Noninvasive glucose monitoring using saliva nano-biosensor

Low dimensional materials for glucose sensing

Biosensors are essential components for effective healthcare management. Since biological processes occur on molecular scales, nanomaterials and nanosensors intrinsically provide the most appropriate landscapes for developing biosensors. Low-dimensional materials have the advantage of offering high surface areas, increased reactivity and unique physicochemical properties for efficient and selective biosensing. So far, nanomaterials and nanodevices have offered significant prospects for glucose sensing. Targeted glucose biosensing using such low-dimensional materials enables much more effective monitoring of blood glucose levels, thus providing significantly better predictive diabetes diagnostics and management. In this review, recent advances in using low dimensional materials for sensing glucose are summarized. Sensing fundamentals are discussed, as well as invasive, minimally-invasive and non-invasive sensing methods. The effects of morphological characteristics and size-dependent properties of low dimensional materials are explored for glucose sensing, and the key performance parameters such as selectivity, stability and sensitivity are also discussed. Finally, the challenges and future opportunities that low dimensional materials can offer for glucose sensing are outlined.

Developments of the Electroactive Materials for Non-Enzymatic Glucose Sensing and Their Mechanisms

A comprehensive review of the electroactive materials for non-enzymatic glucose sensing and sensing devices has been performed in this work. A general introduction for glucose sensing, a facile electrochemical technique for glucose detection, and explanations of fundamental mechanisms for the electro-oxidation of glucose via the electrochemical technique are conducted. The glucose sensing materials are classified into five major systems: (1) mono-metallic materials, (2) bi-metallic materials, (3) metallic-oxide compounds, (4) metallic-hydroxide materials, and (5) metal-metal derivatives. The performances of various systems within this decade have been compared and explained in terms of sensitivity, linear regime, the limit of detection (LOD), and detection potentials. Some promising materials and practicable methodologies for the further developments of glucose sensors have been proposed. Firstly, the atomic deposition of alloys is expected to enhance the selectivity, which is considered to be lacking in non-enzymatic glucose sensing. Secondly, by using the modification of the hydrophilicity of the metallic-oxides, a promoted current response from the electro-oxidation of glucose is expected. Lastly, by taking the advantage of the redistribution phenomenon of the oxide particles, the usage of the noble metals is foreseen to be reduced.

Biosensors and biomarkers for determining gestational diabetes mellitus and jaundice in children

Gestational diabetes and jaundice are the correlated diseases predominantly found in mother and newborn child. Jaundice is a neonatal complication with an increased risk when mother has gestational diabetes. Mothers with diabetes at an early stage of gestational age are at higher risk for hyperbilirubinemia (jaundice) and hypoglycemia. So, it is mandatory to monitor the condition of diabetes and jaundice during the pregnancy period for a healthy child and safest delivery. On the other hand, nanotechnology has displayed a rapid advancement that can be implemented to overcome these issues. The development of high-performance diagnosis using appropriate biomarkers provides their efficacy in the detection gestational diabetes and jaundice. This review covers the aspects from a fast-developing field to generate nanosensors in the nanosized dimensions for the applications to overcome these complications by coupling diagnostics with biomarkers. Further, the serum-based biomarkers have been discussed for these inborn complications and also the diagnosis with the current trend.

Nanosensors for Visual Detection of Glucose in Biofluids: Are We Ready for Instrument-Free Home-Testing?

Making frequent large-scale screenings for several diseases economically affordable would represent a real breakthrough in healthcare. One of the most promising routes to pursue such an objective is developing rapid, non-invasive, and cost-effective home-testing devices. As a first step toward a diagnostic revolution, glycemia self-monitoring represents a solid base to start exploring new diagnostic strategies. Glucose self-monitoring is improving people's life quality in recent years; however, current approaches still present vast room for improvement. In most cases, they still involve invasive sampling processes (i.e., finger-prick), quite discomforting for frequent measurements, or implantable devices which are costly and commonly dedicated to selected chronic patients, thus precluding large-scale monitoring. Thanks to their unique physicochemical properties, nanoparticles hold great promises for the development of rapid colorimetric devices. Here, we overview and analyze the main instrument-free nanosensing strategies reported so far for glucose detection, highlighting their advantages/disadvantages in view of their implementation as cost-effective rapid home-testing devices, including the potential use of alternative non-invasive biofluids as samples sources.

Paper microfluidic device using carbon dots to detect glucose and lactate in saliva samples

Bioanalyses are commonly performed with blood or serum samples. However, these analyses often require invasive and painful blood collection using a needle or finger pricking. Saliva is an alternative and very attractive biological medium for performing clinical analyses, since it contains many types of clinically relevant biomarkers and compounds. Its collection is straightforward and can be achieved in a non-invasive and stress-free way. However, the analytes are frequently present at low concentrations, while the viscosity of whole saliva hinders its analysis using paper devices, especially those with multiple layers (3D-μPADs). This work explores the use of a simple, fast, and low-cost saliva sample pretreatment using a cotton-paper-syringe filtration system, allowing the analysis of saliva samples using multilayer paper devices. The proposed methodology employs the oxidation of glucose and lactate, catalyzed by specific oxidase enzymes, producing hydrogen peroxide. The detection is based on the fluorescence quenching of carbon dots in the presence of hydrogen peroxidase. The concentrations of the analytes showed good linear correlations with the fluorescence quenching, with LODs of 2.60 × 10^-6 and 8.14 × 10^-7 mol L^-1 for glucose and lactate, respectively. The proposed method presented satisfactory intra-day and inter-day repeatabilities, with %RSD values in the range 3.82-6.61%. The enzymatic systems proved to be specific for the analytes and the matrix had no significant influence on the glucose and lactate determinations. The proposed methodology was successfully applied to saliva and serum samples and was validated using certified material.

Electrochemical Behaviour of Real-Time Sensor for Determination Mercury in Cosmetic Products Based on PANI/MWCNTs/AuNPs/ITO

Mercury is a common ingredient found in skin lightening soaps, creams, and makeup-cleansing products. It may cause skin rashes, skin discolouration, and scarring, as well as a reduction in the skin’s resistance to bacterial and fungal infections. By looking at this scenario, developing a sensor that involved a simple procedure and fasts for real-time detection without affecting mercury sensitivity is urgently needed. For that reason, a fast and sensitive electrochemical method was developed to determine mercury in cosmetic products with the composition of polyaniline/multi-walled carbon nanotubes/gold nanoparticles/indium tin oxide sheet using methylene blue as a redox indicator. The significantly enhanced electrochemical performance was observed using cyclic voltammetry (CV) and differential pulse voltammetry (DPV). In order to detect mercury qualitatively and quantitatively, deposition potential and deposition time were respectively optimised to be 0.10 V and 70 s. The modified sensor was revealed a wide detection range of mercury from 0.01 to 10.00 ppm with a limit of detection of 0.08 ppm. The modified sensor towards mercury with a correlation coefficient (r2) was of 0.9948. Multiple cycling, reproducibility, and consistency of different modified sensors were investigated to verify the modified sensor’s performance. The developed sensing platform was highly selective toward mercury among the pool of possible interferents, and the stability of the developed sensor was ensured for at least 21 days after 10 repeated uses. The proposed method is a fast and simple procedure technique for analysing the mercury levels in cosmetic products.

Gold nanoparticle based colorimetric sensing strategy for the determination of reducing sugars

The colorimetric sensors for reducing sugars based on a redox reaction between AuCl₄^- ions and fructose, glucose, lactose, or mannose are presented. Gold nanoparticles (AuNPs) that formed at room temperature as a product of this reaction were registered using a spectrophotometer. Lengthening reaction time had a positive effect on the sensitivity of the developed sensors. Different reducing sugars exhibited distinct reaction rates for AuNP formation, with the rate decreasing in the order fructose > glucose > lactose > mannose. LOD values after 60 min of the reaction for different sugars followed the same trend of 0.067, 0.081, 0.087, and 0.106 mM, while LOQ was 0.223, 0.270, 0.289, and 0.353 mM, respectively. The linear range 60 min since the start of the reaction varied from 0.3 up to 5.0 mM for different sugars. The colorimetric sensor was evaluated for use in real samples of beverages, milk, and saliva.

Recent advances in graphene-based nanobiosensors for salivary biomarker detection

As biosensing research is rapidly advancing due to significant developments in materials, chemistry, and electronics, researchers strive to build cutting-edge biomedical devices capable of detecting health-monitoring biomarkers with high sensitivity and specificity. Biosensors using nanomaterials are highly promising because of the wide detection range, fast response time, system miniaturization, and enhanced sensitivity. In the recent development of biosensors and electronics, graphene has rapidly gained popularity due to its superior electrical, biochemical, and mechanical properties. For biomarker detection, human saliva offers easy access with a large variety of analytes, making it a promising candidate for its use in point-of-care (POC) devices. Here, we report a comprehensive review that summarizes the most recent graphene-based nanobiosensors and oral bioelectronics for salivary biomarker detection. We discuss the details of structural designs of graphene electronics, use cases of salivary biomarkers, the performance of existing sensors, and applications in health monitoring. This review also describes current challenges in materials and systems and future directions of the graphene bioelectronics for clinical POC applications. Collectively, the main contribution of this paper is to deliver an extensive review of the graphene-enabled biosensors and oral electronics and their successful applications in human salivary biomarker detection.

Enzyme-Free Tandem Reaction Strategy for Surface-Enhanced Raman Scattering Detection of Glucose by Using the Composite of Au Nanoparticles and Porphyrin-Based Metal-Organic Framework

In this work, an S hybrid nanosheet with multiple functions is synthesized by in situ modification of gold nanoparticles (AuNPs) onto two-dimensional (2D) metalloporphyrinic metal-organic framework (MOF) (Cu-tetra(4-carboxyphenyl)porphyrin chloride(Fe(III)), designated as AuNPs/Cu-TCPP(Fe). Cu-TCPP(Fe) nanosheets contribute peroxidase-like activity, and AuNPs have glucose oxidase (GOx) mimicking performance, which induce the cascade catalysis reactions to convert glucose into hydrogen peroxide (H₂O₂), and then, by using AuNP catalysis, H₂O₂ oxidizes the no Raman-active leucomalachite green (LMG) into the Raman-active malachite green (MG). Simultaneously, in the presence of AuNPs, sensitive and selective surface-enhanced Raman scattering (SERS) determination of glucose can be achieved. The bioenzyme-free SERS assay based on such AuNPs/Cu-TCPP(Fe) nanosheets is used for detection of glucose in saliva, showing good recovery from 96.9 to 100.8%. The work paves a new way to design a nanozyme-based SERS protocol for biomolecule analysis.

Colorimetric Nanoplasmonics to Spot Hyperglycemia From Saliva

Early diagnostics and point-of-care (POC) devices can save people's lives or drastically improve their quality. In particular, millions of diabetic patients worldwide benefit from POC devices for frequent self-monitoring of blood glucose. Yet, this still involves invasive sampling processes, which are quite discomforting for frequent measurements, or implantable devices dedicated to selected chronic patients, thus precluding large-scale monitoring of the globally increasing diabetic disorders. Here, we report a non-invasive colorimetric sensing platform to identify hyperglycemia from saliva. We designed plasmonic multibranched gold nanostructures, able to rapidly change their shape and color (naked-eye detection) in the presence of hyperglycemic conditions. This "reshaping approach" provides a fast visual response and high sensitivity, overcoming common detection issues related to signal (color intensity) losses and bio-matrix interferences. Notably, optimal performances of the assay were achieved in real biological samples, where the biomolecular environment was found to play a key role. Finally, we developed a dipstick prototype as a rapid home-testing kit.

Non-Invasive Blood Glucose Monitoring Technology: A Review

In recent years, with the rise of global diabetes, a growing number of subjects are suffering from pain and infections caused by the invasive nature of mainstream commercial glucose meters. Non-invasive blood glucose monitoring technology has become an international research topic and a new method which could bring relief to a vast number of patients. This paper reviews the research progress and major challenges of non-invasive blood glucose detection technology in recent years, and divides it into three categories: optics, microwave and electrochemistry, based on the detection principle. The technology covers medical, materials, optics, electromagnetic wave, chemistry, biology, computational science and other related fields. The advantages and limitations of non-invasive and invasive technologies as well as electrochemistry and optics in non-invasives are compared horizontally in this paper. In addition, the current research achievements and limitations of non-invasive electrochemical glucose sensing systems in continuous monitoring, point-of-care and clinical settings are highlighted, so as to discuss the development tendency in future research. With the rapid development of wearable technology and transdermal biosensors, non-invasive blood glucose monitoring will become more efficient, affordable, robust, and more competitive on the market.

Biosensors for the Detection of Bacterial and Viral Clinical Pathogens

Biosensors are measurement devices that can sense several biomolecules, and are widely used for the detection of relevant clinical pathogens such as bacteria and viruses, showing outstanding results. Because of the latent existing risk of facing another pandemic like the one we are living through due to COVID-19, researchers are constantly looking forward to developing new technologies for diagnosis and treatment of infections caused by different bacteria and viruses. Regarding that, nanotechnology has improved biosensors' design and performance through the development of materials and nanoparticles that enhance their affinity, selectivity, and efficacy in detecting these pathogens, such as employing nanoparticles, graphene quantum dots, and electrospun nanofibers. Therefore, this work aims to present a comprehensive review that exposes how biosensors work in terms of bacterial and viral detection, and the nanotechnological features that are contributing to achieving a faster yet still efficient COVID-19 diagnosis at the point-of-care.

The development of an antifouling interpenetrating polymer network hydrogel film for salivary glucose monitoring

Owing to its rapid response and broad detection range, a phenylboronic acid (PBA)-functionalized hydrogel film-coated quartz crystal microbalance (QCM) sensor is used to non-invasively monitor salivary glucose in diabetic patients. However, nonspecific protein adsorption on the PBA-functionalized hydrogel film can cause dramatic loss of sensitivity and accuracy of the sensor. A traditional zwitterionic polymer surface with ultra-low protein fouling can hinder the interaction of PBA in the hydrogel matrix with glucose molecules owing to its steric hindrance, resulting in poor glucose sensitivity of the sensor. Herein, we developed a novel hydrogel film that enhanced the antifouling properties and sensitivity of the QCM sensor by infiltrating a glucose-sensitive monomer (i.e., PBA) into a zwitterionic polymer brush matrix to form an interpenetrating polymer network (IPN). The IPN hydrogel film could minimize the glucose sensitivity loss since the antifouling polymer distributed in its matrix. Moreover, a stable hydration layer was formed in this film that could prevent water from transporting out of the matrix, thus further improving its antifouling properties and glucose sensitivity. The experimental results confirmed that the IPN hydrogel film possessed excellent resistance to protein fouling by mucin from whole saliva with reductions in adsorption of nearly 88% and could also enhance the glucose sensitivity by nearly 2 fold, compared to the PBA-functionalized hydrogel film. Therefore, the IPN hydrogel film provides improved antifouling properties and sensitivity of the QCM sensor, which paves the way for non-invasive monitoring of low concentrations of glucose in saliva.

Non-Invasive Electrochemical Biosensors Operating in Human Physiological Fluids

Non-invasive healthcare technologies are an important part of research and development nowadays due to the low cost and convenience offered to both healthcare receivers and providers. This work overviews the recent advances in the field of non-invasive electrochemical biosensors operating in secreted human physiological fluids, viz. tears, sweat, saliva, and urine. Described electrochemical devices are based on different electrochemical techniques, viz. amperometry, coulometry, cyclic voltammetry, and impedance spectroscopy. Challenges that confront researchers in this exciting area and key requirements for biodevices are discussed. It is concluded that the field of non-invasive sensing of biomarkers in bodily fluid is highly convoluted. Nonetheless, if the drawbacks are appropriately addressed, and the pitfalls are adroitly circumvented, the approach will most certainly disrupt current clinical and self-monitoring practices.

In-Vivo Microsystems: A Review

In-vivo sensors yield valuable medical information by measuring directly on the living tissue of a patient. These devices can be surface or implant devices. Electrical activity in the body, from organs or muscles can be measured using surface electrodes. For short term internal devices, catheters are used. These include cardiac catheter (in blood vessels) and bladder catheters. Due to the size and shape of the catheters, silicon devices provided an excellent solution for sensors. Since many cardiac catheters are disposable, the high volume has led to lower prices of the silicon sensors. Many catheters use a single sensor, but silicon offers the opportunity to have multi sensors in a single catheter, while maintaining small size. The cardiac catheter is usually inserted for a maximum of 72 h. Some devices may be used for a short-to-medium period to monitor parameters after an operation or injury (1-4 weeks). Increasingly, sensing, and actuating, devices are being applied to longer term implants for monitoring a range of parameters for chronic conditions. Devices for longer term implantation presented additional challenges due to the harshness of the environment and the stricter regulations for biocompatibility and safety. This paper will examine the three main areas of application for in-vivo devices: surface devices and short/medium-term and long-term implants. The issues of biocompatibility and safety will be discussed.

The effects of glucose and glucose oxidase on the Uv-vis spectrum of gold nanoparticles: A study on optical biosensor for saliva glucose monitoring

In this study we have investigated the effect of glucose and glucose oxidase (GOD) on the absorption spectrum of gold nanoparticles (Au NPs) with 10-13 nm diameter, in order to improve optical methods of glucose monitoring using surface plasmon resonance of these particles. Different concentrations of glucose solution in water were prepared in the range of human saliva intensity. Two procedures are applied to study glucose effects on the particles; mixing the glucose to the nanocolloid and then adding the GOD, and reversely mixing the glucose and GOD solutions and then pouring in to the nanocolloid. Two different results were obtained that are analyzed based on optical properties. In each method, the effect of glucose and GOD on the size and Uv-vis spectrum of gold nanoparticles has been investigated. Results were interpreted by the physical concept of surface Plasmon resonance (SPR) of Au NPs. This study can open new insight about optical glucose sensing based on surface plasmon of metal nanoparticles.

A new sensitive spectrophotometric method for determination of saliva and blood glucose

There is an increasing need for accurate and inexpensive glucometers as the world moves toward personalized medicine. Among the existing technologies, photometric based devices are more desired due to the cost-effectiveness, ease-of-use and the potential to be adopted in the smart-phone technology for remote sensing and self-monitoring purposes. However, the accuracy, precision, and reproducibility of the results of these devices are heavily dependent on the details of the chosen glucose measuring method. Considering the delicate problems with the current spectrophotometric methods, a new method was developed for more precise, accurate, and fast measurement of blood glucose via the coupled reactions of glucose oxidase and peroxidase using 4-[(4-Hydroxy-3-methoxyphenyl) azo]-benzenesulfonic acid (GASA) as the substrate. Stability of GASA and its oxidized products along with its direct and fast consumption by peroxidase, made it possible to determine blood glucose concentration in <20 s with high reproducibility. The low detection limit of GASA method (0.36 mg dL^-1) with a linear range from 0.36 to 399.6 mg.dL^-1 also allowed determination of salivary glucose concentration (SGC). As compared with the blood samples, the SGC results were more dispersed, especially for the diabetic participants, assumingly due to the diverse nature of salivary samples. However, a good correlation coefficient of 0.81 for non-diabetic individuals showed that it is accurate enough to recognize non-diabetic from diabetic condition. Results of this study disclose the potential application of GASA method as a reliable alternative for the current spectrophotometric methods with the ability to be adopted in miniaturized glucometers.

Sensitive and non-invasive cholesterol determination in saliva via optimization of enzyme loading and platinum nano-cluster composition

To provide rapid and accurate determination of cholesterol, we have developed a simple, disposable, enzyme-based salivary cholesterol biosensor.

Modern noninvasive methods for monitoring glucose levels in patients: a review

This paper presents the current state of the art of noninvasive glucose monitoring. In recent years, we can observe constant increase in the incidence of diabetes. About 40% of all performed blood tests apply to the glucose tests. Formerly, this lifestyle disease occurred mainly in rich countries, but now it is becoming more common in poorer countries. It is related to the increase in life expectancy, unhealthy diet, lack of exercise, and other factors. Untreated diabetes may cause many complications or even death. For this reason, daily control of glucose levels in people with this disorder is very important. Measurements with a traditional glucometer are connected with performing finger punctures several times a day, which is painful and uncomfortable for patients. Therefore, researches on other methods are ongoing. A method that would be fast, noninvasive and cheap could also enable testing the state of the entire population, which is necessary because of the number of people currently living with undiagnosed type 2 diabetes. Although the first glucometer was made in 1966, the first studies on glucose level measurement in tear film were documented as early as 1937. This shows how much a noninvasive method of diabetes control is needed. Since then, there have been more and more studies on alternative methods of glucose measurement, not only from tear fluid, but also from saliva, sweat, or transdermally.

Advances in diagnostic microfluidics

Microfluidics is an emerging field in diagnostics that allows for extremely precise fluid control and manipulation, enabling rapid and high-throughput sample processing in integrated micro-scale medical systems. These platforms are well-suited for both standard clinical settings and point-of-care applications. The unique features of microfluidics-based platforms make them attractive for early disease diagnosis and real-time monitoring of the disease and therapeutic efficacy. In this chapter, we will first provide a background on microfluidic fundamentals, microfluidic fabrication technologies, microfluidic reactors, and microfluidic total-analysis-systems. Next, we will move into a discussion on the clinical applications of existing and emerging microfluidic platforms for blood analysis, and for diagnosis and monitoring of cancer and infectious disease. Together, this chapter should elucidate the potential that microfluidic systems have in the development of effective diagnostic technologies through a review of existing technologies and promising directions.

Intelligent Diabetes Detection System based on Tongue Datasets

Background:

Scanning Electron Microscope (SEM) Camera Imaging shows and helps analyze hidden organs in the human body. SEM image analysis provides in-depth and critical details of organ abnormalities. Similarly, the human tongue finds use in the detection of organ dysfunction with tongue reflexology.

Objective:

To detect diabetes at an early stage using a non-invasive method of diabetes detection through tongue images and to utilize the reasonable cost of modality (SEM camera) for capturing the tongue images instead of the existing and expensive imaging modalities like X-ray, Computed Tomography, Magnetic Resonance Imaging, Positron Emission Tomography, Single-Photon Emission Computed Tomography etc.

Methods:

The tongue image is captured via SEM camera, it is preprocessed to remove noise and resize the tongue such that it is suitable for segmentation. Greedy Snake Algorithm (GSA) is used to segment the tongue image. The texture features of the tongue are analyzed and finally it is classified as diabetic or normal.

Results:

Failure of organs stomach, intestine, liver and pancreas results in change of the color of the tongue, coating thickness and cracks on the tongue. Changes in pancreas proactive behavior also reflect on tongue coating. The tongue coating texture varies from white or vanilla to yellow also the tongue coating thickness also increases.

Conclusion:

In this paper, the author proposes to diagnose Diabetes Type2 (DT2) at an early stage from tongue digital image. The tongue image is acquired and processed with Greedy Snake Algorithm (GSA) to extract edge and texture features.

Plasmonic Detection of Glucose in Serum Based on Biocatalytic Shape-Altering of Gold Nanostars

Nanoparticles have been used as signal transducers for optical readouts in biosensors. Optical approaches are cost-effective with easy readout formats for clinical diagnosis. We present a glucose biosensor based on the biocatalytic shape-altering of gold nanostars via silver deposition. Improved sensitivity was observed due to the nanostars clustering after being functionalised with glucose oxidase (GOx). The biosensor quantified glucose in the serum samples with a 1:1000 dilution factor, and colorimetrically distinguished between the concentrations. The assay demonstrated good specificity and sensitivity. The fabricated glucose biosensor is a rapid kinetic assay using a basic entry level laboratory spectrophotometric microplate reader. Such a biosensor could be very useful in resource-constrained regions without state-of-the-art laboratory equipment. Furthermore, naked eye detection of glucose makes this a suitable biosensor for technology transfer to other point-of-care devices.

Wearable biosensors for healthcare monitoring

Wearable biosensors are garnering substantial interest due to their potential to provide continuous, real-time physiological information via dynamic, noninvasive measurements of biochemical markers in biofluids, such as sweat, tears, saliva and interstitial fluid. Recent developments have focused on electrochemical and optical biosensors, together with advances in the noninvasive monitoring of biomarkers including metabolites, bacteria and hormones. A combination of multiplexed biosensing, microfluidic sampling and transport systems have been integrated, miniaturized and combined with flexible materials for improved wearability and ease of operation. Although wearable biosensors hold promise, a better understanding of the correlations between analyte concentrations in the blood and noninvasive biofluids is needed to improve reliability. An expanded set of on-body bioaffinity assays and more sensing strategies are needed to make more biomarkers accessible to monitoring. Large-cohort validation studies of wearable biosensor performance will be needed to underpin clinical acceptance. Accurate and reliable real-time sensing of physiological information using wearable biosensor technologies would have a broad impact on our daily lives.

Role of Nanotechnology in Diabetic Management

BACKGROUND

Diabetes Mellitus (DM) has emerged as an epidemic that has affected millions of people worldwide in the last few decades. Nanotechnology is a discipline that is concerned with material characteristics at nanoscale and offers novel techniques for disease detection, management and prevention.

OBJECTIVE

Diabetes mellitus is an epidemic disease that has affected millions of people globally. Nanotechnology has greatly enhanced the health status by providing non-obtrusive techniques for the management and treatment of diabetic patients.

METHOD

In diabetes research, the nanotechnology has encouraged the advancement of novel glucose monitoring and several modalities for insulin delivery holding possibilities to enhance the personal satisfaction and life quality for diabetic patients.

RESULT

Nanoparticles hold a great potential in the areas of drug delivery and are explored as vehicles for orally administered insulin formulations. Glucose biosensors equipped with nanoscale materials such as Quantum Dots (QDs), Carbon Nanotubes (CNTs), Magnetic Nanoparticles (MNPs) etc. have shown greater sensitivity. Nanotechnology in diabetic research is heading towards the novel techniques which can provide continuous glucose monitoring offering accurate information and improving patient's compliance.

CONCLUSION

The present review addresses the different aspects of nanoparticles and recent patents related to diabetic management based on nanotechnology.

Naked-Eye Detection of Glucose in Saliva with Bienzymatic Paper-Based Sensor

The high incidence of Diabetes Mellitus in low-income regions has promoted the development of low-cost alternatives to replace blood-based procedures. In this work, we present a bienzymatic paper-based sensor suitable for the naked-eye detection of glucose in saliva samples. The sensor was obtained by a stamping procedure and modified with chitosan to improve the colorimetric readout. The bienzymatic reaction of GOx-HRP coupled with 2,4,6-tribromo-3-hydroxy benzoic acid was applied for the detection of glucose within a range from 0 to 180 mgdL⁻¹ in buffer and artificial saliva solutions. The visual readout was perceived by the naked eye and registered with an office scanner to evaluate the analytical performance. The results showed a limit of detection of 0.37 mgdL⁻¹ (S/N = 3) with an R.S.D. of 1.69% and a linear range from 1 to 22.5 mgdL⁻¹ with an R² of 0.99235. The analysis of human saliva samples was performed without pre-processing, achieving recoveries from 92 to 114%. The naked-eye detection was evaluated under two different light settings, showing average recoveries of 108.58 and 90.65% for standard and low illumination. The proposed device showed potential for easy-to-use, sensitive, low-cost, fast, and device-free detection of salivary glucose suitable for untrained personnel operation and limited facilities.

Enzyme-Based Glucose Sensor: From Invasive to Wearable Device

Blood glucose concentration is a key indicator of patients' health, particularly for symptoms associated with diabetes mellitus. Because of the large number of diabetic patients, many approaches for glucose measurement have been studied to enable continuous and accurate glucose level monitoring. Among them, electrochemical analysis is prominent because it is simple and quantitative. This technology has been incorporated into commercialized and research-level devices from simple test strips to wearable devices and implantable systems. Although directly monitoring blood glucose assures accurate information, the invasive needle-pinching step to collect blood often results in patients (particularly young patients) being reluctant to adopt the process. An implantable glucose sensor may avoid the burden of repeated blood collections, but it is quite invasive and requires periodic replacement of the sensor owing to biofouling and its short lifetime. Therefore, noninvasive methods to estimate blood glucose levels from tears, saliva, interstitial fluid (ISF), and sweat are currently being studied. This review discusses the evolution of enzyme-based electrochemical glucose sensors, including materials, device structures, fabrication processes, and system engineering. Furthermore, invasive and noninvasive blood glucose monitoring methods using various biofluids or blood are described, highlighting the recent progress in the development of enzyme-based glucose sensors and their integrated systems.

Highly Sensitive and Wearable In2O3 Nanoribbon Transistor Biosensors with Integrated On-Chip Gate for Glucose Monitoring in Body Fluids

Nanoribbon- and nanowire-based field-effect transistor (FET) biosensors have stimulated a lot of interest. However, most FET biosensors were achieved by using bulky Ag/AgCl electrodes or metal wire gates, which have prevented the biosensors from becoming truly wearable. Here, we demonstrate highly sensitive and conformal In₂O₃ nanoribbon FET biosensors with a fully integrated on-chip gold side gate, which have been laminated onto various surfaces, such as artificial arms and watches, and have enabled glucose detection in various body fluids, such as sweat and saliva. The shadow-mask-fabricated devices show good electrical performance with gate voltage applied using a gold side gate electrode and through an aqueous electrolyte. The resulting transistors show mobilities of ∼22 cm² V^-1 s^-1 in 0.1× phosphate-buffered saline, a high on-off ratio (10⁵), and good mechanical robustness. With the electrodes functionalized with glucose oxidase, chitosan, and single-walled carbon nanotubes, the glucose sensors show a very wide detection range spanning at least 5 orders of magnitude and a detection limit down to 10 nM. Therefore, our high-performance In₂O₃ nanoribbon sensing platform has great potential to work as indispensable components for wearable healthcare electronics.

Infrared spectroscopy based on broadly tunable quantum cascade lasers and polycrystalline diamond waveguides

Recently emerging broadly tunable quantum cascade lasers (tQCL) emitting in the mid-infrared (MIR) are a versatile alternative to well established thermal emitters in combination with interferometers as applied in Fourier transform infrared (FTIR) spectroscopy.

Toward the Development of a Glucose Dehydrogenase-Based Saliva Glucose Sensor Without the Need for Sample Preparation

BACKGROUND

Strict glycemic control is known to be a vital key in the management of diabetes mellitus (DM). However, traditional methods face limitations in their efficacy due to the pain and invasiveness of needle pricking which often discourages DM patients from performing the required number of tests per day. Saliva glucose (SG) sensing has long been considered a noninvasive alternative to blood glucose monitoring for diabetes management, however the sample preparation and sensor detection limit have been deemed as challenges to overcome. Herein, we describe a preliminary clinical validation of a disposable SG sensor without any requirement for sample preparation.

METHODS

The sensor utilizes glucose dehydrogenase flavine-adenine dinucleotide (GDH-FAD) in conjunction with disposable screen printed electrodes to measure glucose levels in saliva collected directly from 9 healthy subjects. Cyclic voltammetry and amperometric-time (Amp-it) assays were used to develop calibration curves and test subjects. Sensor calibration was performed using simulated saliva at 6.5 pH and 37ºC.

RESULTS

The lower limit of detection was determined to be 0.11 mg/dL. A lag time of 15 minutes with a positive correlation between SG and BG levels was found, which agrees with literature results. The detected SG ranges from 2.38 to 3.40 mg/dL over a BG range of 90 to 143 mg/dL.

CONCLUSION

This is the first reported use of measuring SG with GDH-FAD without prior sample preparation. Upon optimization, the sensor has the potential to serve as a supplement to blood glucose monitoring.

A Lab-on-a-Chip-Based Non-Invasive Optical Sensor for Measuring Glucose in Saliva

A lab-on-a-chip (LOC)-based non-invasive optical sensor for measuring glucose in saliva was fabricated. Existing glucose sensors utilizing blood require acquisition of a blood sample by pricking the finger, which is painful and inconvenient. To overcome these limitations, we propose a non-invasive glucose sensor with LOC, micro-electro-mechanical system and optical measurement technology. The proposed sensor for measuring glucose in saliva involves pretreatment, mixing, and measurement on a single tiny chip. Saliva containing glucose and glucose oxidase for glucose oxidation are injected through Inlets 1 and 2, respectively. Next, H₂O₂ is produced by the reaction between glucose and glucose oxidase in the pretreatment part. The saliva and generated H₂O₂ are mixed with a colorizing agent injected through Inlet 3 during the mixing part and the absorbance of the colorized mixture is measured in the measurement part. The absorbance of light increases as a function of glucose concentration at a wavelength of 630 nm. To measure the absorbance of the colorized saliva, a light-emitting diode with a wavelength of 630 nm and a photodiode were used during the measurement part. As a result, the measured output current of the photodiode decreased as glucose concentration in the saliva increased.

A Third Generation Glucose Biosensor Based on Cellobiose Dehydrogenase Immobilized on a Glassy Carbon Electrode Decorated with Electrodeposited Gold Nanoparticles: Characterization and Application in Human Saliva

Efficient direct electron transfer (DET) between a cellobiose dehydrogenase mutant from Corynascus thermophilus (CtCDH C291Y) and a novel glassy carbon (GC)-modified electrode, obtained by direct electrodeposition of gold nanoparticles (AuNPs) was realized. The electrode was further modified with a mixed self-assembled monolayer of 4-aminothiophenol (4-APh) and 4-mercaptobenzoic acid (4-MBA), by using glutaraldehyde (GA) as cross-linking agent. The CtCDH C291Y/GA/4-APh,4-MBA/AuNPs/GC platform showed an apparent heterogeneous electron transfer rate constant (ks) of 19.4 ± 0.6 s-1, with an enhanced theoretical and real enzyme surface coverage (Γtheor and Γreal) of 5287 ± 152 pmol cm-2 and 27 ± 2 pmol cm-2, respectively. The modified electrode was successively used as glucose biosensor exhibiting a detection limit of 6.2 μM, an extended linear range from 0.02 to 30 mM, a sensitivity of 3.1 ± 0.1 μA mM-1 cm-2 (R2 = 0.995), excellent stability and good selectivity. These performances compared favourably with other glucose biosensors reported in the literature. Finally, the biosensor was tested to quantify the glucose content in human saliva samples with successful results in terms of both recovery and correlation with glucose blood levels, allowing further considerations on the development of non-invasive glucose monitoring devices.

Advancing Point-of-Care (PoC) Testing Using Human Saliva as Liquid Biopsy

Salivary diagnostics is an emerging field for the encroachment of point of care technology (PoCT). The necessity of the development of point-of-care (PoC) technology, the potential of saliva, identification and validation of biomarkers through salivary diagnostic toolboxes, and a broad overview of emerging technologies is discussed in this review. Furthermore, novel advanced techniques incorporated in devices for the early detection and diagnosis of several oral and systemic diseases in a non-invasive, easily-monitored, less time consuming, and in a personalised way is explicated. The latest technology detection systems and clinical utilities of saliva as a liquid biopsy, electric field-induced release and measurement (EFIRM), biosensors, smartphone technology, microfluidics, paper-based technology, and how their futuristic perspectives can improve salivary diagnostics and reduce hospital stays by replacing it with chairside screening is also highlighted.

A technology roadmap of smart biosensors from conventional glucose monitoring systems

The objective of this review article is to focus on technology roadmap of smart biosensors from a conventional glucose monitoring system. The estimation of glucose with commercially available devices involves analysis of blood samples that are obtained by pricking finger or extracting blood from the forearm. Since pain and discomfort are associated with invasive methods, the non-invasive measurement techniques have been investigated. The non-invasive methods show advantages like non-exposure to sharp objects such as needles and syringes, due to which there is an increase in testing frequency, improved control of glucose concentration and absence of pain and biohazard materials. This review study is aimed to describe recent invasive techniques and major noninvasive techniques, viz. biosensors, optical techniques and sensor-embedded contact lenses for glucose estimation.

Glucose monitoring system using nanopellets

The combination of the fields of software engineering, gadgets, and science has stood out among the most revolutionary future innovations. Health issues have been the focus of various engaging and explanatory studies. One such health-related dilemma is diabetes. Diabetes at its serious stage results in impaired vision. Increase in the glucose level is a critical parameter that could result in hyperglycaemia, hypoglycaemia, massive heart attack, strokes, and aneurysms. Monitoring the glucose level in blood is one of the control measures for diabetes in the affected population. A glucose monitoring framework interminably measures and screens the glucose level in blood. A novel framework for measuring the glucose level is proposed in this study. This study employs nanopellets that evaluate the glucose level. When the glucose level increases or decreases, it is continuously recorded and displayed using a microcontroller (mixed signal processor (MSP) 430). The data are then sent to the physician through global system for mobile communication. The typical blood glucose level of human being ranges from 70 to 110 mg/dl. When the insulin level builds up to certain point, hyperglycaemia occurs. When decreases, hypoglycaemia occurs. Hyperglycaemia leads to cataracts, oedema, hypertension, polyuria, and polydipsia. Hypoglycaemia causes perplexity, energy, insensateness, coma, and death.