Hey readers! Most of us rarely check ketones until something feels off, and by then the window for easy action is narrowing. This week brings the first continuous glucose-ketone sensor through the FDA, plus a year of real-world pump data and a remote-monitoring pilot that turned weekly data reviews into measurable glucose gains. Let's get into it.
🩸 A sensor that watches ketones too
Advancing Ketone Monitoring for Type 1 Diabetes reports that on October 19, 2026, the FDA approved Abbott's Libre Duo 10 Day, described as the world's first dual glucose-ketone sensing technology, for people ages 2 and up.
– Breakthrough T1D
This matters because ketone testing is one of the quietest gaps in daily T1D care. Many people don't keep ketone strips at home and rarely check, yet rising ketones are the early signal of diabetic ketoacidosis (DKA). Continuous ketone monitoring (CKM) folds that check into the same wearable already tracking glucose, so a problem can surface before it becomes an emergency.
The major benefit of dual glucose-ketone monitoring is clear: it can detect rising ketone levels early, so people and families with T1D, including very young children using diabetes technology, can take action before DKA occurs.
Ketone levels shift with stress, exercise, illness, diet, and medications like SGLT inhibitors, so a static morning fingerstick can miss a lot. Breakthrough T1D is funding several studies using Abbott-donated dual sensors to build the evidence base, including CKM-REACT in youth on automated insulin delivery, a digital health model for underserved adults, and work on predicting DKA risk and kidney disease progression that builds on SUGARNSALT. The device is approved; the data on how best to act on continuous ketone readings is still being gathered, and that distinction is worth holding onto.
💉 Pumps: a year of outcomes and a wider green light
Device news this week split neatly into two buckets: one with long-term outcome data, and several with clearances and plans. It's worth keeping them apart.
Patch Pumps, Implanted Sensors and a Year of Omnipod 5 Data walks through a 12-month extension of Insulet's tubeless Omnipod 5, following participants in France for an additional 12 months after a 13-week randomized trial.
– jeffparoddy.com
Among 75 participants who continued or switched systems, time in the 70-180 mg/dL range rose by 17.9 percentage points to 62.3%, and HbA1c fell from 8.33% to 7.18%, with quality-of-life measures and avoidance of lows maintained or improved. The author is upfront about the limits.
The extension had no control group, so the comparison is before and after, not system against alternative.
The same piece notes FDA clearance for Beta Bionics' Mint patch pump (expected to launch pharmacy-only in the first quarter of 2027) and planned integration of the iLet system with Senseonics' year-long implanted Eversense 365 sensor. Mint's 3D Intelligence dosing algorithm is still under FDA review and labeled investigational. As the article puts it, "Only the first is outcome data. The other two are products and plans."
Sequel Med Tech's twiist scores FDA clearance in type 2 diabetes reports the twiist automated insulin delivery system is now cleared for adults with insulin-treated type 2 diabetes, a population Sequel estimates at about 5.5 million U.S. insulin users.
– Drug Delivery Business News
The clearance, which Healio dates to October 16, 2026, builds on twiist's March 2024 authorization for type 1 diabetes ages 6 and up. The supporting 307-participant trial showed HbA1c improving by 0.7 percentage points over 13 weeks and time in range rising from 57% to 73%, with no severe hypoglycemia reported. The twiist uses a 300-unit reservoir, a Tidepool Loop-based algorithm, and works with sensors including FreeStyle Libre 3 Plus and Eversense 365.
With twiist, we're bringing a personalized automated insulin delivery experience to the type 2 community that can help improve outcomes while reducing the day-to-day burden of diabetes management.
For T1D readers, the relevant signal is compatibility and algorithm maturity: a pump that pairs with multiple sensors and runs an open-source-derived algorithm is one more flexible option in a crowded field.
📲 Remote monitoring and smart data use
Pilot program highlights importance of remote patient monitoring for diabetes management covers a UC Davis Health program that reviewed CGM data weekly for youth with T1D between visits.
– HME News
The four-month pilot enrolled 20 young people with A1C above 8% who already used CGM. Average time in range rose from 34.4% to 40%, time above target fell from 64.8% to 58.9%, and 35% of participants improved time in range by 10 points or more, which the program associates with an estimated 0.5% to 0.8% A1C improvement. Most participants (83%) wanted remote monitoring to continue.
Continuous glucose monitoring provides a wealth of health information, but the data often goes largely unreviewed between office visits.
That quote names the real gap. The devices already capture enough data; the value comes from someone actually looking at it between appointments and reaching out when the numbers drift. It's a reminder that not every improvement needs new hardware.
🔬 Screening, sensors, and research briefs
A few more items worth a quick look:
Dexcom's CONNECT study in NEJM found Dexcom G7 users with type 2 diabetes not on insulin achieved a mean 1.6% A1C reduction from a baseline of 8.8% and spent about five more hours per day in range, with 97% still using CGM at 26 weeks. It's evidence for using CGM earlier and more broadly. – DexCom, Inc.
Revvity's GSP T1D 3plex kit is a CE-IVDR-certified assay measuring three autoantibodies (GAD65, IA-2, ZnT8) from dried blood spots for population-wide early T1D screening. It's aimed at catching at-risk children before DKA; note it is not FDA-cleared and launches first in Europe. – Clinical Laboratory International
Sava's $36 million Series B, led by Ascensia, backs a wearable glucose microsensor roughly ten times shorter than traditional CGM filaments, targeting CE approval for non-adjunctive use (insulin dosing without routine fingersticks). – G-Medtech News Center
TrialNet's JAKPOT T1D Study is enrolling 78 people ages 12-35 diagnosed within three months to test whether JAK inhibitors abrocitinib and ritlecitinib can preserve insulin production. – TrialNet
Tzield (teplizumab) received FDA accelerated approval on June 12, 2026 for children ages 8-17 with recently diagnosed stage 3 T1D, with PROTECT trial data showing about 95% vs 79% maintaining a meaningful peak C-peptide level at 78 weeks. It carries a boxed warning for serious viral reactivation and does not replace insulin. – Gerti Tashko, MD
That's the issue. The headline is a sensor that finally brings ketone testing into the continuous era, but the quieter lesson running through almost every story is that the data we already collect only helps when someone acts on it, whether that's a weekly CGM review or an early ketone alert. Take care of yourselves out there.