Concept: continuous glucose + ketone sensor
What we should build — a single wearable sensing both glucose and ketones continuously, so closed loops and their users catch failed sites and illness before they become DKA. Dual sensors are now entering trials.
The scorecard
Glucose accuracy presumed on par with current sensors; ketone accuracy is the open question.
Glucose lag unchanged; the value is a new analyte, not lower lag.
Value depends on loops actually consuming the ketone channel — a standards question.
Continuous ketone alerts would address one of pump therapy's most dangerous failure modes.
The entire point — continuous ketone detection, today's biggest sensing gap.
Assumed factory-calibrated to be practical.
Editor’s take
We rank this as the most important sensing upgrade on the roadmap. Ketone blindness is why a kinked cannula can escalate to the ER; a continuous ketone channel turns that from emergency into early warning.
The full picture
Every CGM today is glucose-blind to the one thing that turns a bad day into a hospital visit: ketones. When an infusion site fails or illness strikes, glucose and ketones can climb together toward diabetic ketoacidosis — and the loop, seeing only glucose, reacts late and partially.
A continuous glucose-and-ketone sensor closes that blind spot. Abbott and others have dual-analyte sensors in development, and we treat this as a first-class sensing advance rather than a feature bolt-on. The open questions are ketone accuracy, how loops should act on the new signal, and cost — but the direction is unambiguous, so it earns a concept/early entry near the top of the sensing wishlist.
Coming soon
ETA · CE-marked in Europe (May 2026); US FDA review pending
- →Continuous glucose-and-ketone sensor: Abbott's Libre Duo received the CE Mark in May 2026 and measures both analytes every minute
- →Wearable continuous ketone monitoring under study in clinical trials (e.g. NCT06753994); US FDA clearance for Libre Duo still pending
Sources
- [1]Prevalence, Cost, and Burden of Diabetic Ketoacidosis · peer-reviewed — Reports an international expert consensus recommending a continuous ketone monitoring system, ideally one combining CGM with 3-β-OHB in a single sensor; also documents poor adherence to fingerstick ketone testing and euglycemic DKA risk with SGLT2 inhibitors.
- [2]Abbott secures CE Mark for world's first dual glucose-ketone sensing technology for people with diabetes · manufacturer — Libre Duo measures glucose and ketones every minute for early DKA warning; CE-marked May 2026, not yet cleared in the US.
- [3]Continuous Ketone Monitoring Captures Overt Ketosis in Type 1 Diabetes Caused by Empagliflozin, Low-Carbohydrate Diet, and Exercise · peer-reviewed — Wearable continuous ketone monitor detected sustained ketosis (>1.0 mmol/L for 14 h) while CGM showed euglycemia — exactly the blind spot glucose-only sensing misses.
- [4]Continuous Ketone Monitoring in Participants With Type 1 Diabetes Using SGLT2 Inhibitors as Adjunctive Therapy (NCT06753994) · registry — McGill University trial evaluating wearable continuous ketone monitoring in T1D.