Can my patient with type 1 diabetes get a continuous ketone monitor in Australia now?

Not through a TGA-approved device yet. Abbott's combined glucose-ketone wearable has FDA approval overseas but the TGA has not approved a comparable device for clinical use in Australia. For now, capillary blood ketone testing remains the recommended method during illness, periods of high glucose, or symptoms that might indicate DKA. Watch for TGA updates — your endocrinologist or diabetes specialist nurse will be among the first to know.

How is a continuous ketone monitor different from a CGM?

Continuous glucose monitors (CGMs) measure blood glucose levels only. A combined ketone-glucose device measures both in real time. Ketone levels are the direct marker of DKA risk — and critically, DKA can develop even when glucose appears near-normal (for example, in people using SGLT2 inhibitors or who have reduced their insulin dose). A real-time ketone alert provides an earlier warning signal than glucose monitoring alone.

Continuous ketone monitoring is coming — what to watch for

What just happened

Abbott has received FDA approval for a wearable device that monitors both blood glucose and ketones continuously — a step beyond what current continuous glucose monitors (CGMs) do. For the first time, people with type 1 diabetes may have a device that provides real-time ketone data without needing to remember to test manually.

Australia’s Therapeutic Goods Administration has not yet approved a comparable device. But this is the kind of technology shift that changes how a condition is managed at the general practice level — and the time to understand it is before the device arrives on the shelf, not after.

The scale of the problem it addresses is not abstract. Diabetic ketoacidosis (DKA) caused approximately 9,400 hospitalisations among Australian type 1 diabetes patients in 2023-24. Many of those hospitalisations followed periods where ketone levels rose gradually and undetected — because the person did not test, or tested too late. Current ketone monitoring relies on capillary blood ketone strips or urine ketone sticks. Both require the patient to remember to test at precisely the moment they are most cognitively and physically impaired by the metabolic crisis already underway. That is a design flaw.

The both-and

What continuous ketone monitoring offers

The core advantage is proactive detection. Under current practice, someone with type 1 diabetes experiencing hyperglycaemia or an intercurrent illness should be checking capillary blood ketones. But that requires a ketone meter, strips, a lancing device, cognition under stress, and the presence of supplies. Urine ketone testing lags blood ketone levels by hours.

Continuous monitoring changes the model: the device — or its companion app — alerts the wearer when ketones rise above a threshold, before levels become clinically dangerous. As researchers in the field describe it, this enables “proactive” rather than reactive intervention. An alert at mild ketonaemia (0.6–1.5 mmol/L) is a different clinical moment than a presentation to an emergency department at severe ketonaemia with altered consciousness.

For general practice, this creates a new interpretive challenge: understanding what continuous ketone values mean, when they warrant escalation, and how to counsel patients using the technology. Unlike glucose monitoring — where interpreting CGM traces is now routine general practice capability — ketone monitoring norms and alert thresholds are less familiar clinical territory.

Dr Gary Deed, chair of the RACGP’s Diabetes Network, advises GPs to “watch this space” while TGA approval remains pending. That is the right clinical stance — and a useful preparation window.

What the technology does not resolve

Continuous ketone monitoring changes detection; it does not change treatment. DKA management — fluid resuscitation, insulin correction, electrolyte monitoring — remains hospital-based. What the technology affects is the window of detection before hospitalisation becomes necessary, and how many of those 9,400 annual admissions might be intercepted earlier.

There is also the question of access. Continuous glucose monitors transformed type 1 diabetes management in Australia when they received PBS funding, but that funding took years after TGA device approval. A continuous ketone monitor receiving TGA approval does not automatically mean PBS listing — cost access is likely to be unequal in the interim.

A specific patient group to keep in mind: people using SGLT2 inhibitors alongside insulin. SGLT2 agents carry a risk of euglycaemic DKA — where blood glucose appears near-normal but ketones are rising — because the glucose-lowering mechanism is insulin-independent. In this group, a glucose-only CGM may provide false reassurance. Continuous ketone monitoring would be particularly valuable if and when it becomes available.

My two cents

DKA deaths and serious hospitalisations are not random bad luck. They occur when warning signals are missed or delayed — often because the monitoring infrastructure was designed for a lower-vigilance model, and because the cognitive and physical load of illness is highest at exactly the moment reliable data is most needed.

The technology described here targets that gap directly. It is not available in Australia yet, and there is no timeline. But if you manage patients with type 1 diabetes — especially those who have previously had DKA, those who are less consistent with monitoring, or those on SGLT2 inhibitors — now is a good moment to revisit ketone testing education: what to check, when to check, what levels are concerning, and at what point to seek urgent care rather than managing at home.

That conversation costs nothing and does not require TGA approval.

Verdict: maybe — the technology addresses a real and significant clinical problem; the gap is TGA clearance and PBS funding, neither of which has a confirmed timeline. Watch for both.

Sources cited

Is continuous ketone monitoring on the horizon for Aussies? — newsGP, 2026. https://www1.racgp.org.au/newsgp/clinical/is-continuous-ketone-monitoring-on-the-horizon-for
Wearable non-invasive continuous glucose monitor leads innovation challenge — Diabetes Australia, August 2026. https://www.diabetesaustralia.com.au/mediarelease/wearable-non-invasive-continuous-glucose-monitor-leads-innovation-challenge/