What Your Glucose Monitor Is Missing

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Topic:

Continuous glucose monitoring shows how the body handles glucose, but it cannot reveal how much insulin was required to produce that glucose response. By continuously measuring ketones alongside glucose, the new dual sensor may provide an indirect window into insulin activity, fat burning, and metabolic flexibility while also helping people with diabetes detect dangerous ketone elevations earlier.

Summary:

Dr. Ben Bikman explores a new wearable that continuously measures both glucose and ketones. Unlike a traditional continuous glucose monitor, Abbott’s Libre Duo can track beta-hydroxybutyrate (BHB) alongside glucose, providing another window into what is happening metabolically. For people with diabetes, continuous ketone monitoring could provide earlier warning of dangerous ketoacidosis, particularly in people with type 1 diabetes or those using SGLT2 inhibitors.

Ben explains why ketones provide information that glucose alone cannot. Because insulin strongly suppresses fat release, fat oxidation, and ketone production, changes in ketones can serve as an indirect indicator of insulin activity. A seemingly normal glucose response can therefore hide the fact that the body required a large amount of insulin to produce it, while watching glucose and ketones together may reveal more about how readily the body transitions between glucose and fat metabolism.

Ben sees potential value beyond diabetes as well. During fasting or carbohydrate restriction, glucose would generally fall while ketones rise; after a carbohydrate-rich meal, the opposite occurs. Tracking both signals continuously could therefore offer a more complete picture of metabolic flexibility and help people better understand their individual responses to food, fasting, and other metabolic changes.

References:

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NOTE: The information presented is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Dr. Bikman is not a clinician—and, he is not your doctor. Always seek the advice of your own qualified health providers with questions you may have regarding medical conditions.

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