I think the easiest way is to intercept session calls open, destroyand gc(using session_set_save_handler()) and increase / decrease the value of the session counter in memcached. Sort of:
class Memcache_Save_Handler {
private $memcached;
public function open($save_path, $name) {
$session_count = (int)$this->memcached->get('session_count');
$this->memcached->set('session_count', ++$session_count);
}
public function destroy($id) {
$session_count = (int)$this->memcached->get('session_count');
$this->memcached->set('session_count', --$session_count);
}
}