Diabetes is the 3^rd leading cause of death. More than 285 million people worldwide have diabetes. WHO projected that diabetes death will double between 2005 & 2030. One of common cause of morbidity in ulcer patient is diabetic foot ulcer. There are several treatment options available for diabetic foot ulcer but with its own limitations.

Honey has been used to treat wound since ancient time. But medical evidence supporting this is limited. There are few case reports and also few randomized control trials which have shown effectiveness of honey in treating ulcer. most of reviews on honey has concluded that there is limitation in the quantity of data produced suggested to have more no of trials with honey for wound treatment. Honey has got multiple properties like antioxidant, anti-inflammatory, antimicrobial which may contribute to its wound healing property. Honey may stimulate multiple actions on wounds. It appears to draw fluid from the underlying circulation, providing both moist environment and topical nutrition which may enhance tissue growth. Therefore a randomized controlled trial is needed to establish the effect and role of honey on wound healing and infection clearance in patients with diabetic foot ulcers.

The following study is an Open label randomized controlled clinical trial with 2 arms-Betadine dressing group, honey dressing group. Each group will have 40 patients each. After Informed consent, eligible patients will be randomized to one of the treatment arms. A detailed medical history including diabetes history and its complications, vital signs and physical examination will be performed. Wound will be inspected. Wound stage, size, depth, presence of slough, exudates, malodor and status of the granulation tissue will be noted. Patients will be examined by surgical experts to exclude cellulites, abscess, osteomyelitis or gangrene. Fasting plasma glucose will be done before recruiting the patient.

At the baseline visit microbiological culture from the wound will be obtained. After collection of exudates for culture, treatment with honey or povidone iodine will be started, daily dressings will be done until the patient is discharged. After discharge the dressing frequency may be altered as per the decisions of surgeons. Patients will be examined for clinical response and infection clearance up to 3 weeks. Final examination will be done at 6 week from the commencement of the treatment.

This study is aimed at evaluating the clinical and microbiological efficacy of honey which may help in bringing topical honey preparation as the standard therapy for diabetic ulcer treatment in future