Experts emphasise the need for regular ketone checks in type 1 diabetes, as a new FDA-approved wearable device enables continuous dual glucose and ketone monitoring to help prevent diabetic ketoacidosis.
Experts are urging people with diabetes who are at risk of diabetic ketoacidosis to check ketones regularly and to have a clear plan in place for what to do if levels rise. Christie Beatson, a senior instructor at the Barbara Davis Centre for Diabetes at the University of Colorado, said at the Association of Diabetes Care & Education Specialists annual meeting that monitoring ketones should be treated as a routine part of type 1 diabetes care, especially now that a newly authorised wearable can track glucose and ketones together. The FDA said the Libre Duo 10 Day Continuous Dual Glucose Ketone Monitoring System is the first U.S. wearable approved to continuously measure both markers in people aged two and over with diabetes.
Beatson told the meeting that diabetic ketoacidosis, or DKA, develops when a lack of insulin causes ketones to build up in the blood, leading to a dangerous medical emergency. She said the condition is seen in a meaningful share of adults with type 1 diabetes each year and is especially common at diagnosis in children and adolescents. Beatson also pointed to survey data published in BMJ Open Diabetes Research & Care in 2023 showing that many people with type 1 diabetes do not know the warning signs or routinely test ketones, underlining the gap between clinical guidance and real-world practice.
Until now, home ketone testing has often been awkward or costly. Beatson said urine strips are inconvenient and can be hard to interpret, while blood ketone testing requires a meter and strips that are not always prescribed and may not be covered by insurance. She said continuous dual monitoring could reduce some of those barriers by offering real-time readings and alerts, which may help spot ketosis earlier and lower the risk of repeated DKA episodes, though it may also bring new challenges such as alarm fatigue and the need for more patient education.
Beatson said the practical response should be a written ketone management plan that sets out what to do if levels rise, when to contact a clinic and when to go to emergency care. She cited a January consensus statement in The Lancet Diabetes & Endocrinology as a possible framework for those thresholds. The FDA said the Libre Duo sends readings wirelessly to a compatible smartphone and can alert users when ketone levels reach concerning ranges, giving clinicians and families a new tool but not a substitute for clear instructions and follow-up.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
