Breakthrough T1D Introduces First Global Guidelines for Continuous Ketone Monitoring in Diabetes Management

On December 10, 2025, Breakthrough T1D, the world-leading organization in type 1 diabetes (T1D) research and advocacy, announced a groundbreaking publication in The Lancet Diabetes & Endocrinology. This pivotal paper lays out the first international consensus framework for continuous ketone monitoring (CKM), essential for diabetes management. This innovative guideline is poised to transform how individuals living with diabetes can manage their condition more effectively.

The central concern of the paper, authored by a distinguished team of diabetes experts, including Dr. Thomas Danne of Breakthrough T1D, Dr. Ketan Dhatariya from Norfolk and Norwich University Hospitals, and Dr. Richard Bergenstal of the International Diabetes Center, addresses the life-threatening complication known as diabetic ketoacidosis (DKA). DKA arises when insulin levels are insufficient, causing the body to utilize stored fat for energy, leading to fatal accumulation of ketones in the bloodstream.

Detecting ketones is critical for preventing DKA. While traditional methods, including blood and urine tests, exist, they are not extensively used, often leaving individuals vulnerable. CKMs provide a promising alternative, continually monitoring ketone levels and alerting users to dangerous rises before they escalate into emergencies. Similar to continuous glucose monitors, this technology has the potential to revolutionize diabetes care.

Dr. Danne stated, “The introduction of continuous ketone monitoring could reshape the landscape for those prone to diabetic ketoacidosis. The guidelines we’ve developed ensure that the diabetes community is equipped to harness this technology effectively once it becomes widely available, drastically improving health outcomes.”

The comprehensive consensus was crafted by convening 33 international experts across 14 countries, focusing on several key areas: common terminology for ketone levels, device features displaying changes in ketone rates, alarm protocols, education strategies, and more. This structured approach is aligned with Breakthrough T1D's mission of fostering clinical advancements in T1D care.

As a condition that affects approximately 9.5 million people worldwide, T1D leads to considerable health risks, including severe fluctuations in blood sugar levels and potential organ damage. Notably, it's a widespread misunderstanding that T1D is only found in children; a significant number of cases are diagnosed in adults. The exact causes of this autoimmune disease remain somewhat elusive, believed to stem from a combination of genetic predispositions and environmental influences. Currently, there is no cure, emphasizing the urgent need for advancements in diabetes management.

Breakthrough T1D continues its commitment to making life with type 1 diabetes more manageable. This latest guidance marks a significant step toward integrating advanced technology into everyday diabetes care, aiming to empower patients and healthcare professionals alike. The emphasis is on collaboration within the diabetes community to pave the way for better outcomes in the management of this chronic condition.

In closing, the introduction of these guidelines not only highlights Breakthrough T1D's leadership in diabetes advocacy but also represents hope for millions living with the challenges of T1D. With continuous ketone monitoring on the horizon, the future of diabetes management is brighter and increasingly proactive.