A New Tool Worth Watching: Abbott’s Dual Glucose-Ketone Monitor

For many in the GLUT1 Deficiency community, the ketogenic diet isn’t a lifestyle choice, it’s a lifeline for treating symptoms and a better quality of life. Because GLUT1 Deficiency impairs the transport of glucose across the blood-brain barrier, ketones provided by the ketogenic diet serve as the brain’s alternative fuel source. That makes tracking ketone levels critically important for many families in our community, and some ketogenic diet centers are expanding monitoring beyond ketone levels to include blood glucose, recognizing that both can provide useful information about the body’s metabolic response to the diet and help clinical teams individualize and optimize ketogenic diet therapy.

We’ve been following the development of a new tool from Abbott – the Libre Duo 10-Day system. In late August, Abbott received FDA authorization for this product, the first wearable device in the world designed to continuously monitor both glucose and ketone levels simultaneously in a single sensor, worn for up to 10 days. It was approved earlier this year for some countries across Europe, and efforts are underway to continue the rollouts and approvals in other parts of the world.

Why this is important

Currently, ketone monitoring is done at home by measuring ketones in urine with special test strips or in blood through ketone meters. Some of the challenges: urine ketone tests are hard to interpret precisely and don’t provide real-time reflections of ketone levels. Blood ketone tests are more reliable; however, they require regular finger pricks, which can be difficult, especially for our young patients. A continuous, automatic ketone readout removes that burden and could give families and clinicians a much clearer, real-time picture of what’s happening metabolically throughout the day and night.

Pairing continuous ketone monitoring with continuous glucose monitoring would be especially beneficial for GLUT1 Deficiency patients and clinicians, helping them understand the relationship between the two, how daily activities, foods, illnesses, hormone cycles, and other things impact these levels, and help find an optimal therapeutic balance.

Abbott developed Libre Duo primarily with diabetes patients in mind, particularly those at risk of diabetic ketoacidosis, a dangerous spike in ketones tied to insulin deficiency. That’s a different metabolic context than GLUT1 Deficiency, where therapeutic ketosis is the goal rather than a risk to be avoided. But an accurate, continuous sensor for both ketones and glucose in a single wearable device is exactly the kind of technology our community is interested in. It could help families keep their loved ones living with GLUT1 Deficiency in a stable, therapeutic ketogenic range, without frequent finger-stick testing or the uncertainty around using urine ketone test strips.

What we don’t know yet

It’s important to keep in mind that Libre Duo has not been studied, indicated, or authorized for use in GLUT1 Deficiency or ketogenic diet therapy. Its authorization is specific to diabetes management and diabetic ketoacidosis risk. Whether the sensor’s ketone range, accuracy, and thresholds would even be useful for our community, which has a very different goal of maintaining therapeutic ketosis, is an open question. The good news is that clinicians and researchers in our community are interested and open to studying the possibility of using this device in the management of our disease and are following these developments as well.

We’ll continue to watch how this technology and tool develop for potential use in GLUT1 Deficiency and keep the community updated.

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