Abbott secures CE-Mark for two dual glucose-ketone sensors under the names Libre Duo and Libre Duo 10 Day  – 

Libre Duo systems combine continuous glucose and ketone sensing in a single wearable; select European launch expected later this year

Abbott announced today that it has secured CE-Mark for Libre Duo and Libre Duo 10 Day, the first dual glucose-ketone monitoring systems for people with diabetes. The systems measure both glucose and ketone levels every minute through a single wearable sensor, offering real-time visibility into rising ketones that may signal risk for diabetic ketoacidosis (DKA). Abbott plans to launch the systems in select European countries later this year.

This CE-Mark marks a major milestone in the emerging continuous ketone monitoring (CKM) field, which has drawn growing attention as DKA rates rise globally and as awareness increases around euglycemic ketosis, particularly for people using SGLT-2 inhibitors. Unlike traditional ketone monitoring, which relies on intermittent blood or urine testing, Libre Duo continuously tracks ketone trends alongside glucose levels and integrates directly into Abbott’s broader Libre digital ecosystem. Libre Duo systems are not yet cleared or commercially available in the US.

Libre Duo and Libre Duo 10 Day have different indications for different ages

Libre Duo systems continuously measure both glucose and ketone levels through a single sensor worn on the body, eliminating the need for separate fingerstick blood ketone testing or for the use of urine ketone strips. Abbott said the systems are intended to help people identify rising ketones earlier and potentially intervene before DKA develops.

The CE-Mark covers two separate systems:

  • Libre Duo: offering up to 15 days of wear for adults ages 18 and older; and
  • Libre Duo 10 Day: offering up to 10 days of wear for individuals ages two and older.

Abbott suggested that the shorter-duration pediatric sensor reflects clinical observations suggesting that younger and more active users may have greater difficulty completing longer wear periods reliably. Both systems continuously measure glucose and ketones every minute and are designed to integrate into Abbott’s Libre ecosystem, allowing users to share both glucose and ketone data with caregivers and healthcare providers.

AID integration is intended to be an application of continuous ketone monitoring

Abbott also noted that Libre Duo systems are being designed for compatibility with AID systems. Ketone sensing may eventually emerge as an important additional safety metric for insulin pump users, particularly in situations involving infusion-set failures, undetected pump suspension, or prolonged insulin interruption. In these cases, ketones may begin rising before severe hyperglycemia becomes apparent.

Many leading insulin pump manufacturers have already announced intentions to integrate with the dual glucose-ketone platform, including Sequel (May 2025), Tandem (June 2025), Beta Bionics (June 2025), and Ypsomed (June 2025). We are curious to see opinions from other major manufacturers Insulet and Minimed.

At ATTD 2026, clinicians repeatedly discussed the possibility that continuous ketone sensing could eventually help reduce DKA risk in AID users by identifying rising ketones earlier and prompting more rapid intervention. While Abbott has not yet shared details around alert thresholds, algorithm integration, or future automation capabilities, the regulatory approval suggests substantial interest in incorporating ketone data into future diabetes management systems.

Rising DKA awareness continues driving interest in continuous ketone monitoring

Abbott framed the launch against a backdrop of rising DKA incidence and persistently low ketone-monitoring adherence. The company cited recent data showing that DKA-related hospitalizations have risen substantially over the past decade, including analyses presented at ATTD 2026 demonstrating increasing DKA incidence in both T1D and T2D populations.

The company also highlighted a growing recognition that glucose and ketone levels do not always rise in parallel. In particular, ketones may increase even when glucose remains in range or is only modestly elevated, contributing to the delayed recognition of euglycemic DKA. This issue has become especially relevant as the use of adjunctive therapies like SGLT-2 inhibitors expands among people with diabetes.

Expert consensus and expanding technology ecosystem support CKM momentum

Abbott noted that Libre Duo aligns with recommendations from a recent international expert consensus paper organized through Breakthrough T1D, focused on safe implementation of continuous ketone monitoring. At ATTD 2026 and other recent meetings, multiple clinicians suggested that CKM could become particularly valuable for:

  • People with T1D or T2D using SGLT-2 inhibitors;
  • Individuals with recurrent DKA history;
  • Pediatric populations; and
  • Hospitalized individuals with elevated DKA risk.

Close Concerns’ Questions

  1. How will Abbott position continuous ketone monitoring clinically alongside traditional ketone testing guidelines?
  2. What thresholds will be used to trigger actionable ketone alerts for users?
  3. How will reimbursement pathways for CKM differ from current CGM coverage structures?
  4. What is happening on integration with Insulet and Minimed?

-- by Riya Chatterjee, Nour Khachemoune, Kat Moon, and Kelly Close

Abbott secures CE-Mark for two dual glucose-ketone sensors under the names Libre Duo and Libre Duo 10 Day -
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