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.1

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 here.

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 The conversation highlights how current ketone testing practices remain limited and outdated, with many patients still relying on urine ketone testing due to the cost and inconvenience of blood ketone strips.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.

References

1. 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