Honey vs Refined Sugar: A Gentler Effect on Blood Glucose

Sugar is something most people working on metabolic health try to limit, for good reason. Honey, however, is a more complex molecule than table sugar, and a growing body of research suggests it affects blood glucose differently, and often more gently, than refined sugar does. In a 2018 review in Oxidative Medicine and Cellular Longevity, Bobiş and colleagues drew this evidence together [1], and a 2024 book chapter on honey as an antidiabetic agent reached broadly similar conclusions [5]. This is what they actually report.

Honey is sugar, but not the same sugar

Begin with the honest part. Honey is a caloric sweetener, and it raises blood glucose. What distinguishes it is its composition. Table sugar, or sucrose, is a simple bond of glucose and fructose in equal parts. Honey is a looser mixture of free fructose and glucose, water, and small amounts of minerals, enzymes, organic acids, and antioxidant compounds called polyphenols.

That composition gives honey a lower glycemic index, the measure of how quickly and how high a food pushes blood glucose. Honey sits around 58, compared with about 60 for table sugar and 100 for pure glucose, while fructose alone is near 19 [1]. Gram for gram, honey therefore tends to raise blood glucose somewhat less sharply than the usual sweeteners.

What happens in the body

The most direct human comparison came from a 2004 study in which Al-Waili gave healthy people, people with diabetes, and people with high cholesterol either honey, dextrose (pure glucose), or sucrose, and then tracked their blood. Honey produced a smaller rise in blood glucose than dextrose, prompted a greater release of insulin and C-peptide (a marker that the pancreas is producing insulin), and lowered markers of inflammation and blood fats [2]. The body handled honey more favorably than it handled plain sugar.

Why a sweet food would blunt the glucose response comes down largely to fructose. In the liver, fructose activates an enzyme called glucokinase, which pulls glucose out of the bloodstream and stores it as glycogen. A modest amount of fructose, such as the amount in honey, can therefore prompt the body to take up glucose more efficiently, an effect Erejuwa and colleagues described as the catalytic or fructose effect [3]. Honey's minerals and antioxidants may add to this by easing the oxidative stress that wears on an overworked pancreas [1].

What longer studies show

Over a longer period the picture is mixed. In an 8-week randomized trial in people with diabetes, Bahrami and colleagues found that natural honey reduced body weight and improved blood lipids compared with no honey, which are real benefits. The same trial, however, recorded a rise in HbA1c, a measure of average blood glucose over the prior few months, which is a clear caution [4]. That tension runs through this entire field. Honey performs better than refined sugar on several measures, yet it remains sugar, and people with diabetes who add too much of it can push their long-term numbers in the wrong direction.

How to think about it

The practical conclusion is measured. For anyone who is going to use a sweetener, a small amount of raw honey is a better choice than refined sugar. It raises blood glucose somewhat less, it brings antioxidants and trace minerals rather than empty calories, and the body appears to process it more favorably. None of that makes honey a food to use freely, and none of it makes honey a treatment for diabetes.

Anyone with insulin resistance or diabetes should keep portions small, watch how their own glucose responds (a finger-stick reading or a continuous glucose monitor gives the real answer), and never substitute honey for a prescribed medication. Used with that care, honey is a reasonable way to keep a small amount of sweetness in the diet.

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References

1. Bobiş O, Dezmirean DS, Moise AR. Honey and diabetes: the importance of natural simple sugars in diet for preventing and treating different type of diabetes. Oxid Med Cell Longev. 2018. PMID: 29507651
2. Al-Waili NS. Natural honey lowers plasma glucose, C-reactive protein, homocysteine, and blood lipids in healthy, diabetic, and hyperlipidemic subjects: comparison with dextrose and sucrose. J Med Food. 2004. PMID: 15117561
3. Erejuwa OO, Sulaiman SA, Wahab MS. Fructose might contribute to the hypoglycemic effect of honey. Molecules. 2012. PMID: 22337138
4. Bahrami M, Ataie-Jafari A, Hosseini S, Foruzanfar MH, Rahmani M, Pajouhi M. Effects of natural honey consumption in diabetic patients: an 8-week randomized clinical trial. Int J Food Sci Nutr. 2009. PMID: 19817641
5. Jamwal N, Jasrotia R, Badyal N, Hajam YA, Langer S. Honey: an antidiabetic and hypoglycemic agent to reverse diabetes-induced complications. In: Honey in Food Science and Physiology. Springer; 2024. DOI: 10.1007/978-981-97-3565-5_16