FDA authorizes first wearable device that monitors ketone and blood sugar levels

Original Article ↗ Hacker News Discussion ↗

The FDA has authorized the first wearable sensor that continuously tracks both blood glucose and ketone levels, extending existing continuous glucose monitoring (CGM) technology rather than offering a noninvasive watch-style device. Commenters debate how valuable ketone monitoring really is for people with diabetes: some see it as a meaningful safeguard against diabetic ketoacidosis or rare edge cases, while others argue that better, more accurate glucose sensing would save more lives than adding new biomarkers. The thread also explores potential uses beyond diabetes—such as athletic performance, dieting, fasting, and preventive health—alongside skepticism about technical limits, cost, data access, and the risk that such devices primarily serve wellness or “biohacking” markets.

What the device is and isn’t

  • Minimally invasive arm-mounted sensor similar to existing CGMs; not a watch and not non‑invasive.
  • Main novelty: continuous dual measurement of glucose and ketones; existing OTC wearables (Stelo, Lingo) track only glucose.
  • Some confusion in the thread about mechanisms; no technical details from Abbott are given in the discussion.

Use for people with diabetes

  • Many T1/T2 users say CGMs are already life‑changing because they avoid frequent finger sticks.
  • Several argue ketones add limited value because DKA in diabetics is usually preceded by prolonged high glucose, which CGMs already detect.
  • Others counter that DKA can arise with normal glucose (e.g., insulin rationing, certain meds, illnesses, vomiting, dehydration), so ketone alerts could be a useful extra safeguard, especially for children.
  • Parents of T1 kids and some T1 adults see clear value in not having to remember occasional manual ketone tests when sick.

Ketones: value, risks, and skepticism

  • Some see continuous ketones as mostly a marketing gimmick; ketones are rare in routine T1 care compared to constantly fluctuating glucose.
  • Strong sentiment that vendors should prioritize making glucose sensors more accurate and reliable instead of adding markers.
  • Others note ketones are central both to DKA risk and to therapeutic ketosis (fasting, keto diet, metabolic psychiatry), so long‑term dual datasets could be scientifically valuable.

Sports, dieting, and “healthmaxxing”

  • Endurance and ultra‑athletes are discussed as likely early adopters, though some say it won’t materially change in‑race fueling (strategy is still “eat as much as you can tolerate”).
  • Biohackers and dieters already buy OTC CGMs; some see dual glucose/ketone data as attractive for fasting, keto adherence, or “metabolic flexibility,” others call it pointless for healthy people.

Automated glucose control and hospital use

  • Automated insulin delivery (“closed loop”) via pump + CGM exists, but is not yet approved for hospital use; commenters see big potential gains in ICU, cardiac, neuro, and burn units.
  • Algorithms for tight control in hospital are hard; past trials show hypoglycemia risk when control is too aggressive or protocols are weak.

Non‑invasive sensing and tech/market constraints

  • Multiple comments stress non‑invasive glucose remains technically very hard (optical confounders, skin differences, perfusion, drug interference).
  • There are claims of large IP holders and limited incumbent incentive to create a durable non‑consumable sensor, though other companies (watch makers) might have stronger incentives.
  • Some note historical attempts at optical sensing had poor performance across darker skin tones, creating regulatory and equity issues.

Behavior change, data access, and UX

  • Users describe CGMs as highly motivating for dietary change by making glucose responses visible in real time; others say most patients don’t change behavior much.
  • Preventive and longevity angles (earlier detection of prediabetes, mood/sleep links, “observability” for the body) are discussed but acknowledged as not yet well validated.
  • Interest in open APIs and data export (e.g., xDrip, Loop, personal databases) is high; open‑source looping systems already improve T1 quality of life for some.