Integrating Continuous Dual Glucose-Ketone Monitoring into Clinical Practice

Diabetic ketoacidosis (DKA) is a life-threatening diabetes emergency associated with mortality and severe morbidities in individuals with diabetes. DKA mainly presents with significant hyperglycemia (>250 mg/dL); however, with the increasing use of sodium-glucose transporter 2 inhibitors, we are seeing an increase in euglycemic DKA (euDKA) in both type 1 diabetes and type 2 diabetes. Although severe DKA generally requires emergency department services or inpatient hospitalization, clinicians can play an important role in helping patients prevent DKA by providing comprehensive education to their patients regarding early identification of elevated ketone states and intervention for improvement in ketone production, thus potentially preventing the severity of DKA. Although ketone monitoring is recommended for all patients at risk for developing DKA or euDKA, current ketone monitoring methods have significant limitations. Abbott Diabetes Care (Alameda, CA) is developing a dual monitoring system that continuously measures interstitial glucose and β-hydroxybutyrate using a single sensor. This article discusses how continuous dual glucose-ketone monitoring can be integrated into primary care practice when it becomes available.