Ketamine in Diabetes Care: Metabolic Insights and Clinical Applications.
Pharmaceutics January 8, 2026 Shiryn D Sukhram, Majandra Sanchez, Ayotunde Anidugbe et al.
Depression and diabetic neuropathy often co-occur with diabetes, worsening blood sugar control and quality of life. Ketamine and its S-enantiomer, esketamine, offer rapid antidepressant and pain-relieving effects, but diabetes-related changes and other medications may alter their effectiveness and safety. A scoping review of 11 studies (including human case reports, one randomized trial, narrative reviews, and rodent studies) found short-term improvements in treatment-resistant depression and neuropathic pain, including opioid-sparing postoperative pain relief in gestational diabetes. Blood sugar effects varied, with both high and low blood sugar reported. Interactions with common diabetes drugs and liver enzymes (CYP3A4, CYP2B6) remain poorly studied. The authors call for dedicated pharmacokinetic and pharmacodynamic studies to guide individualized dosing in diabetes.