Demystifying the Use of Honey in Diabetes Management: a Case of Type Ii Diabetes Patients at Kenyatta National Hospital, Nairobi. Martha N. Chege

Abstract

Diabetes is a metabolic disorder where insulin is either not sufficiently produced or properly utilised. Type II diabetes is more common, with the prevalence rate among adults in Kenya being 3.6%. This is of increasing public health concern due to the social and economic burden of the disease. With dietary management and availability of anti-diabetic drugs being far from satisfactory, an increasing number of diabetic populations globally now resort to complementary and alternative medicines. Honey has been seen to be a valuable agent in the management of type II diabetes and associated complications. This study sought to explore the potential and extent of use of honey by diabetics, their knowledge and practices on use of honey as part of the diet. The study was a cross-sectional survey carried out at the Kenyatta National Hospital outpatient diabetes clinic. The study respondents were type II diabetics who were studied for their knowledge, perceptions and practices on use of honey. It also had a retrospective component as three consecutive blood sugar readings were obtained to help show association between use of honey and glycaemic control. Health care providers were key informants in the study to corroborate information obtained from the clients and/or their recorded data. Altogether, questionnaires were administered to 126 respondents with all ethical considerations observed. The distribution of the respondents was 60% females and 40% males with an average age of 57 years. More than 50% of the respondents had completed secondary education and had a source of income, mainly through employment in personal business ventures or formal employment. Slightly more than half of the respondents (52%) lived in rural settings across various counties around Nairobi county. The estimated average monthly income was KES 20, 205 while almost half of the total income (49%) would be spent on the household food per month. xiv Results indicated that only 21.4% of the respondents were using honey as part of their diet. The main reasons for use were mainly to sweeten beverages (40.7%), as an alternative bread spread (33.3%) or because they were advised to use it (18.5%).Respondents who did not use honey either gave reason for it being bad for blood glucose control (47.5%) or they were advised against using it (17.2%). The respondents identified the benefits of honey as improving blood sugar during hypoglycaemia (45%), regulating blood sugar (25%), its role in wound healing (15%) or therapeutic cure for colds and flu (10%). The main source of information on honey use was identified as word of mouth from friends (59.3%), while the main purchase point for almost half of the respondents was directly from farmers (48.1%) and supermarkets (40%). Among respondents using honey, 63%used a teaspoon per day. The modes of consumption identified were either as bread spread (51.9%), in boiled water (33.3%), as a sweetener in tea (14.8%) and plain ingestion (14.8%). Knowledge or perceived benefits of honey in managing diabetes, did not translate to its actual use. There was no significant difference in the mean blood glucose levels between those using honey and those not using honey. However, those using honey were more likely to have normal readings compared to those not using honey. Generally, the longer the respondents consumed honey, the more likely they were to have elevated blood glucose, but with less associated complications of nephropathy, ketoacidosis and diabetic foot. In conclusion, there was an apparent lack of knowledge on benefits associated with use of honey in diabetes management. Knowledge on the benefits of honey did not translate to its use as part of the diabetics' diet. There were no standard practices of honey consumption among diabetics. There is lack of guidelines or policy in the country in this area.