Considerable evidence from experimental studies shows that the honey may provide benefits in the management of diabetes mellitus. The benefits could be a better control of the hyperglycemic state, limiting other metabolic disorders and diminishing the deleterious effects on different organs that may produce diabetic complications. Anyway, there are some data and literature with contrary discussions regarding the use of honey in diabetic diseases.
Animal models of diabetes were employed chemically (streptozotocin or alloxan), and this may not entirely reflect the development of type 2 diabetes in humans. More studies on animals are necessary but following other animal models, closer than human type 2 diabetes.
Optimal doses for human consumption must be established, and longer period experiments must be developed, due to the fact that diabetes mellitus is a chronic disease.
Answering the main question of the study, it is true that honey may be used as a potential antidiabetic agent that has the potential to reduce the complications of diabetes, long-term studies using honey as an alternative or a complementary therapy in human subjects suffering from type 2 diabetes mellitus are needed, with a larger number of patients, randomized clinical trials set up with different levels of diabetes, treated with different doses of honey, following both short-term and long-term treatment.
As stated recently , “The use of honey in diabetic patients still has obstacles and challenges and needs more large sample sized, multicenter clinical controlled studies to reach better conclusions.”
Diabetes is a metabolic disorder with multifactorial and heterogeneous etiologies. Two types of diabetes are common among humans: type 1 diabetes that occurs when the immune system attacks and destroys insulin and type 2 diabetes, the most common form, that may be caused by several factors, the most important being lifestyle, but also may be determined by different genes. Honey was used in folk medicine for a long time, but the health benefits were explained in the last decades, when the scientific world was concerned in testing and thus explaining the benefits of honey. Different studies demonstrate the hypoglycemic effect of honey, but the mechanism of this effect remains unclear. This review presents the experimental studies completed in the recent years, which support honey as a novel antidiabetic agent that might be of potential significance for the management of diabetes and its complications and also highlights the potential impacts and future perspectives on the use of honey as an antidiabetic agent.
Diabetes mellitus is one of the top diseases in modern times, with more than 285 million people estimated in 2010 and about 438 million people predicted for 2030 in all over the world . Diabetes prevalence may be genetically determined or can be developed during lifetime at any age. This disease takes no account of age for example, but scientific studies reveal that it is more common in developing countries than in the rest of the world (developed countries and third world countries) . The increasing incidence may be due to demographic changes and undesirable result of risk factors such as obesity and sedentary life.
What is in fact diabetes mellitus? Diabetes is a metabolic disorder with multifactorial and heterogeneous etiologies. The high blood sugar level is the “symptom” known for diabetes, but other symptoms should not be ignored: increased thirst and hunger, unexplained fatigue, increased urination, blurred vision, and unexpected weight loss. Two types of diabetes are common among humans: type 1 diabetes that occurs when the immune system attacks and destroys insulin. This type of diabetes is believed to be genetically determined but also environmental factors are important in the determination of the disease. The symptoms of this type of diabetes generally start quickly, in a matter of weeks. Type 2 diabetes, the most common form, may be caused by several factors, the most important being lifestyle, but also it may be determined by different genes. This type of disease is developed during several years, and the symptoms are also not noticeable; for this reason, many people find themselves with diabetes without specific or unusual symptoms. Type 2 diabetes is most of the time related to overweight or obese state.
Although diabetes mellitus is a chronic disease of endocrine diagnosis and remains the major cause of mortality worldwide [2–5], it is not a death sentence.
Nowadays, the medical world is turning more and more on the health benefits of natural products, medicinal herbs, and also honey, in the management of this illness. Together with classic medical treatment, using recipes of traditional medicine, including the use of apicultural products (i.e., honey), the diabetic patients can maintain the normal level of insulin in the blood and also their overall health condition.
Honey composition comprises more than 200 components, with fructose, glucose, and water as main substances. Honey was used in folk medicine back in time at the beginning of our era, but their health benefits were based only on eye observations, without having any basis for scientific support. Only in the last decades, the scientific world was concerned in testing and explaining the benefits of honey. These research studies explain to a large extent many medicinal effects of honey such as antioxidant [6–11], hepatoprotective [12–14], cardioprotective [15–17], antibacterial [18–23], anti-inflammatory [24–26], or antitumor [27–30].
For a long time, there has been a myth that honey could not be used in diabetic patient’s diet, due to the high content of carbohydrates from its chemical composition. Considering the background of the research team that has been working on characterization of different types of honey from Romania and worldwide and the determination of its biological properties for a long period, we considered being appropriate to gather in a review, literature studies that may answer the question: is honey a good substitute for sugar in diabetic diet? Are natural simple sugars important in preventing and treating diabetes mellitus?
Therefore, the present study acknowledged different scientific studies, demonstrating the use of honey in diabetes mellitus: preclinical and clinical studies, animal model studies, and human studies that demonstrate the potential impact of honey on this complex disease.
2. Fructose and the Hypoglycemic Effect of Honey
Fructose content of honey varies from 21 to 43% and the fructose/glucose ratio from 0.4 to 1.6 or even higher [31–34]. Although fructose is the sweetest naturally occurring sweetener, it has a glycemic index of 19, compared to glucose which has 100 or sucrose (refined sugar) with 60 . Different studies reveal the hypoglycemic effect of honey, but the mechanism of this effect remains unclear. It was suggested that fructose, selective mineral ions (selenium, zinc, copper, and vanadium), phenolic acids, and flavonoids might have a role in the process [10, 11, 31, 33, 36, 37].
There is evidence that fructose tends to lower blood glucose in animal models of diabetes [38, 39]. Mechanisms involved in this process may include reduced rate of intestinal absorption , prolongation of gastric emptying time [41, 42], and reduced food intake [43, 44]. Fructose stimulates glucokinase in hepatocytes, which plays an important role in the uptake and storage of glucose as glycogen by the liver. Glucose on the other hand, which is present beside fructose in honey, enhances the absorption of fructose and promotes its hepatic actions through its enhanced delivery to the liver [45, 46].
The pancreas is an important organ in diabetes, because it secrets two glucose-regulating hormones—insulin and glucagon—and honey might protect this organ against oxidative stress and damage with its antioxidant molecules, this being another potential mechanism of hypoglycemic effect of honey [32, 47].
Different studies were made on the effect of fructose on glycemic control, glucose-regulating hormones, appetite-regulating hormones, body weight, food intake, and oxidation of carbohydrates or energy expenditure [38, 44, 48–61].
Fructose administrated alone or as part of sucrose molecule in normal rats improved glucose homeostasis and insulin response compared to rats which received glucose . Other studies show that fructose supplementation in normal or type 2 model of diabetic rats produced lower levels of plasma insulin and glucose, more than other administrated sugars .
3. Animal Model Experiments
Different animal models were used to study the possible hypoglycemic effect of honey. The most used experimental tool for inducing type 1 and type 2 diabetes is streptozotocin and alloxan of appropriate doses [63–66].
A study of six weeks  on healthy nondiabetic rats fed with a honey-containing diet exhibits good results: weight was reduced statistically significant, but no significant decreasing for glycosylated hemoglobin or food intake was observed.
Long-term honey feeding in Sprague-Dawley rats (52 weeks) produces a significant decrease of HbA1c levels but increases HDL cholesterol . In sucrose-fed and sugar-free diet-fed rats, in the same experiment, HDL cholesterol levels were decreased and no other differences were observed for other lipids. Weight gain was similar for honey and sugar-free diet-fed rats but less compared to sucrose-fed rats.
Busseroles et al.  fed healthy rats with 65 g/100 g combined fructose and glucose or a honey-based diet for two weeks and the level of blood fructose, serum vitamin E, and serum vitamin E/triglycerides increased, while glucose content remains unchanged and triglyceride content decreased.
Feeding healthy rats with a diet containing 20% honey for 33 days, Nemoseck et al.  obtained significant decrease of triglycerides, leptin content, body weight, food/energy intake, and epididymal fat weight but not significantly glucose decrease, total cholesterol decrease, adiponectin, and C-reactive proteins. This experiment shows that longer period of feeding must be used, to obtain significant results.
Erejuwa et al. [11, 47] found no significant differences in fasting blood glucose or body weight in honey-fed rats.
If honey was demonstrated to have hypoglycemic effect in healthy animals, the same beneficial effect was observed in induced diabetic animals. A very important observation regarding honey and diabetes is that honey augments the antihyperglycemic effect of standard antidiabetic drugs in induced diabetes [10, 33].
Rabbits with diabetes induced by alloxan were used in one experiment, and three types of sweeteners were used for feeding the animals . Pure honey of Apis florea and Apis dorsata and adulterated honey were given in different doses in a rabbit’s diet, and a dose-dependent rise in blood glucose was registered.
Another study  of alloxan-induced diabetic rats fed with honey and healthy rats fed with fructose shows different results: glucose decreased significantly in alloxan-induced diabetic rats and not significantly in fructose-fed rats. Body weight increased in healthy fructose-fed rats, and hypoglycemic effect and also the same effect were found for streptozotocin-induced diabetic rats . Table 1 summarizes the preclinical studies on healthy and induced diabetic animals, using honey solution or other sweeteners in their diet.
Table 1: Preclinical studies on animal models regarding the effect of honey on induced diabetes mellitus.
Table 1: Preclinical studies on animal models regarding the effect of honey on induced diabetes mellitus.
4. Honey versus Sugars in Human Clinical Trials
Human diet must have all types of nutrients required in the metabolic transformations and life support. Water, proteins, lipids, carbohydrates, vitamins, minerals, amino acids, and bioactive compounds are needed by the human body, and all of these compounds are taken from the diet. Maintaining a healthy life, equilibrate diet, and intake of each and every one of these nutrients is the key factor of health in general. Different diseases have as a starting point unbalances in metabolism, because of lack or excess of one or more nutrients.
Diabetes, as stated before, represents the high level of blood sugars due to low or no insulin production in the body. Experimental studies on animals suggest the beneficial effects of honey as a diet supplement and encouraging results on control of diabetes mellitus and additional complications are presented in medical studies; the experiments and reports on humans (healthy or diabetic) are rather sparse.
The published studies present favourable effects of honey in both healthy and diabetic subjects [16, 31, 72–76]. Since oxidative stress is implicated and mainly responsible for diabetes development, the antioxidant effects of honey are very important in this disease management .
The study of Al-Waili  on healthy, diabetic, or patients with hypertriglyceridemia shows promising results, when honey was used in their diet, compared with dextrose and sucrose. Thus, lipid profile was improved, normal and elevated C-reactive protein was lowered, and also homocysteine value and triacylglycerol were decreased in patients with hypertriglyceridemia. In diabetic patients, honey compared with dextrose caused a significantly lower rise of plasma glucose level (PGL). Honey caused greater elevation of insulin compared to sucrose; after different time of consumption, it reduces blood lipids, homocysteine, and CRP in normal subjects. The conclusion was that honey compared with dextrose and sucrose caused lower elevation of PGL in diabetics. This experimental study on healthy, diabetic, and hyperlipidemic human subjects demonstrates the different intake rate of refined sugar and honey, the raising of blood sugar and also raising their insulin levels.
Sugar is a refined product, obtained from different natural sources, but follows a technological process, leading to an almost pure substance—sucrose—highly used in modern life in the food industry.
Honey, on the other hand, being also a natural sweet product, has a complex composition, but compared to sugar, it has a lower glycemic index and energetic value. When we talk about refined sugar, it is easy to state the exact chemical composition, very simple actually, but talking about honey, many aspects should be considered regarding its composition. Botanical and geographical origins determine the specific composition and properties of all types of honeys.
Table 2 presents comparatively the chemical composition of refined sugar and honey.
Table 2: Average chemical composition of honey compared to sugar.
The fact that refined sugar is almost 100% sucrose, and very small amounts of other components compared to honey, makes the last one, an important sweetener, with almost 80% simple sugars from the total chemical composition (35–40% fructose and 30–35% glucose).
Even though the exact mechanism by which honey may have beneficial effects upon blood glucose is not very clear; from comparative experiments, some conclusions about the importance of fructose in honey are available. Fructose is known to stimulate glucokinase in hepatocytes, which plays an important role in the uptake and storage of glucose as glycogen by the liver , the amount of fructose in honey being very important for its hypoglycemic effects.
A study on humans  evaluated for a large period of time wherein a group of twenty adult patients with type 2 diabetes volunteered to stop their medication and use honey as treatment for their disease. This nonrandomized, open clinical trial aiming to study the safety and efficiency of honey as unique treatment revealed interesting results (Table 3).
Table 3: Clinical studies regarding the effect of honey in human diabetic subjects.
Besides glycemic index (GI), peak incremental index (PII) is used to assess the glycemic effect (the effect on blood glucose level after ingestion of various foods) .
C-peptide is considered a good marker of insulin secretion, being cosecreted with insulin by the pancreatic cells as a by-product, with no biological activity of its own , of the enzymatic cleavage of proinsulin to insulin. Scientific studies regarding the effects of honey on insulin and C-peptide levels are controversial in healthy and diabetic patients [54, 83, 84].
A study made in the National Institute of Diabetes in Cairo, Egypt, on twenty diabetic young patients and ten healthy nondiabetic ones try to elucidate this controversy . Glucose, sucrose, and honey were administrated diluted with 200 ml water, according to the patient’s weight (amount of sugar/honey = weight of the subject in kg × 1.75, with a maximum of 75 g). The diluted sugars and honey were ingested in the morning by every participant, one week apart for each sugar type, the whole test lasting for three weeks. Blood tests were made before ingestion and after every 30 min postprandial of sugars, until 120 min (2 hours). Serum C-peptide level and glucose assay were measured for all blood samples.
The glycemic index and peak incremental index were lower both in patients and control group, when honey was used compared to glucose and fructose, but the level of C-peptide was different in patients and control group.
Honey causes a postprandial rise of plasma C-peptide levels compared to sucrose and glucose in nondiabetic patients, suggesting that honey might have a direct stimulatory effect on the healthy beta cells of the pancreas .
Although honey has lower GI than sugar (Table 2), an average value for honey is presented , according to fructose/glucose ratio, and GI value of different honeys is also different .
Twenty healthy subjects from Erciyes University, Kayseri, Turkey, were subjected voluntarily to a test of ingesting 50 g of pure glucose in 250 ml water and an amount of honey that corresponds to 50 g glucose (accordingly to the physicochemical analysis of honey used in the test). Capillary blood samples were taken from the finger in the next morning after sugar consumption and again every 15 minutes after second ingestion of sugars in the next day, until 120 minutes. Serum glucose and serum insulin level decreased after 2 hours of honey intake, and C-peptide level increased slightly 2 hours after honey intake. This study demonstrates how different types of honey, having different GI values, influence the parameters usually measured for diabetes control in a different manner .
Sixty healthy subjects aged 18 to 30 years, enrolled in one experiment in Isfahan University of Medical Science, Iran , receive 80 g of honey and 80 g sucrose dissolved in 250 ml water once a day for six weeks. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood sugar (FBS) were determined from each participant at the beginning and in the end of the study. No significant change was registered in SBP and DBP in both groups at the beginning and in the end of the study, but FBS registered a significant reduction in the honey group at the end of the study, compared to the sucrose group .
Different studies mentioned before show that honey consumption reduces body weight but also blood glucose in healthy and diabetic patients compared to sugar intake. A study on type 2 diabetic patients consuming natural honey shows that body weight may be reduced and blood lipids and glucose as well . The study consists of 58 patients with type 2 diabetes, with fasting blood sugar of 110–220 mg/dl, with same oral hypoglycemic drugs, but no insulin treatment. The experimental group () receives natural honey for eight weeks following an experimental scheme, and the control group () did not receive honey or other sweeteners. The participants continued their usual diet over the study period. The body weight and fast blood sugar were measured every 2 weeks, and constant decreasing was registered . Scientific studies reviewed by Erejuwa et al. [12, 33] demonstrate that fructose and oligosaccharides from honey contribute to its hypoglycemic effect. In addition to lowering oxidative stress and hyperglycemia, honey consumption ameliorates other metabolic disorders associated with diabetes, such as reduced levels of hepatic transaminases, triglycerides, and glycosylated hemoglobin (HbA1c) and increased HDL cholesterol [12, 31].
Several honey types from different parts of the world ameliorate metabolic abnormalities in type 1 and type 2 diabetic patients [36, 73, 88]. These studies investigate the acute effects of honey on hyperglycemia and metabolic disorders, because the diabetic parameters were measured postprandial in studies which last from two to eight weeks. Table 3 summarizes the clinical studies on humans, applied treatment, and the main obtained results.
5. Honey in Diabetic Wound Healing
Besides the health benefits of ingesting honey in diabetes, another important use of honey could be in managing diabetic wounds . These wounds are not like typical wounds, they are slower in healing or they do not heal at all, leading to complications that conventional medications do not work.
Honey was used in alternative medicine for healing different wounds since ancient times, the use of honey in diabetic wound management being more recent. Diabetic patients sometimes suffer from different complications such as arterial disease, vascular problems, ulcerations, and foot complications [90, 91].
Even if diabetic wounds are similar to wounds from normal patients, the healing process in the former is very slow and problematic and the medical costs are extremely high. Honey is a potential candidate to be used in these treatments because it is available, natural, and not expensive. But how can honey work at the wound site? The honey diluted with water or different body fluids forms hydroxyl radicals and hypochlorite anions at the wound site. The antioxidants present in the honey act through two different mechanisms in a wound: first, antioxidants fight against microorganisms and lower the infection in the wound [75, 92, 93]; second, the same antioxidants reduce the reactive oxygen species and inflammation caused by the wound, helping in the healing process [94–96].
The antimicrobial activity of honey is due to acidic pH, osmotic effect, hydrogen peroxide, and nitric oxide. The presence of nitric oxide metabolites in honey as well as the production of NO products by honey in different body fluids improves the healing process [74, 80, 97].
Debridement, wound odor, scar formation, and inflammation control are very important in diabetic wound management . The slow healing process in diabetic wounds is due to the peripheral arterial diseases and peripheral neuropathy that occur with diabetes; the blood vessels tend to shrink, reducing blood circulation in the respective areas. The nerves do not receive enough blood (nutrients) and may become damaged and more vulnerable to injury. The stimulating tissue growth when honey is used is due to the chemical composition, the presence of assimilable sugars, vitamins, amino acids, and phenolics that increases oxygen and nutrients in the wound area [98, 99].
Numerous studies show evidence of successful honey treatments against diabetic wounds all over the world [100–105]. Honey applications reduce wound ulcer pain and size and deodorization of the wound, and reduction of healing time and are safe and there are no side effects.
A recent study  brings new evidence in demonstrating the effects of Manuka honey in wound healing. The results reported by the authors, based on the capacity of this type of honey to improve the responsiveness to oxidative damage, as well as stimulation of cell proliferation, could help to understand how Manuka honey develops its healing effect on wounds.
Although, some guidelines for honey applications must be used such as natural unheated honey should be used in treatments and stored in dark glass bottles in cool places. Different medical grade honey with standardized antibacterial activity for use in wound treatments are known, such as Apiban (Apimed: Cambridge, New Zealand), Woundcare 18+ (Comvita: Te Puke, New Zealand), and Medihoney (Capilano: Richmonds, Queensland, Australia) . If these honeys are not available, any dark honey with high antibacterial activity may be used.
1Life Sciences Institute “King Michael I of Romania”, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania 2Faculty of Animal Breeding and Biotechnology, Technology Department, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
Correspondence should be addressed to Adela Ramona Moise; firstname.lastname@example.org
Received 21 August 2017; Revised 21 November 2017; Accepted 24 December 2017; Published 4 February 2018
Academic Editor: Undurti N. Das
Copyright © 2018 Otilia Bobiş et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
CHD:Coronary heart disease
DBP:Diastolic blood pressure
FBG:Fasting blood glucose
FBS:Fasting blood sugar
FPG:Fasting plasma glucose
HHS:Hyperglycemic hyperosmolar state
PII:Peak incremental index
PGL:Plasma glucose level
SBP:Systolic blood pressure
SGOT:Serum glutamic oxaloacetic transaminase
SGPT:Serum glutamate pyruvate transaminase
TAS:Total antioxidant status
TBARS:Thiobarbituric acid reactive substances
VLDL:Very low-density lipoprotein.
Conflicts of Interest
The authors declare that there are no conflicts of interest regarding the publication of this paper.
All authors contributed equally to this paper.
J. E. Shaw, R. A. Sicree, and P. Z. Zimmet, “Global estimates of the prevalence of diabetes for 2010 and 2030,” Diabetic Research and Clinical Practice, vol. 87, no. 1, pp. 4–14, 2010. View at Publisher · View at Google Scholar · View at Scopus
M. Wei, S. P. Gaskill, S. M. Haffner, and M. P. Stern, “Effects of diabetes and level of glycemia on all-cause and cardiovascular mortality: the San Antonio Heart Study,” Diabetes Care, vol. 21, no. 7, pp. 1167–1172, 1998. View at Publisher · View at Google Scholar · View at Scopus
E. L. M. Barr, P. Z. Zimmet, T. A. Welborn et al., “Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose and impaired glucose tolerance. the Australian Diabetes, Obesity and Lifestyle Study,” Circulation, vol. 116, no. 2, pp. 151–157, 2007. View at Publisher · View at Google Scholar · View at Scopus
G. R. Kokil, P. V. Rewatkar, A. Verma, S. Thareja, and S. R. Naik, “Pharmacology and chemistry of diabetes mellitus and antidiabetic drugs: a critical review,” Current Medicinal Chemistry, vol. 17, no. 35, pp. 4405–4423, 2010. View at Publisher · View at Google Scholar · View at Scopus
G. Roglic and N. Unwin, “Mortality attributable to diabetes: estimates for the year 2010,” Diabetic Research and Clinical Practice, vol. 87, no. 1, pp. 15–19, 2010. View at Publisher · View at Google Scholar· View at Scopus
G. Beretta, P. Granata, M. Ferrero, M. Orioli, and R. M. Facino, “Standardization of antioxidant properties of honey by a combination of spectrophotometric/fluorimetric assays and chemometrics,” Analytica Chimica Acta, vol. 533, no. 2, pp. 185–191, 2005. View at Publisher · View at Google Scholar · View at Scopus
J. Bertoncelj, T. Golob, U. Dobersek, and M. Jamnik, “Evaluation of the phenolic content, antioxidant activity and color of Slovenian honey,” Food Chemistry, vol. 105, no. 2, pp. 822–828, 2007. View at Publisher · View at Google Scholar · View at Scopus
L. A. Mărghitaş, D. Dezmirean, A. Moise, O. Bobiş, L. Laslo, and S. Bogdanov, “Physico-chemical and bioactive properties of different floral origin honeys from Romania,” Food Chemistry, vol. 112, no. 4, pp. 863–867, 2009. View at Publisher · View at Google Scholar · View at Scopus
J. M. Alvarez-Suarez, S. Tulipani, D. Díaz et al., “Antioxidant and antimicrobial capacity of several monofloral Cuban honeys and their correlation with color, polyphenol content and other chemical compounds,” Food and Chemical Toxicology, vol. 48, no. 8-9, pp. 2490–2499, 2010. View at Publisher · View at Google Scholar · View at Scopus
O. O. Erejuwa, S. A. Sulaiman, M. S. Wahab, K. N. S. Sirajudeem, S. Salleh, and S. Gurtu, “Antioxidant protective effect of glibenclamide and metformin in combination with honey in pancreas of streptozotocin induced diabetic rats,” International Journal of Molecular Science, vol. 11, no. 5, pp. 2056–2066, 2010. View at Publisher · View at Google Scholar · View at Scopus
O. O. Erejuwa, S. Gurtu, S. A. Sulaiman, M. S. Ab Wahab, K. N. Sirajudeen, and M. S. Salleh, “Hypoglycemic and antioxidant effects of honey supplementation in streptozotocin-induced diabetic rats,” International Journal for Vitamin and Nutrition Research, vol. 80, no. 1, pp. 74–82, 2010. View at Publisher · View at Google Scholar · View at Scopus
O. O. Erejuwa, S. A. Sulaiman, and M. S. Wahab, “Hepatoprotective effect of Tualang honey supplementation in streptozotocin-induced diabetic rats,” International Journal of Applied Research and Natural Products, vol. 4, pp. 37–41, 2012. View at Google Scholar
R. M. Galal, H. F. Zaki, M. M. Seif El-Nasr, and A. M. Agha, “Potential protective effect of honey against paracetamol-induced hepatotoxicity,” Archives of Iranian Medicine, vol. 15, no. 11, pp. 674–680, 2012.View at Google Scholar
M. Asaduzzaman, M. Sohanur Rahman, S. Munira et al., “Effects of honey supplementation on hepatic and cardiovascular disease (CVD) marker in streptozotocin-induced diabetic rats,” Journal of Diabetes & Metabolism, vol. 6, no. 9, p. 592, 2015. View at Publisher · View at Google Scholar
M. K. Rakha, Z. I. Nabil, and A. A. Hussein, “Cardioactive and vasoactive effects of natural wild honey against cardiac malperformance induced by hyperadrenergic activity,” Journal of Medicinal Food, vol. 11, no. 1, pp. 91–98, 2008. View at Publisher · View at Google Scholar · View at Scopus
N. Yaghoobi, N. Al-Waili, M. Ghayour-Mobarhan et al., “Natural honey and cardiovascular risk factors; effects on blood glucose, colesterol, triacylglycerole, CRP and body weight compared with sucrose,” The Scientific World Journal, vol. 8, pp. 463–469, 2008. View at Publisher · View at Google Scholar · View at Scopus
M. D. I. Khalil, E. M. Tanvir, R. Afroz, S. A. Sulaiman, and S. H. Gan, “Cardioprotective effects of tualang honey: amelioration of cholesterol and cardiac enzymes levels,” BioMed Research International, vol. 2015, Article ID 286051, 8 pages, 2015. View at Publisher · View at Google Scholar · View at Scopus
R. J. Weston, “The contribution of catalase and other natural products to the antibacterial activity of honey: a review,” Food Chemistry, vol. 71, no. 2, pp. 235–239, 2000. View at Publisher · View at Google Scholar · View at Scopus
H. T. Tan, R. A. Rahman, and S. H. Gan, “The antibacterial properties of Malaysian Tualang honey against wound and enteric microorganisms in comparison to Manuka honey,” BMC Complementary and Alternatively Medicine, vol. 9, no. 1, pp. 1–8, 2009. View at Publisher · View at Google Scholar · View at Scopus
M. D. Mandal and S. Mandal, “Honey: its medicinal property and antibacterial activity,” Asian Pacific Journal of Tropical Biomedicine, vol. 1, no. 2, pp. 154–160, 2011. View at Publisher · View at Google Scholar · View at Scopus
D. P. Mohapatra, V. Thakur, and S. K. Brar, “Antibacterial efficacy of raw and processed honey,” Biotechnology Research International, vol. 2011, Article ID 917505, 6 pages, 2011. View at Publisher · View at Google Scholar
E. N. Hammond and E. S. Donkor, “Antibacterial effect of Manuka honey on Clostridium difficile,” BMC Research Notes, vol. 6, no. 1, p. 188, 2013. View at Publisher · View at Google Scholar · View at Scopus
E. K. Nishio, J. M. Ribeiro, A. G. Oliveira et al., “Antibacterial synergic effect of honey from two stingless bees: Scaptotrigona bipunctata Lepeletier, 1836 and S. postica Latreille, 1807,” Scientific Reports, vol. 6, no. 1, article 21641, 2016. View at Publisher · View at Google Scholar · View at Scopus
A. J. J. van den Berg, E. van den Worm, H. C. Q. van Ufford, S. B. A. Halkes, M. J. Hoechstra, and C. J. Beukelman, “An in vitro examination of the antioxidant and anti-inflammatory properties of buckwheat honey,” Journal of Wound Care, vol. 17, no. 4, pp. 172–178, 2008. View at Publisher · View at Google Scholar
M. Kassim, M. Achoui, M. R. Mustafa, M. A. Mohd, and K. M. Yusoff, “Ellagic acid, phenolic acids and flavonoids in Malaysian honey extracts demonstrate in vitro anti-inflammatory activity,” Nutrition Research, vol. 30, no. 9, pp. 650–659, 2010. View at Publisher · View at Google Scholar · View at Scopus
D. M. Borsato, A. S. Pridente, P. M. Doll-Boscardin et al., “Topical anti-inflammatory activity of a monofloral honey of Mimosa scabrella provided by Melipona marginata during winter in southern Brazil,” Journal of Medicinal Food, vol. 17, no. 7, pp. 817–825, 2014. View at Publisher · View at Google Scholar · View at Scopus
N. S. Yaacob, A. Nengsih, and M. N. Norazmi, “Tualang honey promotes apoptotic cell death induced by tamoxifen in breast cancer cell lines,” Evidence-Based Complementary and Alternatively Medicine, vol. 2013, Article ID 989841, 9 pages, 2013. View at Publisher · View at Google Scholar · View at Scopus
J. M. Alvarez-Suarez, F. Giampieri, and M. Battino, “Honey as a source of dietary antioxidants: structures, bioavailability and evidence of protective effects against human chronic diseases,” Current Medicinal Chemistry, vol. 20, no. 5, pp. 621–638, 2013. View at Publisher · View at Google Scholar · View at Scopus
H. K. Bulut and F. G. Tüfekci, “Honey prevents oral mocositis in children undergoing chemotherapy: a quasi-experimental study with a control group,” Complementary Therapies in Medicine, vol. 29, pp. 132–140, 2016. View at Publisher · View at Google Scholar · View at Scopus
L. M. Porcza, C. Simms, and M. Chopra, “Honey and cancer: current status and future directions,” Diseases, vol. 4, no. 4, pp. 1–26, 2016. View at Publisher · View at Google Scholar
M. Bahrami, A. Ataie-Jafari, S. Hosseini, M. H. Foruzanfar, M. Rahmani, and M. Pajouhi, “Effects of natural honey consumption in diabetic patients: an 8-week randomized clinical trial,” International Journal of Food Science and Nutrition, vol. 60, no. 7, pp. 618–626, 2009. View at Publisher · View at Google Scholar · View at Scopus
P. Deibert, D. KOnig, B. Kloock, M. Groenefeld, and A. Berg, “Glycaemkic and insulinaemic properties of some German honey varieties,” European Journal of Clinical Nutrition, vol. 64, no. 7, pp. 762–764, 2010. View at Publisher · View at Google Scholar · View at Scopus
O. O. Erejuwa, S. A. Sulaiman, M. S. Wahab, S. K. N. Salam, S. Salleh, and S. Gurtu, “Comparison of antioxidant effects of honey, glibenclamide, metformin and their combinations in the kidneys of streptozotocin-induced diabetic rats,” International Journal of Molecular Sciences, vol. 12, no. 12, pp. 829–843, 2011. View at Publisher · View at Google Scholar · View at Scopus
K. Münstedt, M. Bohme, A. Hauenschild, and I. Hrgovic, “Consumption of rapeseed honey leads to higher serum fructose levels compared with analogue glucose/fructose solutions,” European Journal of Clinical Nutrition, vol. 65, no. 1, pp. 77–80, 2011. View at Publisher · View at Google Scholar · View at Scopus
J. P. Bantle, “Dietary fructose and metabolic sindrome and diabetes,” The Journal of Nutrition, vol. 139, no. 6, pp. 1263S–1268S, 2009. View at Publisher · View at Google Scholar · View at Scopus
N. Al-Waili, “Intrapulmonary administration of natural honey solution, hyperosmolar dextrose or hypoosmolar distill water to normal individuals and to patients with type 2 diabetes mellitus or hypertension: their effects on blood glucose level, plasma insulin and C-peptide, blood pressure and peaked expiratory flow rate,” European Journal of Medical Research, vol. 8, no. 7, pp. 295–303, 2003. View at Google Scholar
M. E. Cortés, P. Vigil, and G. Montenegro, “The medicinal value of honey: a review on its benefits on human health, with a special focus on its effects on glycemic regulation,” Ciencia e Investigación Agraria, vol. 38, no. 2, pp. 303–317, 2011. View at Publisher · View at Google Scholar
S. Kwon, Y. J. Kim, and M. K. Kim, “Effect of fructose or sucrose feeding with different levels on oral glucose tolerance test in normal and type 2 diabetic rats,” Nutrition Research and Practice, vol. 2, no. 4, pp. 252–258, 2008. View at Publisher · View at Google Scholar
O. O. Erejuwa, S. A. Sulaiman, and M. S. Wahab, “Fructose might contribute to the hypoglycemic effect of honey,” Molecules, vol. 17, no. 12, pp. 1900–1915, 2012. View at Publisher · View at Google Scholar · View at Scopus
G. L. Kellet, E. Brot-Laroche, and O. J. Mace, “Sugar absorption in the intestine: the role of GLUT2,” Annual Reviews of Nutrition, vol. 28, no. 1, pp. 35–54, 2008. View at Publisher · View at Google Scholar · View at Scopus
T. H. Moran and P. R. McHugh, “Distinction among three sugars in their effects on gastric emptying and satiety,” American Journal of Physiology Regulatory, Integrative and Comparative Physiology, vol. 241, no. 1, pp. R25–R30, 1981. View at Publisher · View at Google Scholar
P. C. Gregory, M. McFadyen, and D. V. Rayner, “Relation between gastric emptying and short-term regulation of food intake in the pig,” Physiology & Bahaviour, vol. 45, no. 4, pp. 677–683, 1989. View at Publisher · View at Google Scholar · View at Scopus
L. Thibault, “Dietary carbohydrates: effects on self-selection, plasma glucose and insulin and brain indoleaminergic systems in rat,” Appetite, vol. 23, no. 3, pp. 275–286, 1994. View at Publisher · View at Google Scholar · View at Scopus
C. J. Meirelles, L. A. Oliveira, A. A. Jordao, and A. M. Navarro, “Metabolic effects of the ingestion of different fructose sources in rats,” Experimental and Clinical Endocrinology & Diabetes, vol. 119, no. 4, pp. 218–220, 2011. View at Publisher · View at Google Scholar · View at Scopus
T. Fujisawa, J. Riby, and N. Kretchmer, “Intestinal absorption of fructose in the rat,” Gastroenterology, vol. 101, no. 2, pp. 360–367, 1991. View at Publisher · View at Google Scholar
K. Ushijima, J. E. Riby, T. Fujisawa, and N. Kretchmer, “Absorption of fructose by isolated small intestine of rats is via a specific saturable carrier in the absence of glucose and by the disaccharide-related transport system in the presence of glucose,” The Journal of Nutrition, vol. 125, no. 8, pp. 2156–2164, 1995. View at Google Scholar
O. O. Erejuwa, S. A. Sulaiman, M. S. Wahab, K. N. S. Sirajudeen, M. S. Salleh, and S. Gurtu, “Antioxidant protection of Malaysian Tualang honey in pancreas of normal and streptozotocin-induced diabetic rats,” Annales d’Endocronologie, vol. 71, no. 4, pp. 291–296, 2010. View at Publisher · View at Google Scholar · View at Scopus
M. Shiota, P. Galassetti, and K. Igawa, “Inclusion of low amounts of fructose with an intraportal glucose load increases net hepatic glucose uptake in the presence of relative insulin deficiency in dog,” American Journal of Physiology Endocrinology and Metabolism, vol. 288, no. 6, pp. E1160–E1167, 2005. View at Publisher · View at Google Scholar · View at Scopus
T. Iburi, H. Izumiyama, and Y. Hirata, “Endocrine glands of pancreas,” Nihon Rinsho, vol. 69, pp. 95–99, 2011. View at Google Scholar
J. L. Sievenpiper, R. J. de Souza, A. Mirrahimi et al., “Effect of fructose on body weight in controlled feefing trials: a systematic review and meta-analysis,” Annals of Internal Medicine, vol. 156, no. 4, pp. 291–304, 2012. View at Publisher · View at Google Scholar
N. Vaisman, E. Niv, and Y. Izkhakov, “Catalytic amounts of fructose may improve glucose tolerance in subjects with uncontrolled non-insulin-dependent diabetes,” Clinical Nutrition, vol. 25, no. 4, pp. 617–621, 2006. View at Publisher · View at Google Scholar · View at Scopus
K. F. Petersen, D. Laurent, C. Yu, G. W. Cline, and G. I. Shulman, “Stimulating effects of low-dose fructose on insulin-stimulated hepatic glycogen synthesis in humans,” Diabetes, vol. 50, no. 6, pp. 1263–1268, 2001. View at Publisher · View at Google Scholar
K. L. Teff, S. S. Elliott, M. Tschop et al., “Dietary fructose reduces circulating insulin and leptin, attenuates postprandial suppression of ghrelin, and increases triglycerides in women,” The Journal of Clinical Endocrinology & Metabolism, vol. 89, no. 6, pp. 2963–2972, 2004. View at Publisher · View at Google Scholar · View at Scopus
C. Ionescu-Târgovişte, E. Popa, E. Sintu, N. Mihalache, D. Cheta, and I. Mincu, “Blood glucose and plasma insulin responses to various carbohydrates in type 2 non-insulin-dependent diabetes,” Diabetologia, vol. 24, no. 2, pp. 80–84, 1983. View at Publisher · View at Google Scholar · View at Scopus
A. L. Sunehag, G. Toffolo, M. Campioni, D. M. Bier, and M. W. Haymond, “Short-term high dietary fructose intake had no effects on insulin sensitivity and secretion or glucose and lipid metabolism in healthy, obese adolescents,” Journal of Pediatric Endocrinology and Metabolism, vol. 21, no. 3, pp. 225–235, 2008. View at Publisher · View at Google Scholar
E. T. Ngo Sock, K. A. Le, M. Ith, R. Kreis, C. Boesch, and L. Tappy, “Effects of a short-term overfeeding with fructose or glucose in healthy young males,” British Journal of Nutrition, vol. 103, no. 07, pp. 939–943, 2009. View at Publisher · View at Google Scholar · View at Scopus
M. E. Bocarsly, E. S. Powell, N. M. Avena, and B. G. Hoebel, “High-fructose corn syrup causes characteristics of obesity in rats: increased body weight, body fat and triglyceride levels,” Pharmacology, Biochemistry and Behavior, vol. 97, no. 1, pp. 101–106, 2010. View at Publisher · View at Google Scholar · View at Scopus
L. C. Dolan, S. M. Potter, and G. A. Burdock, “Evidence-based review on the effect of normal dietary consumption of fructose on blood lipids and body weight of overweight and obese individuals,” Critical Reviews in Food Science and Nutrition, vol. 50, no. 10, pp. 889–918, 2010. View at Publisher · View at Google Scholar · View at Scopus
M. Madero, J. C. Arriaga, D. Jalal et al., “The effect of two energy-restricted diets, a low-fructose diet versus a moderate natural fructose diet, on weight loss and metabolic syndrome parameters: a randomized controlled trial,” Metabolism Clinical and Experimental, vol. 60, no. 11, pp. 1551–1559, 2011.View at Publisher · View at Google Scholar · View at Scopus
V. S. Malik, M. B. Schulze, and F. B. Hu, “Intake of sugar-sweetened beverages and weight gain: a systematic review,” The American Journal of Clinical Nutrition, vol. 84, no. 2, pp. 274–288, 2006. View at Google Scholar
R. L. Jentjens, K. Underwood, J. Achten, K. Currell, C. H. Mann, and A. E. Jeukendrup, “Exogenous carbohydrate oxidation rates are elevated after combined ingestion of glucose and fructose during exercise in the heat,” Journal of Applied Physiology, vol. 100, no. 3, pp. 807–816, 2006. View at Publisher · View at Google Scholar · View at Scopus
P. G. Prieto, J. Cancelas, M. L. Villanueva-Peñacarrillo, and I. Valverde, “Plasma D-glucose, D-fructose and insulin responses after oral administration of D-glucose, D-fructose and sucrose to normal rats,” Journal of the American College of Nutrition, vol. 23, no. 5, pp. 414–419, 2004. View at Publisher · View at Google Scholar · View at Scopus
K. Srinivasan, B. Viswanad, L. Asrrat, C. L. Kaul, and P. Ramaro, “Combination of high-fat diet-fed and low-dose streptozotocin-treated rat: a model for type 2 diabetes and pharmacological screening,” Pharmacological Research, vol. 52, no. 4, pp. 313–320, 2005. View at Publisher · View at Google Scholar · View at Scopus
S. Lenzen, “The mechanisms of alloxan- and streptozotocin-induced diabetes,” Diabetologia, vol. 51, no. 2, pp. 216–226, 2008. View at Publisher · View at Google Scholar · View at Scopus
M. S. Akhtar and M. S. Khan, “Glycemic responses to three different types of honeys given to normal and alloxan-diabetic rabbits,” Journal of Pakistan Medical Association, vol. 39, no. 4, pp. 107–113, 1989. View at Google Scholar
A. A. Fasanmade and O. T. Alabi, “Differential effects of honey on selected variables in alloxan-induced and fructose-induced diabetic rats,” African Journal of Biomedical Research, vol. 11, no. 20, pp. 191–196, 2008. View at Google Scholar
L. M. Chepulis, “The effect of honey compared to sucrose, mixed sugars and a sugar free diet on weight gain in young rats,” Journal of Food Science, vol. 72, no. 3, pp. S224–S229, 2007. View at Publisher · View at Google Scholar · View at Scopus
L. Chepulis and N. Starkey, “The long-term effects of feeding honey compared with sucrose and a sugar-free diet on weight gain, lipid profiles and DEXA measurements in rats,” Journal of Food Science, vol. 73, no. 1, pp. H1–H7, 2008. View at Publisher · View at Google Scholar · View at Scopus
J. Busseroles, E. Gueux, and E. Rock, “Substituting honey for refined carbohydrates protects rats from hypertriglyceridemic and prooxidative effects of fructose,” The Journal of Nutrition, vol. 132, pp. 3379–3382, 2002. View at Google Scholar
T. M. Nemoseck, E. G. Carmody, and A. Furchner-Evanson, “Honey promotes lower weight gain, adiposity, and tryglycerides than sucrose in rats,” Nutrition Research, vol. 31, no. 1, pp. 55–60, 2011. View at Publisher · View at Google Scholar · View at Scopus
O. O. Erejuwa, S. A. Sulaiman, M. S. Wahab, K. N. S. Sirajudeen, and M. S. Salzihan, “Effects of Malaysian Tualang honey supplementation on glycemia, free radical scavenging enzymes and markers of oxidative stress in kidneys of normal and streptozotocin-induced diabetic rats,” International Journal of Cardiology, vol. 137, article S45, 2009. View at Publisher · View at Google Scholar
A. Ahmad, M. K. Azim, M. A. Mesaik, and R. A. Khan, “Natural honey modulates physiological glycemic response compared to simulated honey and D-glucose,” Journal of Food Science, vol. 73, no. 7, pp. H165–H167, 2008. View at Publisher · View at Google Scholar · View at Scopus
M. Abdulrahman, M. El-Hefnawy, R. Hussein, and A. A. El-Goud, “The glycemic and peak incremental indices of honey, sucrose and glucose in patients with type 1 diabetes mellitus: effects on C-peptide level – a pilot study,” Acta Diabetologica, vol. 48, no. 2, pp. 89–94, 2011. View at Publisher · View at Google Scholar · View at Scopus
N. S. Al-Waili, “Identification of nitric oxide metabolites in various honeys: effects of intravenous honey on plasma and urinary nitric oxide metabolites concentration,” Journal of Medicinal Food, vol. 6, no. 4, pp. 359–364, 2003. View at Publisher · View at Google Scholar
N. S. Al-Waili, “Investigating the antimicrobial activity of natural honey and its effects on the pathogenic bacterial infections of surgical wounds and conjunctiva,” Journal of Medicinal Food, vol. 7, no. 2, pp. 210–222, 2004. View at Publisher · View at Google Scholar · View at Scopus
O. P. Agrawal, A. Pachauri, H. Yadav et al., “Subjects with impaired glucose tolerance exhibit a high degree of tolerance to honey,” Journal of Medicinal Food, vol. 10, no. 3, pp. 473–478, 2007. View at Publisher · View at Google Scholar · View at Scopus
N. Gheldorf, X. H. Wang, and N. J. Engeseth, “Buckwheat honey increases serum antioxidant capacity in humans,” Journal of Agricultural and Food Chemistry, vol. 51, no. 5, pp. 1500–1505, 2003. View at Publisher · View at Google Scholar · View at Scopus
N. S. Al-Waili, “Natural honey lowers plasma glucose, C-reactive protein, homocysteine, and blood lipids in healthy, diabetic and hyperlipidemic subjects: comparison with dextrose and sucrose,” Journal of Medicinal Food, vol. 7, no. 1, pp. 100–107, 2004. View at Publisher · View at Google Scholar · View at Scopus
E. Van Schaftingen and A. Vandercammen, “Stimulation of glucose phosphorylation by fructose in isolated rat hepatocytes,” The FEBS Journal, vol. 179, no. 1, pp. 173–177, 1989. View at Publisher · View at Google Scholar · View at Scopus
M. A. Abdulrhman, “Honey as a sole treatment of type 2 diabetes mellitus,” Endocrynology & Metabolic Syndrome, vol. 5, no. 2, p. 232, 2016. View at Publisher · View at Google Scholar
D. J. Jenkins, T. M. Wolever, R. H. Taylor et al., “Glycemic index of foods: a physiological basis for carbohydrate exchange,” American Journal of Clinical Nutrition, vol. 34, no. 3, pp. 362–366, 1981. View at Google Scholar
Y. Ido, A. Vindigni, and K. Chang, “Prevention of vascular and neural dysfunction in diabetic rats by C-peptide,” Science, vol. 277, no. 5325, pp. 563–566, 1997. View at Publisher · View at Google Scholar · View at Scopus
S. Elliot, N. Keim, and J. Stern, “Fructose, weight gain and the insulin,” The American Journal of Clinical Nutrition, vol. 76, pp. 911–922, 2002. View at Google Scholar
M. Watford, “Small amounts of dietary fructose dramatically increase hepatic glucose uptake through a Novel Mechanism of Glucokinase Activation,” Nutrition Reviews, vol. 60, no. 8, pp. 253–257, 2002. View at Publisher · View at Google Scholar · View at Scopus
M. Soylu, T. Atayoğlu, N. Incaç, and S. Silici, “Glycemic index values of multifloral Turkish honeys and effect of their consumption on glucose metabolism,” Journal of Apicultural Research, vol. 54, no. 3, pp. 155–162, 2015. View at Publisher · View at Google Scholar · View at Scopus
F. Atkinson, K. Powell, and J. Brandt-Miller, “International tables of glycemic index and glycemic load values: 2008,” Diabetes Care, vol. 31, no. 12, pp. 2281–2283, 2008. View at Publisher · View at Google Scholar · View at Scopus
H. Rasad, A. Dashtabi, M. Khansari et al., “The effect of honey consumption compared with sucrose on blood pressure and fasting blood glucose in healthy young subjects,” Global Journal of Medicine Research and Studies, vol. 1, no. 4, pp. 117–121, 2014. View at Google Scholar
M. Abdulrhman, M. El Hefnawy, R. Ali, I. Abdel Hamid, A. Abou El-Goud, and D. Refai, “Effects of honey, sucrose and glucose on blood glucose and C-peptide in patients with type 1 diabetes mellitus,” Complementary Theraphy in Clinical Practice, vol. 19, no. 1, pp. 15–19, 2013. View at Publisher · View at Google Scholar · View at Scopus
F. Alam, A. Islam, S. H. Gan, and I. Khalil, “Honey: a potential therapeutic agent for managing diabetic woulds,” Evidence-Based Complementary and Alternative Medicine, vol. 2014, Article ID 169130, 16 pages, 2014. View at Publisher · View at Google Scholar · View at Scopus
N. Singh, D. G. Armstrong, and B. A. Lipsky, “Preventing foot ulcers in patients with diabetes,” JAMA, vol. 293, no. 2, pp. 217–228, 2005. View at Publisher · View at Google Scholar · View at Scopus
L. A. Lavery, K. R. Higgins, and D. R. Lanctot, “Preventing diabetic foot ulcer recurrence in high-risk patients: use of temperature monitoring as a self-assessment tool,” Diabetes Care, vol. 30, no. 1, pp. 14–20, 2007. View at Publisher · View at Google Scholar · View at Scopus
R. A. Cooper, P. C. Molan, and K. G. Harding, “Antibacterial activity of honey against strains of Staphylococcus aureus from infected wounds,” Journal of the Royal Society of Medicine, vol. 92, no. 6, pp. 283–285, 1999. View at Publisher · View at Google Scholar
L. Estevinho, A. P. Pereira, L. Moreira, L. G. Dias, and E. Pereira, “Antioxidant and antimicrobial effects of phenolic compounds extracts of Northeast Portugal honey,” Food and Chemical Toxicology, vol. 46, no. 12, pp. 3774–3779, 2008. View at Publisher · View at Google Scholar · View at Scopus
K. A. Mathews and A. G. Binnington, “Wound management using honey,” Compendium on Continuing Education for the Practicing Verterinarian, vol. 24, no. 1, pp. 53–59, 2002. View at Google Scholar
V. Bansal, B. Medhi, and P. Pandhi, “Honey – a remedy rediscovered and its therapeutic utility,” Kathmandu University Medical Journal, vol. 3, no. 3, pp. 305–309, 2005. View at Google Scholar
T. T. Phan, L. Wang, P. See, R. J. Grayer, S. Y. Chan, and S. T. Lee, “Phenolic compounds of Chromolaena adorata protect cultured skin cells from oxidative damage: implications for cutaneous wound healing,” Biological and Pharmaceutical Bulletin, vol. 24, no. 12, pp. 1373–1379, 2001. View at Publisher · View at Google Scholar · View at Scopus
N. S. Al-Waili and N. Saleeb, “Honey increased nitric oxide and product in saliva of healthy volunteers,” in FASEB Conference, pp. 11–15, San Diego, 2003.
P. C. Molan, “The role of honey in the management of wounds,” Journal of Wound Care, vol. 8, no. 8, pp. 415–418, 1999. View at Publisher · View at Google Scholar
P. C. Molan, “Re-introducing honey in the management of wounds and ulcers-theory and practice,” Ostomy/Wound Management, vol. 48, no. 11, pp. 28–40, 2002. View at Google Scholar
A. V. Kamaratos, K. N. Tzirogiannis, S. A. Iraklianou, G. I. Panoutsopoulos, I. E. Kanellos, and A. I. Melidonis, “Manuka honey-impregnated dressings in the treatment of neuropathic diabetic foot ulcers,” International Wound Journal, vol. 11, no. 3, pp. 259–263, 2014. View at Publisher · View at Google Scholar · View at Scopus
A. Shukrimi, A. R. Sulaiman, A. Y. Halim, and A. Azril, “A comparative study between honey and povidone iodine as dressing solution for Wagner type II diabetic foot ulcers,” Medical Journal of Malaysia, vol. 63, no. 1, pp. 44–46, 2008. View at Google Scholar
H. A. Alzahrami, B. A. Bakhotmah, and L. Boukraa, “In vitro susceptibility of diabetic wound bacteria to mixture of honey, Commiphora molmol and Nigella sativa,” The Open Nutraceuticals Journal, vol. 4, pp. 172–175, 2011. View at Publisher · View at Google Scholar · View at Scopus
M. Al Saeed, “Therapeutic efficacy of conventional treatment combined with Manuka honey in the treatment of patients with diabetic foot ulcers: a randomized controlled study,” The Egyptian Journal of Hospital Medicine, vol. 53, pp. 1064–1071, 2013. View at Publisher · View at Google Scholar
M. Lotfy, G. Badra, V. Burham, and F. Q. Alenzi, “Combined used of honey, bee propolis and myrth in healing a deep, infected wound in a patient with diabetes mellitus,” British Journal of Medical Science, vol. 63, no. 4, pp. 171–173, 2006. View at Google Scholar
S. A. Meo, S. A. Al-Asiri, A. L. Mahesar, and M. J. Ansari, “Role of honey in modern medicine,” Saudi Journal of Biological Sciences, vol. 24, no. 5, pp. 975–978, 2017. View at Publisher · View at Google Scholar · View at Scopus
J. M. Alvarez-Suarez, F. Giampieri, M. Cordero et al., “Activation of AMPK/Nrf2 signalling by Manuka honey protects human dermal fibroblasts against oxidative damage by improving antioxidant response and mitochondrial function promoting wound healing,” Journal of Functional Foods, vol. 25, pp. 38–49, 2016. View at Publisher · View at Google Scholar · View at Scopus
S. A. Meo, M. J. Ansari, K. Sattar, C. H. Ullah, W. Hajjar, and S. Alasiri, “Honey and diabetes mellitus: obstacles and challenges – road to be repaired,” Saudi Journal of Biological Sciences, vol. 24, pp. 1038–1042, 2017. View at Publisher · View at Google Scholar · View at Scopus