Diabetes KOL at ADA: NIT2 CGM Penetration Could Be Material; Mixed Ketone Takes

Research evidence excerpt

Diabetes KOL at ADA: NIT2 CGM Penetration Could Be Material; Mixed Ketone Takes

USA | Medical Supplies & Devices EquityJuneResearch7, 2026

Diabetes KOL at ADA: NIT2 CGM Penetration

Could Be Material; Mixed Ketone Takes

Key takes from ADA lunch w/Diabetes KOL Dr Horton: 1) Mixed views on Ketone,

w/ limited NT interest; potentially more in medium-long term; 2) Pump form

factor more important than algo; competition dilutes PODD but stickiness limits

switching; 3) NIT2 CGM a big opportunity, penetration could rise from ~18-20%

in his practice to 60%; use likely near full wear; 4) DXCM winning some more

NIT2 starts on brand/coverage; 5) GLP-1s reducing insulin intensity in T2D.

We hosted Dr William Horton, Assistant Professor (Endocrinology & Metabolism) at UVA. Dr Horton

has a bullish LT view on continuous ketone monitoring (CKM), particularly when integrated into

AID algos to simultaneously manage glucose and ketones, which he sees as key to enabling safe

use of SGLT2 inhibitors in T1D. T1 patients have inherent DKA risk, though he cautioned that NT

adoption may face friction as endos have shown mixed interest given a lack of clear action

protocols for ketone readings & concern about increased provider workload from too many alerts.

The KOL noted that pricing Libre Duo in line with CGM would be sensible, but flagged that

asymptomatic ketone elevations are common and could generate unnecessary patient anxiety

without established clinical workflows. NIH-sponsored research on ketone-aware AID algorithms

is underway, with data expected in ~2 yrs, which he views as the key catalyst to unlock CKM's

full clinical value. He pushed back on DXCM's position that glucose readings are enough to combat

DKA, citing scenarios where glucose & ketones are poorly correlated.