Diana Isaacs, PharmD, is an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic.

The World’s First Dual Glucose-Ketone Monitor Receives Clearance in Europe

On May 27, 2026, Abbott announced the receipt of CE mark in Europe for the world’s first dual glucose-ketone monitor in patients with diabetes. The Libre Duo and Libre Duo 10 Day devices are both designed to continuously measure glucose and ketone levels every minute, allowing patients to simultaneously monitor glucose levels for diabetes management and predict diabetic ketoacidosis (DKA) through rising ketones.

Diabetes Dialogue cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, break down the groundbreaking new approval and what it could mean for patients in the US awaiting a similar decision from the US Food and Drug Administration.

Check out the full episode on the latest diabetes news

In this segment, Isaacs and Bellini explain that the system continuously measures glucose and ketones through a single wearable sensor, providing minute-by-minute visibility into rising ketone levels that may signal impending DKA. The conversation highlights how current ketone testing practices remain limited and outdated, with many patients still relying on urine ketone testing due to the cost and inconvenience of blood ketone strips. Against this backdrop, the panel positions continuous ketone monitoring as a substantial advancement in diabetes care that may ultimately become standard practice, particularly in type 1 diabetes management.

A significant portion of the discussion focuses on the rationale for the two sensor versions. The Libre Duo 15-day sensor is intended for adults, while the Libre Duo 10 Day is approved for pediatric patients aged 2 years and older. The speakers note that shorter wear duration in children resulted in improved reliability and fewer sensor failures during clinical testing, reflecting the unique challenges associated with pediatric sensor wear, including higher activity levels, variable movement, and greater rates of adhesion-related complications.

The cohosts place particular emphasis on the clinical implications for patients using SGLT2 inhibitors. While these therapies provide important cardiovascular and renal benefits in both type 2 diabetes and chronic kidney disease, their association with euglycemic DKA has limited broader use in some populations, particularly individuals with type 1 diabetes. Bellini and Isaacs suggest that continuous ketone monitoring could provide a safer framework for using these medications by identifying rising ketone levels earlier and allowing clinicians to individualize therapy before progression to clinically significant DKA.

Additional high-priority use cases discussed include individuals with type 1 diabetes using insulin pumps or automated insulin delivery systems, where interruptions in insulin delivery can rapidly precipitate ketosis and DKA. The speakers note that infusion set failures may occur without immediate symptoms, leading to delayed recognition until nausea, vomiting, or hospitalization develops. Continuous ketone monitoring is framed as a potential tool to identify these events much earlier and reduce avoidable emergency department visits and hospital admissions.

The conversation also explores broader patient populations that may benefit from the technology, including patients with recurrent DKA, hospitalized individuals at elevated risk for ketosis, and pediatric patients with highly variable glycemic patterns. The panel stresses that ketone formation does not correlate linearly with glucose levels, reinforcing the need for direct ketone monitoring rather than relying solely on hyperglycemia as a predictor of DKA risk.

The speakers additionally discuss practical and logistical considerations surrounding implementation, including reimbursement, device cost, insurance coverage, and integration with automated insulin delivery systems. They speculate that Abbott’s introduction of integrated ketone sensing may influence patient preferences between continuous glucose monitoring platforms, particularly as competing systems currently lack this capability.

The discussion concludes with optimism regarding the broader future of continuous ketone monitoring, while acknowledging that not all individuals with diabetes will require the technology. Ultimately, the panel characterizes the approval as a significant step toward more proactive, individualized diabetes management and a potential shift in the standard of care for patients at highest risk for DKA.

Editor’s Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others.

1: Abbott. Abbott Secures CE Mark for World’s First Dual Glucose-Ketone Sensing Technology for People With Diabetes. May 27, 2026. Accessed May 29, 2026. 

https://abbott.mediaroom.com/2026-05-27-Abbott-secures-CE-Mark-for-worlds-first-dual-glucose-ketone-sensing-technology-for-people-with-diabetes

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Diabetes Dialogue cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, cover the recent approval of the Libre Duo and Libre Duo 10 Day monitors.

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Addressing Pediatric Patients and Caregivers Fears in Dermatology, With Lisa Swanson, MD

, host Mona Shahriari, MD and pediatric dermatologist Lisa Swanson, MD continued their discussion on the emotional realities of pediatric dermatology, focusing on the burden chronic skin disease places not only on patients but also on parents and caregivers.

The conversation began with Shahriari reflecting on the importance of counseling families following diagnoses such as vitiligo. She described a memorable encounter with the mother of a child diagnosed with a small patch of vitiligo, recalling the parent’s immediate fear and emotional reaction despite the limited extent of disease. Shahriari emphasized that much of dermatologic care involves reassuring families that skin disease is not their fault and helping them navigate fears surrounding a child’s future and self-confidence.

Swanson expanded on the psychological burden associated with pediatric inflammatory skin disease, particularly atopic dermatitis. She referenced research showing elevated anxiety and depression levels among parents of children with atopic dermatitis, noting that in some cases parental emotional distress may even exceed that experienced by adult patients with the condition themselves. Swanson also mentioned hearing discussions suggesting that atopic dermatitis may contribute to strain within marriages and family dynamics, particularly due to chronic sleep disruption and differing opinions regarding treatment decisions.

The pair discussed how lack of sleep, stress, and long-term caregiving responsibilities can intensify emotional exhaustion among parents. Swanson noted that pediatric dermatologists frequently find themselves serving as mediators between caregivers who may disagree about treatment approaches or disease severity.

Later in the segment, Shahriari shifted the discussion toward the emotional expectations often placed on women physicians. She noted that behaviors frequently accepted in male physicians, such as directness or emotional detachment, are often interpreted differently when displayed by women clinicians, who may instead be labeled as cold or difficult.

Swanson acknowledged struggling with those expectations throughout her career, particularly while balancing advocacy, leadership, and compassion in pediatric dermatology. She explained that women physicians are often expected to remain endlessly empathetic while simultaneously maintaining clinical authority and professionalism.

The discussion concluded with both physicians reflecting on the importance of boundaries in medicine. While empathy remains central to patient care, Shahriari and Swanson emphasized that constantly absorbing the emotional burdens of others can lead to exhaustion if physicians fail to prioritize their own well-being alongside that of their patients.

Editor’s note: This segment was summarized with the help of AI tools.

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This segment of the May episode of The Medical Sisterhood highlights the importance of addressing patients' and parents' fears in dermatology.

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Addressing Pediatric Patients' and Caregivers' Fears in Dermatology, With Lisa Swanson, MD

Ann Marie Navar, MD, PhD, is an associate professor of cardiology at the University of Texas Southwestern Medical Center.

Adherence, Persistence, and Long-Term Success in ASCVD Lipid-Lowering Therapy

This episode, titled 'Adherence, Persistence, and Long-Term Success in ASCVD Lipid-Lowering Therapy,' features expert cardiologists discussing the significant challenge of long-term medication adherence in ASCVD management, distinguishing between adherence, meaning consistent day-to-day medication use, and persistence, meaning the sustained continuation of therapy over time. The panel identifies insurance changes and cost barriers as leading drivers of treatment discontinuation in the United States, emphasizing that clinicians must actively help patients navigate payer systems to maintain uninterrupted access to their medications. Positive reinforcement through repeat lipid panels is highlighted as a powerful motivational tool, with patients responding favorably to seeing their LDL cholesterol decline over time. One panelist shares an observation from clinical trial data showing surprisingly high adherence to a therapy requiring fasting administration, attributing this to the structured morning routine that helped patients build a consistent habit, and drawing a broader lesson that providing patients with a clear, repeatable framework for taking their medication improves long-term compliance.

The discussion then turns to the comparative adherence profiles of self-administered biweekly injectable monoclonal antibodies such as evolocumab and alirocumab versus healthcare professional-administered inclisiran given every six months, with emerging data suggesting that placing the administration responsibility on the healthcare team may support better long-term persistence. The panelists acknowledge that individual patient preferences, logistical factors such as travel distance to a clinic, insurance coverage, and the overall prescriber-patient relationship all influence which approach works best. The episode closes with a memorable analogy likening monoclonal antibody therapy to repeatedly emptying a bucket under a leaking roof, while inclisiran represents repairing the roof itself every six months, offering patients an intuitive framework for understanding why consistent adherence to their chosen therapy is essential to keeping LDL under control and reducing long-term cardiovascular risk.

In the next episode, 'Personalizing Therapy Across High-Risk Conditions and Comorbidities in ASCVD,' panelists will continue their discussion on ASCVD and highlight how clinicians can integrate non-statin therapies into practice for patients who remain above LDL goal on maximally tolerated statin therapy, while examining how comorbidities such as type 2 diabetes and chronic kidney disease inform individualized treatment selection and intensification strategies.

Compare statins, ezetimibe, bempedoic acid and PCSK9 inhibitors for side effects, dosing preferences, and shared decision-making tips.

Safety, Tolerability, and Patient-Centered Decision-Making in ASCVD Lipid Therapy

In 'Safety, Tolerability, and Patient-Centered Decision Making in ASCVD Lipid Therapy,' our panel delves into the safety and tolerability landscape of lipid-lowering therapies, beginning with a reassessment of statin side effects. The panel references a recent Lancet meta-analysis indicating that only four of 66 reported statin side effects in package inserts are statistically significant in blinded outcomes trials, with the most clinically relevant concerns being a modest increase in glucose levels in patients at borderline risk for diabetes and occasional minor effects on liver function. The discussion then addresses the safety profile of PCSK9 inhibitors, with the panel noting that injectable monoclonal antibodies such as evolocumab and alirocumab are generally very well tolerated, with injection site reactions being rare and typically minor. A practical tip is offered for reducing injection discomfort by allowing the medication to reach room temperature before administration. The safety profile of inclisiran is similarly favorable, with only transient and clinically insignificant elevations in liver function tests noted, attributed to its liver-specific mechanism of activation that avoids muscle tissue, a point panelists find particularly useful when counseling patients concerned about musculoskeletal side effects. The emerging oral PCSK9 inhibitor enlicitide is also highlighted as showing tolerability comparable to placebo in trials of up to one year in duration, with the caveat that fasting is required to optimize absorption.

The conversation then shifts to patient-centered considerations around dosing frequency and route of administration, with the panel acknowledging that preferences vary widely between patients and even between prescribers, noting that endocrinologists tend to be more comfortable with injectables given their familiarity with insulin administration. The panelists discuss the practical trade-offs between daily oral therapy and less frequent injectable regimens, recognizing that while less frequent dosing can improve convenience, missed injection appointments in patients with unpredictable schedules can create treatment gaps. The episode concludes by emphasizing that shared decision-making, in which patients are actively involved in selecting the therapy that best fits their lifestyle, preferences, and access, is essential to optimizing adherence and achieving long-term LDL goals in ASCVD management.

Our next episode, 'Adherence, Persistence, and Long-Term Success in ASCVD Lipid-Lowering Therapy,' further explores ASCVD, highlighting the critical role of medication adherence and persistence in achieving sustained LDL lowering, and examining the practical strategies, shared decision-making, and patient-provider relationship factors that drive long-term treatment success.

Compare statin side effects with ezetimibe, bempedoic acid and PCSK9 inhibitors, plus practical dosing tips and shared decision-making.

Christopher G. Bunick, MD, PhD, is an associate professor of dermatology at Yale University School of Medicine.

What Does New Phase 3 Amlitelimab Data Suggest for Atopic Dermatitis?

, hosts Christopher Bunick, MD, PhD, and Lindsay Ackerman, MD, discussed why the phase 3 amlitelimab data in atopic dermatitis may be more clinically meaningful than headline efficacy numbers alone initially suggest.

Bunick emphasized that understanding the study population is critical when interpreting the results from the COAST 1, COAST 2, and SHORE trials. Across the studies, each enrolled roughly 600 patients with moderate-to-severe atopic dermatitis, representing a sizable late-stage clinical program. He highlighted the diversity of the enrolled population, noting relatively strong representation of Black patients compared with many dermatology trials, alongside a notably large proportion of Asian participants, reflecting a broader global patient population.

The hosts also underscored the substantial disease burden among trial participants. According to Bunick, patients had lived with atopic dermatitis for nearly two decades on average, and many entered the studies with extensive body surface area involvement and high baseline disease severity. A large percentage had also previously received systemic therapies, including biologics, JAK inhibitors, and traditional immunosuppressive agents, suggesting investigators were studying a particularly treatment-resistant population rather than patients with milder disease.

Another point Bunick stressed was the rigor of the statistical analysis. The trials used nonresponder imputation methodology, meaning any participant who discontinued treatment, deviated from protocol, or required rescue therapy was automatically counted as a treatment failure. He argued that this conservative approach makes the efficacy findings more impressive when viewed in context.

Ackerman expanded on the significance of the long-term response patterns seen with amlitelimab, particularly the durability of efficacy through 52 weeks and the similarity between dosing every 4 weeks and every 12 weeks. She contrasted this upstream immune modulation strategy with more downstream approaches such as cytokine blockade or JAK inhibition, suggesting that targeting the OX40 ligand pathway may allow for broader recalibration of immune activity rather than suppression of isolated inflammatory signals.

She also noted that responses appeared to deepen over time, with later efficacy outcomes surpassing those seen at earlier time points despite the increasingly stringent nature of long-term analyses. Ackerman suggested this pattern could reflect gradual restoration of immune balance through preservation of regulatory T-cell function and normalization of aberrant T-cell memory responses, raising the possibility that upstream pathway modulation may eventually reshape how chronic inflammatory diseases such as atopic dermatitis are treated.

Relevant disclosures for Bunick include AbbVie, South Beach Symposium, Almirall, Apogee Therapeutics, Arcutis Biotherapeutics, Daiichi Sankyo, Eli Lilly, LEO Pharma, US, Novan, Novartis, Ortho Dermatologics, Palvella Therapeutics, Pfizer Inc., Sanofi, Sun Pharmaceutical Industries Ltd., Timber Pharmaceuticals, and UCB. Relevant disclosures for Ackerman include AbbVie, Alumis, Amgen, Arcutis, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Dermavant, Galderma, L'Oréal, Novartis, Sun Pharmaceutical, and UCB.

Sanofi. Press Release: AAD: new results from Sanofi’s amlitelimab phase 3 studies in atopic dermatitis presented in late-breaking research session. Sanofi.com. Published March 28, 2026. Accessed May 28, 2026. 

https://www.sanofi.com/en/media-room/press-releases/2026/2026-03-28-15-00-00-3264184

Kyowa Kirin. Kyowa Kirin Announces Discontinuation of Rocatinlimab Clinical Trials - Kyowa Kirin. Kyowakirin.com. Published March 3, 2026. Accessed May 28, 2026. 

https://www.kyowakirin.com/media_center/news_releases/2026/e20260303_01.html

Amlitelimab was discussed in the ABCs in Dermatology podcast, with the hosts highlighting atopic dermatitis patient demographics and high disease burden.

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Heather Johnson, MD, is a preventive cardiologist at Lynn Women’s Health and Wellness Institute in Baptist Health South Florida and a clinical affiliate associate professor at Florida Atlantic University.

Heather Johnson, MD, discusses progress in providing more individualized care to female cardiovascular patients, as well as what remains to be done.

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Recent Advancements and Ongoing Roadblocks in Cardiovascular Care for Women

Igor Barjaktarevic, MD, PhD, is the medical director of the chronic obstructive pulmonary disease program at the David Geffen School of Medicine at UCLA.

Igor Barjaktarevic, MD, discussed findings at ATS 2026, where the recombinant therapy outperformed weekly plasma-derived augmentation on key pharmacokinetic endpoints.

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Efdoralprin Alfa Normalizes Alpha-1 Antitrypsin Levels in Phase 2 ElevAATe

In a recent episode of The Medical Sisterhood podcast, Lisa Swanson, MD, spoke about the importance of female mentorship in medicine.

Visibility, Mentorship, and the Emotional Toll of Pediatric Dermatology, With Lisa Swanson, MD

Assistant Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine) at the Icahn School of Medicine at Mount Sinai, New York

Oren Cohen, MD, discusses his research and points toward more clinically deployable cardiovascular risk tools for patients with OSA.


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SuperLearner ML Improves Cardiovascular Risk Prediction in OSA

This episode covers Abbott’s Libre Duo and Libre Duo 10 Day systems, Eli Lilly’s retatrutide, and the recent Dexcom sensor theft.

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Diabetes Dialogue: CKM Systems, Triple Agonists, and a Sensor Scandal Ahead of ADA

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Saroglitazar received FDA Priority Review for adults with PBC after phase 3 data showed improved biochemical response versus placebo.

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FDA Grants Priority Review to Saroglitazar NDA for Primary Biliary Cholangitis

Simon Couillard, MD, FRCPC, MSc, from Université de Sherbrooke.



At ATS 2026, Couillard discussed a win ratio analysis showing dupilumab significantly improved remission outcomes, particularly among patients with elevated eosinophils and FeNO.

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Dupilumab Nearly Doubled Remission Odds in Type 2 Asthma, With Simon Couillard, MD

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Latest News

The World’s First Dual Glucose-Ketone Monitor Receives Clearance in Europe

Addressing Pediatric Patients' and Caregivers' Fears in Dermatology, With Lisa Swanson, MD

Adherence, Persistence, and Long-Term Success in ASCVD Lipid-Lowering Therapy

Safety, Tolerability, and Patient-Centered Decision-Making in ASCVD Lipid Therapy

What Does New Phase 3 Amlitelimab Data Suggest for Atopic Dermatitis?