People with diabetes are often told they should not eat sweets and other foods that contain sugar because they may cause a spike in blood sugar levels. So, could honey be a healthful alternative to sugar-filled sweets and snacks?

Blood sugar (glucose) levels are the amounts of sugar found in the blood. Sugar is the body's primary source of energy.

Sugar is broken down by insulin, a hormone produced in the pancreas. The bodies of people with diabetes do not produce enough insulin or use it correctly.

What are carbohydrates?

Carbohydrates, which are broken down into sugar provide the body with most of its needed energy. Carbohydrates make up half of recommended daily caloric intake.

Carbohydrates are present in most foods, including:

• fruits
• vegetables
• milk
• grains
• beans
• honey
• white sugar
• brown sugar
• candy
• desserts

The amount and type of carbohydrates consumed affect blood sugar levels. To keep their blood sugar at a safe level, people with diabetes should limit their total carbohydrate intake to between 45 grams (g) and 60 g per meal or less. As such, it is important to choose healthful, non-processed, high-fiber carbohydrates and control portion sizes.

What is honey?

Raw honey starts out as flower nectar. After being collected by bees, nectar naturally breaks down into simple sugars and is stored in honeycombs. The honeycombs trigger the nectar to evaporate, which creates a thick, sweet liquid known as honey.

Honey, like other sugars, is a condensed source of carbohydrates. One tablespoon of honey contains at least 17 g of carbohydrates.

While this amount may seem small, it adds up pretty quickly depending on how many carbohydrates a person consumes at a meal sitting. While honey is made up of sugar, it also contains vitamins, minerals, and antioxidants.

Processed vs. raw honey

Most of the honey available today is processed, which means it has been heated and filtered after being gathered from the beehive.

Raw honey, by contrast, has not been drained of its nutritional value and health benefits.

Switching to raw honey can help keep sugar levels down as long as people eat it alongside diabetes medications and other healthful diet choices.

Nutritional content of honey vs. white sugar

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

One tablespoon of honey has about 64 calories, and one tablespoon of sugar is around 49 calories.

While the calorie amounts in each teaspoon appear high, honey is very sweet, so most people only use between one and two teaspoons at a time.

The reason honey is higher in calories than sugar is that it is much denser and heavier.

Another big difference between the two is in how the body digests them. Honey is broken down in the body by enzymes, while sugar is not.

The glycemic index (GI) measures how much a particular carbohydrate may raise blood sugar levels. The GI for honey is around 55, which is considered a low GI food.

Foods with low GIs only cause small increases in blood sugar. As such, they may provide a reduced risk for type 2 diabetes.

Honey consumption may affect blood glucose and insulin

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

A small study carried out in Dubai, United Arab Emirates (UAE), looked at how honey and sugar affect blood sugar.

The study found that 75g of honey raised blood sugar and insulin levels in people without diabetes within 30 minutes. A similar test, using the same amount of pure glucose, saw blood sugar levels rise to slightly higher levels. The effect was similar in people with type 2 diabetes.

In the UAE study, the participants experienced an initial rise in blood sugar levels. However, the levels dropped within 2 hours. Overall, the blood sugar levels were much lower and remained lower in the honey group, compared to the white sugar group.

Because blood sugar levels were better in the groups taking the honey, researchers suggested that honey increased insulin levels. Because insulin helps to move glucose out of the blood, it is possible that the increased insulin from the honey helped to bring down sugar levels.

A study carried out at King Saud University, Saudi Arabia, also explored the connection between honey and blood glucose. It found that honey:

• decreased fasting serum glucose (glucose after fasting for at least 8 hours)
• increased fasting C-peptide (peptide helps stabilize and equal out insulin)
• increased 2-hour postprandial C-peptide (amount of peptide after eating)

Further research on honey consumption and type 2 diabetes

Additional studies have looked at the effect of adding honey to the diets of people with type 2 diabetes.

Effect on long-term blood glucose levels

An 8-week study carried out at the University of Tehran, Iran, found that individuals who consumed honey long-term experienced increased blood sugar levels.

However, the study also showed that people with type 2 diabetes who ate the honey lost weight and had reduced cholesterol levels in their blood.

In line with their findings, the researchers in Tehran recommended "cautious consumption" of honey for people with diabetes.

Anti-microbial and anti-bacterial properties

Other studies have presented significant evidence of the health benefits of consuming honey for people with type 2 diabetes. In fact, several studies find honey can benefit people with diabetes as it:

• has anti-microbial properties
• has anti-bacterial properties
• is an excellent source of antioxidants

Fighting bacteria and reducing inflammation

One report from Athens, Greece, finds these properties make honey beneficial for:

• fighting resistant bacteria
• preventing inflammatory processes from diabetes

In addition, antioxidants may also protect against many other diseases.

Complementing anti-diabetes medication

Another study, this one published in the Journal of Diabetes and Metabolic Disorders, reported that combining diabetes medications with honey is beneficial.

These findings support using honey to supplement diabetes treatment due to its:

• potent antioxidants
• ability to lower blood sugar
• ability to increase insulin

Replacing sugar with honey for diabetes

Consumption of raw honey has many benefits, including increasing insulin and decreasing blood sugar.

Honey is a healthful sweetener, especially when compared to refined sugars, such as white sugar, turbinado, cane sugar, and powdered sugar. While honey contains more carbohydrates and calories than white sugar, it is natural, less processed, and contains some nutrients.

People with type 2 diabetes who want to include honey in their daily diet should introduce it slowly, consuming a little at a time to see how their blood sugars react.

While honey does provide some health benefits, other whole foods contain more concentrated doses of nutrients, such as antioxidants and fiber.

Honey is very sweet, so adding small amounts can really sweeten a beverage or food.

For people with diabetes, using honey in very small amounts should not cause blood glucose to spike dramatically. So, people with diabetes may consume honey instead of sugar in moderation, as part of a healthful diet.