How Ketamine Impacts Blood Sugar

A lesser-known effect of Ketamine is that it tends to cause temporary, yet significant, fluctuations in blood sugar. While smaller amounts are shown to possibly increase blood glucose in a person, there is strong evidence that their levels often decrease following moderate-heavy doses, sometimes to dangerously low levels.

Helpful precautions include having sugary beverages or snacks on-hand for post-use.

Ketamine Often Causes Significant Blood Sugar Fluctuations

While the mechanism of action is not yet fully understood, there is strong evidence that Ketamine use may result in temporary, yet notable, changes in blood glucose concentrations. 

Healthy blood sugar levels (except after a meal) is 70-100mg/dl. Small doses are shown to often increase blood glucose above that range (“hyperglycemia”), and moderate-heavy doses generally decreases it, sometimes below the normal range (“hypoglycemia”). Ketamine’s effects on people with type I and II diabetes, which are becoming more prevalent in America, are complicated and warrant its own future discussion.

One study monitored the point-of-care testing for blood glucose (POCT-BG) for a patient receiving IV Ketamine therapy. 

While this patient has Type 1 diabetes, blood glucose levels dropped below healthy range more than ⅓ of the time. 

Similar effects of Ketamine administration have been reported in rabbits (Sharif & Abouazra, 2009).

Effects of Hypoglycemia Include:

• Release of growth hormone and cortisol, which manifests as sweating, shaking, pale skin, and heart palpitations. 

• Impaired cognitive function, confusion, drowsiness, memory loss, coma

• Seizures, followed by temporary paralysis in parts of the body (“Todd’s Paresis”)

• Cardiovascular complications, including irregular heartbeat (arrhythmia), tachycardia (above 100 BPM) or bradycardia (below 60 BPM).

What Can You Do if You’re Experiencing Symptoms of Low Blood Sugar Post-Ketamine Use?

Because Ketamine is also shown to dehydrate cells and tissue (another topic for a later date), beverages such as Pedialyte and ElectroLit are great for replenishing both sugar and electrolytes. 

Oral glucose, honey, candies are great as well. 

Luckily, unlike other sedatives, Ketamine generally does not suppress motor function for swallowing, so there’s minimal risk of choking and asphyxiation (Melanson & Leri, 2021). 

Sources Cited:

Lortrakul J, Pattanaseri K. A Case Report of Ketamine-induced Hypoglycemia in Treatment Resistance Depression. Clin Psychopharmacol Neurosci. 2024;22(3):541-543. doi:10.9758/cpn.23.1155

Melanson B, Leri F. Effect of ketamine on the physiological responses to combined hypoglycemic and psychophysical stress. IBRO Neurosci Rep. 2021;11:81-87. Published 2021 Aug 23. doi:10.1016/j.ibneur.2021.08.002

Sharif, Suleiman I., and Hanan A. Abouazra. “Effect of intravenous ketamine administration on blood glucose levels in conscious rabbits.” American Journal of Pharmacology and Toxicology, vol. 4, no. 2, 1 Feb. 2009, pp. 38–45, https://doi.org/10.3844/ajptsp.2009.38.45. 

Amiel SA. The consequences of hypoglycaemia. Diabetologia. 2021;64(5):963-970. doi:10.1007/s00125-020-05366-3