Continuous Ketone Monitoring Consensus Report 2021

Author:

Nguyen Kevin T.1ORCID,Xu Nicole Y.1ORCID,Zhang Jennifer Y.1ORCID,Shang Trisha1ORCID,Basu Ananda2,Bergenstal Richard M.3ORCID,Castorino Kristin4ORCID,Chen Kong Y.5ORCID,Kerr David4ORCID,Koliwad Suneil K.6ORCID,Laffel Lori M.7ORCID,Mathioudakis Nestoras8ORCID,Midyett L. Kurt9ORCID,Miller Joshua D.10ORCID,Nichols James H.11ORCID,Pasquel Francisco J.12ORCID,Prahalad Priya13,Prausnitz Mark R.14ORCID,Seley Jane Jeffrie15ORCID,Sherr Jennifer L.16ORCID,Spanakis Elias K.1718ORCID,Umpierrez Guillermo E.12ORCID,Wallia Amisha19ORCID,Klonoff David C.20ORCID

Affiliation:

1. Diabetes Technology Society, Burlingame, CA, USA

2. University of Virginia, Charlottesville, VA, USA

3. International Diabetes Center, Minneapolis, MN, USA

4. Sansum Diabetes Research Institute, Santa Barbara, CA, USA

5. National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA

6. University of California, San Francisco, San Francisco, CA, USA

7. Joslin Diabetes Center, Boston, MA, USA

8. Johns Hopkins University, Baltimore, MD, USA

9. Midwest Pediatric Specialists, Overland Park, KS, USA

10. Stony Brook University, Stony Brook, NY, USA

11. Vanderbilt University Medical Center, Nashville, TN, USA

12. Emory University, Atlanta, GA, USA

13. Stanford University, Stanford, CA, USA

14. Georgia Institute of Technology, Atlanta, GA, USA

15. Weill Cornell Medicine, New York, NY, USA

16. Yale University, New Haven, CT, USA

17. Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA

18. University of Maryland, Baltimore, MD, USA

19. Northwestern University, Chicago, IL, USA

20. Mills-Peninsula Medical Center, San Mateo, CA, USA

Abstract

This article is the work product of the Continuous Ketone Monitoring Consensus Panel, which was organized by Diabetes Technology Society and met virtually on April 20, 2021. The panel consisted of 20 US-based experts in the use of diabetes technology, representing adult endocrinology, pediatric endocrinology, advanced practice nursing, diabetes care and education, clinical chemistry, and bioengineering. The panelists were from universities, hospitals, freestanding research institutes, government, and private practice. Panelists reviewed the medical literature pertaining to ten topics: (1) physiology of ketone production, (2) measurement of ketones, (3) performance of the first continuous ketone monitor (CKM) reported to be used in human trials, (4) demographics and epidemiology of diabetic ketoacidosis (DKA), (5) atypical hyperketonemia, (6) prevention of DKA, (7) non-DKA states of fasting ketonemia and ketonuria, (8) potential integration of CKMs with pumps and automated insulin delivery systems to prevent DKA, (9) clinical trials of CKMs, and (10) the future of CKMs. The panelists summarized the medical literature for each of the ten topics in this report. They also developed 30 conclusions (amounting to three conclusions for each topic) about CKMs and voted unanimously to adopt the 30 conclusions. This report is intended to support the development of safe and effective continuous ketone monitoring and to apply this technology in ways that will benefit people with diabetes.

Funder

abbott diabetes care

Publisher

SAGE Publications

Subject

Biomedical Engineering,Bioengineering,Endocrinology, Diabetes and Metabolism,Internal Medicine

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