Based on NIH | Should I be cautious about how much honey I consume while taking metformin, and is there a recommended limit to avoid blood sugar issues or interactions?

Honey does not have a direct drug interaction with metformin, but it is still important to be cautious with the amount you consume because honey is a concentrated sugar that can raise blood glucose and affect long‑term control. Metformin by itself rarely causes low blood sugar, so honey is not needed for routine use; however, small amounts of fast sugar like honey can be used to quickly treat low blood sugar if it ever occurs, especially when metformin is combined with other diabetes medicines. ^{[1] [2]} In everyday eating, honey should be counted as a carbohydrate and limited to keep blood sugars and A1C in a healthy range. ^{[3] [4]}

Does honey interact with metformin?

• There is no known harmful chemical interaction between honey and metformin. Metformin does not usually cause hypoglycemia (low blood sugar) when taken alone under normal circumstances. ^{[1] [2]}
• Low blood sugar can still occur in certain situations (for example, if you skip meals, drink alcohol, exercise without eating, or add other glucose‑lowering medicines like sulfonylureas or insulin). In those cases, quick sugars including honey are appropriate for treatment. ^{[2] [5]}
• Official medication guides advise carrying fast-acting glucose sources and note that honey or table sugar can be used to rapidly raise blood sugar if symptoms of hypoglycemia arise. This is emergency use, not daily supplementation. ^{[6] [7]}

How honey affects blood sugar

• Honey is mostly sugar (glucose and fructose), so it raises blood glucose, particularly after meals. In people with type 2 diabetes, regular honey intake has been shown to increase hemoglobin A1C (the 2–3 month average of blood sugar), even when fasting glucose did not change. ^[8]
• Some small trials have noted potential benefits on weight and cholesterol with honey products, but they did not show meaningful improvements in fasting glucose or A1C over 40 days. ^{[9] [10]}
• Animal studies have suggested honey combined with metformin or sulfonylureas may lower glucose more than the drug alone, but animal data do not replace human evidence and should not guide dosing decisions. ^[11]

Practical limits and how to include honey safely

• There is no metformin‑specific “maximum” for honey; instead, focus on total carbohydrate budgeting for diabetes. Carbohydrate needs vary by person, and an individualized carb plan per meal is recommended rather than a single fixed number. ^[4]
• From a diabetes nutrition perspective, prioritize non‑starchy vegetables and minimally processed foods, and keep added sugars (including honey) to small amounts. ^[3]
• A reasonable, cautious approach for most adults with type 2 diabetes is:
  • Limit added sugars, including honey, to the smallest amounts needed for taste often no more than 1–2 teaspoons (5–10 mL) at a time, and budget these within your meal’s total carb target. (Use your clinician’s or dietitian’s carb goals.)
  • Pair honey with protein, fiber, or fat (for example, plain yogurt or whole‑grain toast with nut butter) to slow the glucose rise. Monitor your glucose response with your meter or CGM and adjust. ^{[3] [4]}
  • Avoid using honey daily as a “health food”; treat it as an occasional sweetener within your carb plan to help keep A1C in range. Be aware that regular intake can nudge A1C up over weeks to months. ^[8]

Special situations: hypoglycemia and combination therapy

• If you ever develop low blood sugar symptoms (shakiness, sweating, confusion) while on metformin plus other glucose‑lowering medicines, use fast‑acting carbs immediately: glucose tablets or gel are preferred, but honey or table sugar can work in a pinch, followed by checking your blood sugar. ^{[6] [7]}
• Metformin combined with insulin or sulfonylureas increases hypoglycemia risk, and those doses may need adjustment. ^[12] Discuss targets and rescue plans with your clinician. ^[5]

Alcohol and timing with meals

• Take metformin with meals to reduce stomach side effects and support glucose control. Avoid heavy alcohol use, which raises the risk of lactic acidosis and can contribute to hypoglycemia, especially with missed meals. ^{[13] [14] [15] [16]}

Bottom line

• There is no direct harmful interaction between honey and metformin, but honey is an added sugar that can raise blood glucose and A1C if consumed regularly. ^{[1] [8]}
• Keep honey to small, occasional amounts within your personalized carb plan, and use it for treating low blood sugar only when needed, particularly if you’re on additional diabetes medications. ^{[6] [2]}
• Work with a dietitian or diabetes educator to set meal‑by‑meal carb goals and test your individual glucose response, so you can enjoy foods safely while maintaining control. This individualized approach is recommended over a one‑size‑fits‑all limit. ^[4]

Would you like help estimating a carb budget for your typical meals so you can decide how much room you have for a small amount of honey?