The Future of Dual Glucose–Ketone Monitoring in Youth with Diabetes

Diabetic ketoacidosis (DKA) is the most common acute complication and leading cause of mortality in children and adolescents with diabetes. While DKA is mainly seen in type 1 diabetes, youth with type 2 diabetes, especially adolescents, are also susceptible to this condition. As a standard of care, individuals at risk for DKA and their caregivers are provided with instructions for preventing and managing ketone development. However, the use of urine ketone or blood ketone monitoring is often suboptimal. Abbott Diabetes Care (Alameda, CA) is developing a dual monitoring system that continuously measures interstitial glucose and β-hydroxybutyrate using a single continuous dual glucose-ketone (DGK) sensor. The use of continuous ketone monitors in the pediatric population has the potential to improve at-home monitoring and early initiation of intervention with rising ketone levels prior to severe DKA requiring hospitalization. This article reviews the importance of ketone testing, examines current testing options, and discusses how DGK, a novel testing technology, can reduce the occurrence of DKA in children and adolescents who are living with diabetes.