Could continuous ketone monitoring be the next step in diabetes care?
01 Sep 2026
Continuous glucose monitoring (CGM) has changed diabetes care in Australia, but experts say there may be a need for technology that can also track ketone levels continuously.
At present, people in Australia can check ketones through capillary blood testing or urine testing. Both options have been subsidised through the National Diabetes Services Scheme (NDSS) since 2017.
Professor Ketan Dhatariya, a diabetes specialist from the United Kingdom, said checking glucose levels alone may not always give enough warning that DKA is developing.
He said current ketone testing relies on people remembering to test when they feel unwell. This can lead to delays in testing or in repeating the test.
Blood ketone testing provides a more immediate result, while urine testing measures a breakdown product of ketones and can therefore take longer to reflect changes in blood ketone levels.
High ketone levels can become dangerous, particularly for people with type 1 diabetes, and may lead to DKA, which can be life-threatening.
In 2023–24, DKA was linked to about 9400 hospitalisations among Australians with type 1 diabetes.
Research is now looking at continuous ketone monitoring technology that could work alongside CGM devices. The technology would continuously track ketone levels and alert users when levels begin to rise.
Professor Dhatariya said this could allow people to act earlier, before ketone levels become high enough to cause serious illness or require hospital care.
The United States Food and Drug Administration recently approved the first device that continuously monitors both glucose and ketone levels. Similar technology has not yet been approved by Australia’s Therapeutic Goods Administration (TGA).
Dr Gary Deed, Chair of RACGP Specific Interests Diabetes, said the technology could provide another way to support people at risk of DKA if it becomes available in Australia.
However, he said more evidence and TGA approval are needed before GPs should be concerned about using the technology.
Both experts also highlighted the importance of education. GPs and patients would need to understand what continuous ketone readings mean and what action should be taken when levels rise.
Professor Dhatariya said most people likely to benefit from continuous ketone monitoring would be those with type 1 diabetes. Some people with type 2 diabetes may also be at risk of DKA, including some people taking SGLT2 inhibitors.
As the technology develops, healthcare professionals will need clear guidance on how to respond to different ketone readings and help patients understand when action is needed.
Could continuous ketone monitoring be the next step in diabetes care?
Source: newsGP / RACGP, Australian Institute of Health and Welfare (AIHW), Therapeutic Goods Administration (TGA).