their findings.

Get some tips here on natural ways to improve insulin sensitivity.

Honey may be a healthful substitute for refined sugars, such as white sugar, turbinado, cane sugar, and powdered sugar.

However, people should use it in moderation. It, too, can cause blood sugar levels to spike, especially when a person uses honey in addition to, rather than instead of, another form of sugar.

Some manufacturers produce honey that is not pure and may contain added sugars or syrups.

It is also important to note that raw honey can contain a toxin that can cause botulism or otherwise be dangerous for infants younger than 1 year.

While honey provides nutrients, other foods, such as fresh fruits and vegetables, are better sources of these, and they also provide more fiber and water, minimizing any hike in blood sugar levels.

People with diabetes should consume sweeteners of any kind as infrequently as possible because frequent blood sugar spikes can cause diabetes to progress more rapidly.

For those who would like to try raw honey, various products are available for purchase online.

Click here to find out more about which sweeteners are suitable for people with diabetes.

Carbohydrates break down into sugar during digestion and provide the body with most of its energy.

How many carbohydrates can a person with diabetes eat?

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Honey contains carbohydrates and can raise a person's blood sugar levels.

The National Institute of Diabetes and Digestive and Kidney Diseases recommend that carbohydrates make up 45–65 percent of a person's recommended daily caloric intake.

According to the Institute of Medicine's Food and Nutrition Board, the medical community has not set a recommended daily amount of carbohydrates, fats, and protein for people with diabetes. The right amounts depend on the individual.

Determining how many carbs to consume involves many considerations, including:

A person with diabetes should work with their healthcare team to figure out the right amount for them.

Once a person knows how many carbs they should be eating each day, they can adjust food choices and portion sizes accordingly.

It is also important to note that the type, as well as the amount, of carbs influences blood sugar levels. Healthcare professionals can help determine each individual's carbohydrate requirements.

Fiber intake is crucial in managing post-meal blood sugar spikes. Each meal should contain plenty of fiber.

The daily recommended fiber intake is:

  • for females aged 19–30 years: 28 grams (g)
  • for males aged 19–30 years: 33.6 g

Generally, if a person eats three meals a day, each should contain 8.5–11.2 g of fiber to meet daily fiber needs and help manage blood sugar levels.

The majority of a person's carb intake should comprise healthful, unprocessed, high-fiber carbohydrates. These are in whole grains, such as barley, and in wholemeal bread, legumes, peas, whole oats, and whole fruits and vegetables.

Honey may have many health benefits. Compared with other forms of sugar, it may promote higher levels of insulin and lower levels of blood sugar.

However, confirming that it is a safe alternative for people with diabetes requires more research.

It is best to replace other sugars with honey, rather than using honey as an additional sweetener. Consume it in moderation, and if it causes a significant boost in blood sugar levels, stop using it.

People with diabetes should speak to a doctor before adding more honey to their diet.

Q:

Do you recommend that people with diabetes eat honey, or should they avoid it?

A:

I advise everyone to consume the least amount of sweeteners possible, whether from natural or processed sugars.

The more frequent exposure the palate has to sweet flavors, the more the palate desires sweetness, so I am a fan of eating fewer sweetened foods, in general.

That said, if a person does sweeten foods, raw, unpasteurized, local honey can be a great replacement for refined sugars, and it has potential benefits.

I also recommend stevia and erythritol as occasional sweeteners that help people with diabetes to manage their carbohydrate intake and blood sugar levels.

Natalie Butler, RD, LD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.