Continuous Dual Glucose-Ketone Monitoring

Diabetic ketoacidosis (DKA) occurring during pregnancy is an obstetric emergency that can result in significant adverse outcomes for both the pregnant person and the fetus. While DKA generally presents with glucose levels >250 mg/dL, up to 30% of DKA cases involve euglycemic DKA (euDKA) wherein glucose levels <200 mg/dL have been reported. However, detection and prevention of DKA in pregnancy can be challenging for both the pregnant individual and health care providers due to variable clinical presentations of the disease and the limitations of current ketone monitoring technologies. Abbott Diabetes Care (Alameda, CA) is developing a continuous dual glucose-ketone monitoring (DGK) system that utilizes a single sensor to enable continuous monitoring of interstitial glucose and β-hydroxybutyrate, the primary metabolic product of blood ketones. This article reviews the challenges of monitoring ketones during pregnancy and discusses how DGK could be considered for use in clinical practice once it becomes commercially available.