Continuous Ketone Monitoring Consensus Report 2021

Kevin T. Nguyen, Nicole Y. Xu, Jennifer Y. Zhang, Trisha Shang, Ananda Basu, Richard M. Bergenstal, Kristin Castorino, Kong Y. Chen, David Kerr, Suneil K. Koliwad, Lori M. Laffel, Nestoras Mathioudakis, L. Kurt Midyett, Joshua D. Miller, James H. Nichols, Francisco J. Pasquel, Priya Prahalad, Mark R. Prausnitz, Jane Jeffrie Seley, Jennifer L. SherrElias K. Spanakis, Guillermo E. Umpierrez, Amisha Wallia, David C. Klonoff*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)689-715
Number of pages27
JournalJournal of Diabetes Science and Technology
Issue number3
StatePublished - May 2022


  • acetoacetate
  • continuous
  • ketoacidosis
  • ketone
  • β-hydroxybutyrate

ASJC Scopus subject areas

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


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