Patients with diabetes often face a brutal “syndemic”—a tangled web of chronic illness, Relentless nerve pain (neuropathy), and severe depression, all fueled by a common biological enemy: metabolic inflammation and Advanced Glycation End-products (AGEs). In this episode, we explore why ketamine, with its rapid antidepressant and non-opioid painkilling properties, looks like the perfect “two birds, one stone” solution on paper.

But in practice, it requires walking a high-stakes “metabolic tightrope.” We dive into the complex risks:

* The Glucose Rollercoaster: Ketamine can trigger a stress response that spikes blood sugar (hyperglycemia), yet in Type 1 diabetics, it has also been linked to dangerous, delayed drops (hypoglycemia).

* The Liver “Traffic Jam”: In Typ ...