Ketone Profiles in Community-Dwelling Adults with Type 1 Diabetes Using Continuous Ketone Monitoring

We aimed to assess continuous ketone monitor (CKM) profiles in community-dwelling adults with type 1 diabetes. Two-weeks CKM (Abbott, Alameda, CA) run-in data (PARTNER study: ACTRN12624000448549) were analyzed by groups <0.6, 0.6-0.9, and ≥1.0 mmol/L defined as at least one reading in the highest ketone range. Results are median interquartile range (IQR). Sixty-four participants (age 49.8 [40.2-64.1] yrs; HbA1c 7.4 [6.9-8.0]% 57 [52-64] mmol/mol) were studied; 61% consistently had ketones <0.6 mmol/L, and 23% and 16% experienced peak ketones between 0.6 and 0.9 mmol/L and ≥1.0 mmol/L, respectively. Maximum time-in-range 0.6-0.9 mmol/L and ≥1.0 mmol/L were 5.3% and 2.4%, respectively. Median glucose was on average 47 mg/dL higher (95% confidence interval (CI) 19-73; P = 0.001) during episodes of CKM ketones ≥1.0 mmol/L compared with time-matched control periods <0.6 mmol/L. Most community-dwelling adults with type 1 diabetes have ketones <0.6 mmol/L. Glucose levels rose with elevated ketones but were not a diagnostic substitute.