Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


OBJECTIVE: The objective of this systematic review is to determine whether or not honey could be used as an effective topical treatment for diabetic foot ulcers in diabetic patients.

STUDY DESIGN: Review of three primary journal articles published in English between the years of 2008 and 2010.

DATA SOURCES: Two Randomized Controlled Trials comparing honey as a treatment for diabetic foot ulcers to either previous failed treatments or Povidone Iodine Solution, and a pilot prospective study, exploring the effectiveness of PEDYPHAR a royal jelly ointment. All articles were found using Pubmed, OVID and Cochrane Database.

OUTCOMES MEASURED: Healing time and percent of patients to reach wound closure or a state of healing ready for surgical closure was assessed in all of the studies. Healing was assessed by surgeons and was determined based on size of the ulcer and change in grade and stage using either the University of Texas Diabetic Wound Classification or the Wagner Classification, inflammation,
presence of bacterial cultures and, presence of exudate.

RESULTS: The Shukrimi et al. study showed that honey used as a dressing for diabetic foot ulcers was as effective as the control group using Povidone Iodine in days for healing. Moghazy et al. demonstrated that honey used on different stages of diabetic foot ulcers was effective at providing healing in a relatively short duration. The pilot prospective study by Abdelatif et al. also portrayed efficient healing with the use of PEDYPHAR and healing time was completed in a timely manner. The only side affect noted in the three studies was in the pilot prospective study. Four patients encountered mild burning with application of the PEDYPHAR ointment, but still continued with its use.

CONCLUSIONS: All studies showed that honey was effective in allowing for healing improvements in treating diabetic foot ulcers. Further studies are needed to assess the stages in which honey is most efficient in healing and where surgery may be necessary before use of honey. In addition, comparing honey that is raw versus honey that has been heat-treated as is the kind for consumer consumption.