Minimally invasive and continuous glucose monitoring sensor based on non-enzymatic porous platinum black-coated gold microneedles

Tuning N-heterocyclic carbene wingtips to form electrochemically stable adlayers on metals

Self-assembled monolayers (SAMs) are employed in electrochemical biosensors to passivate and functionalize electrode surfaces. These monolayers prevent the occurrence of undesired electrochemical reactions and act as scaffolds for coupling bioaffinity reagents. Thiols are the most common adlayer used for this application; however, the thiol-gold bond is susceptible to competitive displacement by naturally occurring solvated thiols in biological fluids, as well as to desorption under continuous voltage interrogation. To overcome these issues, N-heterocyclic carbene (NHC) monolayers have been proposed as an alternative for electrochemical biosensor applications due to the strong carbon-gold bond. To maximize the effectiveness of NHCs for SAMs, a thorough understanding of both the steric effects of wingtip substituents and NHC precursor type to the passivation of electrode surfaces is required. In this study, five different NHC wingtips as well as two kinds of NHC precursors were evaluated. The best performing NHC adlayers can be cycled continuously for four days (over 30 000 voltammetric cycles) without appreciably desorbing from the electrode surface. Benchmark thiol monolayers, in contrast, rapidly desorb after only twelve hours. Investigations also show NHC adlayer formation on other biosensor-relevant electrodes such as platinum and palladium.

A self-powered and supercapacitive microneedle continuous glucose monitoring system with a wide range of glucose detection capabilities

Continuous detection of sudden changes in blood glucose is essential for individuals with diabetes who have difficulty in maintaining optimal control of their blood glucose levels. Hypoglycemic shock or a hyperglycemic crisis are likely to occurs in patients with diabetes and poses a significant threat to their lives. Currently, commercial continuous glucose monitoring (CGM) has limits in the glucose concentration detection range, which is 40-500 mg/dL, making it difficult to prevent the risk of hyperglycemic shock. In addition, current CGMs are invasive, cause pain and irritation during usage, and expensive. In this research, we overcome these limitations by introducing a novel mechanism to detect glucose concentration using supercapacitors. The developed CGM, which is self-powered and minimally invasive due to the use of microneedles, can detect a wider range of glucose concentrations than commercial sensors. In addition, efficacy and stability were proven through in vitro and in vivo experiments. Thus, this self-powered, microneedle and supercapacitive-type CGM can potentially prevent both hypoglycemic and complications of hyperglycemia without pain and with less power consumption than current commercial sensors.

[Translated article] Medical Devices in Patients With Diabetes and Contact Dermatitis

The development and commercialization of glucose sensors and insulin pumps has revolutionized the management of diabetes. These devices have been linked to multiple cases of contact dermatitis in recent years, however, giving rise to a growing interest in identifying the sensitizing allergens. Isobornyl acrylate was clearly identified as one of the main allergens responsible for contact dermatitis among users of the FreeStyle glucose sensor and was subsequently removed from the product ingredients. Remarkably, however, it is still used in most other sensors on the market. The common adhesive ingredients colophony and abietic acid derivatives have also been shown to be sensitizing agents. New components under study, such as dipropylene glycol diacrylate, N,N-dimethylacrylamide, and triethylene glycol methacrylate have recently been identified as allergens, though they are not commercially available for clinical testing. The benefits offered by glucose sensors and insulin pumps may be offset by sensitization to product ingredients, in some cases forcing discontinuation and diminishing quality of life. Dermatologists should play a role in this clinical and research scenario, offering case-by-case guidance to endocrinologists on skin care and possible alternatives for patients with glucose sensors and insulin pumps who develop contact dermatitis. They should also collaborate with the manufacturers developing these devices.

Advances in biomedical systems based on microneedles: design, fabrication, and application

Wearable devices have become prevalent in biomedical studies due to their convenient portability and potential utility in biomarker monitoring for healthcare. Accessing interstitial fluid (ISF) across the skin barrier, microneedle (MN) is a promising minimally invasive wearable technology for transdermal sensing and drug delivery. MN has the potential to overcome the limitations of conventional transdermal drug administration, making it another prospective mode of drug delivery after oral and injectable. Subsequently, combining MN with multiple sensing approaches has led to its extensive application to detect biomarkers in ISF. In this context, employing MN platforms and control schemes to merge diagnostic and therapeutic capabilities into theranostic systems will facilitate on-demand therapy and point-of-care diagnostics, paving the way for future MN technologies. A comprehensive analysis of the growing advances of microneedles in biomedical systems is presented in this review to summarize the latest studies for academics in the field and to offer for reference the issues that need to be addressed in MN application for healthcare. Covering an array of novel studies, we discuss the following main topics: classification of microneedles in the biomedical field, considerations of MN design, current applications of microneedles in diagnosis and therapy, and the regulatory landscape and prospects of microneedles for biomedical applications. This review sheds light on the significance of microneedle-based innovations, presenting an analysis of their potential implications and contributions to the community of wearable healthcare technologies. The review provides a comprehensive understanding of the field's current state and potential, making it a valuable resource for academics and clinicians seeking to harness the full potential of MN applications.

Dermal tissue penetration of in-plane silicon microneedles evaluated in skin-simulating hydrogel, rat skin and porcine skin

Recently, microneedle-based sensors have been introduced as novel strategy for in situ monitoring of biomarkers in the skin. Here, in-plane silicon microneedles with different dimensions and shapes are fabricated and their ability to penetrate skin is evaluated. Arrays with flat, triangular, hypodermic, lancet and pencil-shaped microneedles, with lengths of 500-1000 μm, widths of 200-400 μm and thickness of 180-500 μm are considered. Fracture force is higher than 20 N for all microneedle arrays (MNA) confirming a high mechanical stability of the microneedles. Penetration force in skin-simulating hydrogels, excised rat abdominal skin and porcine ear skin is at least five times lower than the fracture force for all MNA designs. The lowest force for skin penetration is required for triangular microneedles with a low width and thickness. Skin tissue staining and histological analysis of rat abdominal skin and porcine ear skin confirm successful penetration of the epidermis for all MNA designs. However, the penetration depth is between 100 and 300 μm, which is considerably lower than the microneedle length. Tissue damage estimated by visual analysis of the penetration hole is smallest for triangular microneedles. Penetration ability and tissue damage are compared to the skin prick test (SPT) needle applied in allergy testing.

The Emergence of AI-Based Wearable Sensors for Digital Health Technology: A Review

Disease diagnosis and monitoring using conventional healthcare services is typically expensive and has limited accuracy. Wearable health technology based on flexible electronics has gained tremendous attention in recent years for monitoring patient health owing to attractive features, such as lower medical costs, quick access to patient health data, ability to operate and transmit data in harsh environments, storage at room temperature, non-invasive implementation, mass scaling, etc. This technology provides an opportunity for disease pre-diagnosis and immediate therapy. Wearable sensors have opened a new area of personalized health monitoring by accurately measuring physical states and biochemical signals. Despite the progress to date in the development of wearable sensors, there are still several limitations in the accuracy of the data collected, precise disease diagnosis, and early treatment. This necessitates advances in applied materials and structures and using artificial intelligence (AI)-enabled wearable sensors to extract target signals for accurate clinical decision-making and efficient medical care. In this paper, we review two significant aspects of smart wearable sensors. First, we offer an overview of the most recent progress in improving wearable sensor performance for physical, chemical, and biosensors, focusing on materials, structural configurations, and transduction mechanisms. Next, we review the use of AI technology in combination with wearable technology for big data processing, self-learning, power-efficiency, real-time data acquisition and processing, and personalized health for an intelligent sensing platform. Finally, we present the challenges and future opportunities associated with smart wearable sensors.

Microneedles coated with composites of phenylboronic acid-containing polymer and carbon nanotubes for glucose measurements in interstitial fluids

A microneedle (MN) sensor coated with a sensing composite material was proposed for measuring glucose concentrations in interstitial fluid (ISF). The sensing composite material was prepared by blending a polymer containing glucose-responsive phenylboronic acid (PBA) moieties (i.e., polystyrene-block-poly(acrylic acid-co-acrylamidophenylboronic acid)) with conductive carbon nanotubes (CNTs). The polymer exhibited reversible swelling behavior in response to glucose concentrations, which influenced the distribution of the embedded CNTs, resulting in sensitive variations in electrical percolation, even when coated onto a confined surface of the MN in the sensor. We varied the ratio of PBA moieties and the loading amount of CNTs in the sensing composite material of the MN sensor and tested them in vitro using an ISF-mimicking gel with physiological glucose concentrations to determine the optimal sensitivity conditions. When tested in animal models with varying blood glucose concentrations, the MN sensor coated with the selected sensing material exhibited a strong correlation between the measured electrical currents and blood glucose concentrations, showing accuracy comparable to that of a glucometer in clinical use.

Microneedle-based glucose monitoring: a review from sampling methods to wearable biosensors

Blood glucose (BG) monitoring is critical for diabetes management. In recent years, microneedle (MN)-based technology has attracted emerging attention in glucose sensing and detection. In this review, we summarized MN-based sampling for glucose collection and glucose analysis in detail. First, different principles of MN-based biofluid extraction were elaborated, including external negative pressure, capillary force, swelling force and iontophoresis, which would guide the shape design and material optimization of MNs. Second, MNs coupled with different analysis approaches, including Raman methods, colorimetry, fluorescence, and electrochemical sensing, were emphasized to exhibit the trend towards highly integrated wearable sensors. Finally, the future development prospects of MN-based devices were discussed.

Epidermal Wearable Biosensors for the Continuous Monitoring of Biomarkers of Chronic Disease in Interstitial Fluid

Healthcare technology has allowed individuals to monitor and track various physiological and biological parameters. With the growing trend of the use of the internet of things and big data, wearable biosensors have shown great potential in gaining access to the human body, and providing additional functionality to analyze physiological and biochemical information, which has led to a better personalized and more efficient healthcare. In this review, we summarize the biomarkers in interstitial fluid, introduce and explain the extraction methods for interstitial fluid, and discuss the application of epidermal wearable biosensors for the continuous monitoring of markers in clinical biology. In addition, the current needs, development prospects and challenges are briefly discussed.

In-situ synthesis of Pt nanoparticles/reduced graphene oxide/cellulose nanohybrid for nonenzymatic glucose sensing

In recent years, nanocellulose-based bioinorganic nanohybrids have been exploited in numerous applications due to their unique nanostructure, excellent catalytic properties, and good biocompatibility. To the best of our knowledge, this is the first report on the simple and effective synthesis of graphene/cellulose (RGO/CNC) matrix-supported platinum nanoparticles (Pt NPs) for nonenzymatic electrochemical glucose sensing. The Pt/RGO/CNC nanohybrid presented a porous network structure, in which Pt NPs, RGO, and CNCs were integrated well. Here, cellulose nanocrystals act as a biocompatible framework for wrapped RGO and monodispersed Pt nanoparticles, effectively preventing the restacking of graphene during reduction. The superior glucose sensing performance of Pt/RGO/CNC modified glass carbon electrode (GCE) was achieved with a linear concentration range from 0.005 to 8.5 mM and a low detection limit of 2.1 μM. Moreover, the Pt/RGO/CNC/GCE showed remarkable sensitivity, selectivity, durability, and reproducibility. The obtained results indicate that the CNCs-based bioinorganic nanohybrids could be a promising electrode material in electrochemical biosensors.

Microneedle-Based Glucose Sensor Platform: From Vitro to Wearable Point-of-Care Testing Systems

Significant advanced have recently been made in exploiting microneedle-based (MN-based) diabetes devices for minimally invasive wearable biosensors and for continuous glucose monitoring. Within this emerging class of skin-worn MN-based sensors, the ISF can be utilized as a rich biomarker source to diagnose diabetes. While initial work of MN devices focused on ISF extraction, the recent research trend has been oriented toward developing in vivo glucose sensors coupled with optical or electrochemical (EC) instrumentation. This outlook highlights the essential characteristics of the sensing mechanisms, rational design, sensing properties, and applications. Finally, we describe the opinions about the challenge and prospects of optical and EC MN-based device platforms for the fabrication of wearable biosensors and their application potential in the future.

Recent Progress in Microneedles-Mediated Diagnosis, Therapy, and Theranostic Systems

Theranostic system combined diagnostic and therapeutic modalities is critical for the real-time monitoring of disease-related biomarkers and personalized therapy. Microneedles, as a multifunctional platform, are promising for transdermal diagnostics and drug delivery. They have shown attractive properties including painless skin penetration, easy self-administration, prominent therapeutic effects, and good biosafety. Herein, an overview of the microneedles-based diagnosis, therapies, and theranostic systems is given. Four microneedles-based detection methods are concluded based on the sensing mechanism: i) electrochemistry, ii) fluorometric, iii) colorimetric, and iv) Raman methods. Additionally, robust microneedles are suitable for implantable drug delivery. Microneedles-assisted transdermal drug delivery can be primarily classified as passive, active, and responsive drug release, based on the release mechanisms. Microneedles-assisted oral and implantable drug delivery mechanisms are also presented in this review. Furthermore, the key frontier developments in microneedles-mediated theranostic systems as the major selling points are emphasized in this review. These systems are classified into open-loop and closed-loop theranostic systems based on the indirectness and directness of feedback between the transdermal diagnosis and therapy, respectively. Finally, conclusions and future perspectives for next-generation microneedles-mediated theranostic systems are also discussed. Taken together, microneedle-based systems are promising as the new avenue for diagnosis, therapy, and disease-specific closed-loop theranostic applications.

Sensitive Electrochemical Non-Enzymatic Detection of Glucose Based on Wireless Data Transmission

Miniaturization and wireless continuous glucose monitoring are key factors for the successful management of diabetes. Electrochemical sensors are very versatile and can be easily miniaturized for wireless glucose monitoring. The authors report a microneedle-based enzyme-free electrochemical wireless sensor for painless and continuous glucose monitoring. The microneedles (MNs) fabricated consist of a 3 × 5 sharp and stainless-steel electrode array configuration. Each MN in the 3 × 5 array has 575 µm × 150 µm in height and width, respectively. A glucose-catalyzing layer, porous platinum black, was electrochemically deposited on the tips of the MNs by applying a fixed cathodic current of 2.5 mA cm-2 for a period of 200 s. For the non-interference glucose sensing, the platinum (Pt)-black-coated MN was carefully packaged into a biocompatible ionomer, nafion. The surface morphologies of the bare and modified MNs were studied using field-emission scanning electron microscopy (FESEM) and energy-dispersive X-ray analysis (EDX). The wireless glucose sensor displayed a broad linear range of glucose (1→30 mM), a good sensitivity and higher detection limit of 145.33 μA mM-1 cm-2 and 480 μM, respectively, with bare AuMN as a counter electrode. However, the wireless device showed an improved sensitivity and enhanced detection limit of 445.75, 165.83 μA mM-1 cm-2 and 268 μM, respectively, with the Pt-black-modified MN as a counter electrode. The sensor also exhibited a very good response time (2 s) and a limited interference effect on the detection of glucose in the presence of other electroactive oxidizing species, indicating a very fast and interference-free chronoamperometric response.

Continuous Glucose Monitoring System Based on Percutaneous Microneedle Array

A continuous blood glucose monitoring system (CGMS) which include a microneedle-array blood glucose sensor, a circuit module, and a transmission module placed in a wearable device is developed in this research. When in use, the wearable device is attached to the human body with the microneedle array inserted under the skin for continuous blood glucose sensing, and the measured signals are transmitted wirelessly to a mobile phone or computer for analysis. The purpose of this study is to replace the conventionally used method of puncture for blood collection and test strips are used to measure the blood glucose signals. The microneedle sensor of this CGMS uses a 1 mm length needle in a 3 mm × 3 mm microneedle array for percutaneous minimally invasive blood glucose measurement. This size of microneedle does not cause bleeding damage to the body when used. The microneedle sensor is placed under the skin and their solutions are discussed. The blood glucose sensor measured the in vitro simulant fluid with a glucose concentration range of 50~400 mg/dL. In addition, a micro-transfer method is developed to accurately deposit the enzyme onto the tip of the microneedle, after which cyclic voltammetry (CV) is used to measure the glucose simulation solution to verify whether the difference in the amount of enzyme on each microneedle is less than 10%. Finally, various experiments and analyses are carried out to reduce the size of the device, test effective durability (approximately 7 days), and the feasibility of minimally invasive CGMS is evaluated by tests on two persons.

Skin Patchable Sensor Surveillance for Continuous Glucose Monitoring

Diabetes mellitus is a physiological and metabolic disorder affecting millions of people worldwide, associated with global morbidity, mortality, and financial expenses. Long-term complications can be avoided by frequent, continuous self-monitoring of blood glucose. Therefore, this review summarizes the current state-of-art glycemic control regimes involving measurement approaches and basic concepts. Following an introduction to the significance of continuous glucose sensing, we have tracked the evolution of glucose monitoring devices from minimally invasive to non-invasive methods to present an overview of the spectrum of continuous glucose monitoring (CGM) technologies. The conveniences, accuracy, and cost-effectiveness of the real-time CGM systems (rt-CGMs) are the factors considered for discussion. Transdermal biosensing and drug delivery routes have recently emerged as an innovative approach to substitute hypodermal needles. This work reviews skin-patchable glucose monitoring sensors for the first time, providing specifics of all the major findings in the past 6 years. Skin patch sensors and their progressive form, i.e., microneedle (MN) array sensory and delivery systems, are elaborated, covering self-powered, enzymatic, and non-enzymatic devices. The critical aspects reviewed are material design and assembly techniques focusing on flexibility, sensitivity, selectivity, biocompatibility, and user-end comfort. The review highlights the advantages of patchable MNs' multi-sensor technology designed to maintain precise blood glucose levels and administer diabetes drugs or insulin through a "sense and act" feedback loop. Subsequently, the limitations and potential challenges encountered from the MN array as rt-CGMs are listed. Furthermore, the current statuses of working prototype glucose-responsive "closed-loop" insulin delivery systems are discussed. Finally, the expected future developments and outlooks in clinical applications are discussed.

Continuous Lactate Monitoring System Based on Percutaneous Microneedle Array

Lactate measurement is important in the fields of sports and medicine. Lactate accumulation can seriously affect an athlete’s performance. The most common problem caused by lactate accumulation in athletes is muscle soreness due to excessive exercise. Moreover, from a medical viewpoint, lactate is one of the main prognostic factors of sepsis. Currently, blood sampling is the most common approach to lactate measurement for lactate sensing, and continuous measurement is not available. In this study, a low-cost continuous lactate monitoring system (CLMS) is developed based on a percutaneous microneedle array that uses a three-electrode lactate sensor. The working electrode has an area of 10 mm × 6 mm, including a 3 × 3 array of stainless-steel microneedles. The length, width, and thickness of each needle are 1 mm, 0.44 mm, and 0.03 mm, respectively. The working electrode is then plated with gold, polyaniline, lactate enzyme, Nafion, and Poly(2-hydroxyethyl methacrylate) (poly HEMA). The reference electrode is a 2 × 1 array covered with AgCl, and the counter electrode is a 2 × 1 array plated with gold. The sensor is incorporated into the CLMS and connected to a smartphone application and the cloud. The CLMS was tested on 40 human subjects who rode indoor bicycles, starting at 100 W and increasing in steps of 25 W at intervals of 5 min until exhaustion. The data acquired from the app connected to the CLMS were analyzed to determine the subjects’ lactate response to exercise and the feasibility of assessing exercise performance and training exercise intensity by using the proposed system.

E-Skin: The Dawn of a New Era of On-Body Monitoring Systems

Real-time "on-body" monitoring of human physiological signals through wearable systems developed on flexible substrates (e-skin) is the next target in human health control and prevention, while an alternative to bulky diagnostic devices routinely used in clinics. The present work summarizes the recent trends in the development of e-skin systems. Firstly, we revised the material development for e-skin systems. Secondly, aspects related to fabrication techniques were presented. Next, the main applications of e-skin systems in monitoring, such as temperature, pulse, and other bio-electric signals related to health status, were analyzed. Finally, aspects regarding the power supply and signal processing were discussed. The special features of e-skin as identified contribute clearly to the developing potential as in situ diagnostic tool for further implementation in clinical practice at patient personal levels.

A Redox Cu(II)-Graphene Oxide Modified Screen Printed Carbon Electrode as a Cost-Effective and Versatile Sensing Platform for Electrochemical Label-Free Immunosensor and Non-enzymatic Glucose Sensor

A novel copper (II) ions [Cu(II)]-graphene oxide (GO) nanocomplex-modified screen-printed carbon electrode (SPCE) is successfully developed as a versatile electrochemical platform for construction of sensors without an additionally external redox probe. A simple strategy to prepare the redox GO-modified SPCE is described. Such redox GO based on adsorbed Cu(II) is prepared by incubation of GO-modified SPCE in the Cu(II) solution. This work demonstrates the fabrications of two kinds of electrochemical sensors, i.e., a new label-free electrochemical immunosensor and non-enzymatic sensor for detections of immunoglobulin G (IgG) and glucose, respectively. Our immunosensor based on square-wave voltammetry (SWV) of the redox GO-modified electrode shows the linearity in a dynamic range of 1.0-500 pg.mL-1 with a limit of detection (LOD) of 0.20 pg.mL-1 for the detection of IgG while non-enzymatic sensor reveals two dynamic ranges of 0.10-1.00 mM (sensitivity = 36.31 μA.mM-1.cm-2) and 1.00-12.50 mM (sensitivity = 3.85 μA.mM-1.cm-2) with a LOD value of 0.12 mM. The novel redox Cu(II)-GO composite electrode is a promising candidate for clinical research and diagnosis.