Continuous ketone monitors, type 1 diabetes and DKA

Last checked September 28, 2026

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This site gives general information, not medical advice. Talk to your doctor or diabetes team before changing how you monitor or treat any condition.

For people with type 1 diabetes, and others at risk of diabetic ketoacidosis (DKA), ketone levels are a medical matter. Follow the plan from your diabetes team and the guidance from the NHS or the American Diabetes Association. No consumer ketone sensor replaces the testing your care team asks for.

What DKA is

Diabetic ketoacidosis (DKA) is a serious condition in which a lack of insulin makes ketones build up in the blood. It mainly affects people with type 1 diabetes, can happen in people with type 2 diabetes who need insulin, and sometimes happens when type 1 diabetes is first diagnosed. Symptoms usually come on within 24 hours and include thirst, peeing more, stomach pain, feeling or being sick, deep breathing, fruity-smelling breath, tiredness or confusion, and blurred vision (NHS). The ADA describes DKA as a medical emergency (ADA).

What official guidance says about ketones

NHS: gives blood ketone bands for people with diabetes and says to call 999 or go to A&E with blood ketones over 3 mmol/L, urine ketones of 2+ or more, or symptoms of DKA (NHS). The bands are on our ketone levels page.
ADA: advises checking ketones when blood glucose is high or when unwell, prefers a blood ketone meter to urine strips, and says to seek emergency care at 1.6 mmol/L or above (ADA).

What continuous ketone monitoring adds

Abbott’s Libre Duo 10 Day, authorized by the FDA on 25 August 2026 for people with diabetes aged 2 and over, tracks ketones in the background of a glucose sensor and alarms above 3.0 mmol/L. An FDA director, Dr Michelle Tarver, said knowing ketones are rising in real time “can be the difference between early intervention and a life-threatening emergency” (FDA). In the studies behind the authorization the device picked up raised ketones before DKA set in. Libre Duo facts.

Abbott cites a survey in which only 18% of people with type 1 diabetes owned a blood ketone meter and a third had no ketone testing supplies at all (Abbott).

What the expert recommendations say

In December 2025, 33 experts from 14 countries published the first international recommendations on continuous ketone monitoring in people with diabetes (Breakthrough T1D, Lancet Diabetes & Endocrinology). As summarized by Diabetes on the Net, they:

set common terms for ketone levels (normal, elevated, high, urgent high) and an alarm above 3.0 mmol/L, limiting alarms to the urgent-high level to avoid alarm fatigue;
ask for trend arrows, as on glucose sensors;
recommend a backup blood ketone meter to check readings against symptoms, and education on what to do about raised ketones;
name groups who may particularly benefit: insulin pump users, people with complications such as kidney or heart disease, and women with diabetes in pregnancy.

Consumer sensors are not medical devices

SiBio’s KS3 is sold as a non-medical product and its maker says it is not for diagnosing, treating or monitoring disease (SiBio). No consumer ketone sensor replaces the testing a diabetes team asks for.