Real-World Ketone Testing Patterns Among People Using FreeStyle Libre
Authors' conclusion
Most readers did not demonstrate adherence to standard-of-care recommendations for ketone monitoring and infrequently recheck ketones after elevated readings. Incorporation of continuous ketone monitoring into FSL would address limitations with current ketone testing methodologies and adherence to ketone monitoring guidelines.
Study context
- Population
- Individuals using a FreeStyle Libre (FSL) reader and blood ketone test strips, real-world data September 2014 to September 2024>2.5 million ketone readings
- Exposure
- ≤0.5 mmol/L vs 0.6-1.4 mmol/L vs 1.5-2.9 mmol/L vs ≥3.0 mmol/L
- Outcome
- Ketone testing patterns
Methodological detailsanalysis by reader
- Analysis by reader
Main finding
As reported in the abstract
Readers that never recorded a ketone test
92.4%
Readers that performed a ketone test when glucose exceeded 250 mg/dL
5%
Observational data: associations, not effects.
Further findings
Glucose in the 24 h before the ketone test
- Users with ketones ≥3.0 mmol/L had higher glucose concentrations in the preceding 24 h
Timing of ketone testing and retesting, ketones ≥1.5 mmol/L
- Ketone testing typically delayed after glucose surpassed 250 mg/dL
- 5-8 h
- Retesting ketones within 24-72 h was rare
Original publication
Real-World Ketone Testing Patterns Among People Using FreeStyle Libre. Diabetes Technol Ther. Published 11 May 2026. doi:10.
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