Can manuka honey raise blood glucose in people with diabetes on insulin or sulfonylureas?
Executive summary
Manuka honey contains digestible carbohydrates (primarily glucose and fructose) and therefore can raise blood glucose when eaten, even though some studies report a lower glycaemic response than pure glucose or table sugar [1] [2]. Preclinical and small human studies suggest potential long‑term or tissue‑level benefits of Manuka honey on insulin secretion, oxidative stress and pancreatic markers, but those findings do not negate the immediate blood‑glucose–raising effect of its sugars and are limited in scope and generalisability [3] [4].
1. Immediate pharmacology: ingestible sugars in Manuka honey will affect blood glucose
Honey is composed chiefly of glucose and fructose, so eating Manuka honey delivers carbohydrate that is absorbed and raises circulating glucose; clinical guidance for people using insulin emphasizes counting carbohydrates because “all types, including honey, will raise your blood glucose” [2]. Direct glycaemic testing of Manuka samples in healthy volunteers showed blood‑glucose curves peaking at about 30 minutes, demonstrating that Manuka honey produces a measurable post‑prandial glucose rise—albeit typically smaller than the same carbohydrate load of pure glucose [1].
2. Magnitude matters: lower GI but not zero—implications for insulin and sulfonylurea users
Multiple consumer and manufacturer sources point out Manuka’s moderate glycaemic index (GI reported around the mid‑50s) and claim it produces a slower or smaller spike than table sugar [5] [6]. ScienceDirect’s controlled GI testing confirms Manuka samples produced lower incremental glucose area under the curve than a glucose standard, but they still caused a clear peak at 30 minutes [1]. For people on insulin or sulfonylureas—medications whose dosing depends on carbohydrate intake or that increase insulin action—this means Manuka honey is not inert: it must be counted as a carbohydrate and will influence insulin dosing and hypoglycaemia/hyperglycaemia risk [2].
3. Longer‑term and mechanistic claims are intriguing but not directly exculpatory
Preclinical animal work and small human reports suggest Manuka honey may have anti‑inflammatory, antioxidant and even pancreatic regenerative effects that could improve insulin secretion or sensitivity over time [3] [7]. Suppliers and blogs summarize studies that report increased C‑peptide or insulin markers after honey consumption, and some hypothesize polyphenols inhibit carbohydrate‑digesting enzymes, moderating glycaemic response [8] [4]. Those findings are hypothesis‑generating but do not demonstrate that a serving of Manuka will prevent an acute glucose rise after ingestion—nor do they establish safe substitution rules for people taking insulin or sulfonylureas [3] [4].
4. Clinical risk framing: what this means for patients on insulin or sulfonylureas
Practical clinical guidance is consistent across sources: because Manuka is a carbohydrate source that raises blood sugar, people on insulin or secretagogues must include it in carbohydrate counting and monitor glucose after use; topical application avoids systemic carbohydrate exposure and is safer for wound care purposes [2] [9]. The evidence that Manuka produces a lower glycaemic response than glucose does not eliminate the need to adjust insulin or medication dosing when Manuka is consumed as food, because the net glucose effect is still measurable and individualized [1] [2].
5. Limitations, conflicting claims and the research gaps that matter
Much of the supportive literature is either preclinical (animal models) or small human studies, often industry‑referenced or observational, which limits firm conclusions about long‑term metabolic benefit in people with diabetes [3] [8] [5]. The apparent paradox—Manuka may improve insulin markers over time while still raising glucose acutely—stems from different endpoints and study designs; there is no robust, large randomized trial proving that regular dietary Manuka eliminates the need to count its carbohydrates or reliably reduces insulin requirements in people taking insulin or sulfonylureas [3] [4].
6. Bottom line
Manuka honey will raise blood glucose after ingestion and must be treated as a source of carbohydrate by people using insulin or sulfonylureas; it may produce a smaller or slower spike than pure glucose, and some early studies suggest possible longer‑term benefits, but those do not negate the immediate glycaemic effect and current clinical advice to count carbs and monitor glucose closely [1] [2] [3].