Challenges and Strategies in Developing an Enzymatic Wearable Sweat Glucose Biosensor as a Practical Point-Of-Care Monitoring Tool for Type II Diabetes

Glucose Oxidase-Based Glucose Biosensing with a Simple Dual Ag/AgCl Probe Conductivity Readout

We describe a conductometric assay of the enzymatic conversion of glucose to gluconic acid by dissolved glucose oxidase (GOx), using the generation of proton and gluconate from the reaction product dissociation for glucose detection. Simple basics of ionic conductivity, a silver/silver chloride wire pair, and a small applied potential translate glucose-dependent GOx activity into a scalable cell current. Enzyme immobilization and complex sensor design, involving extra nanomaterials or microfabrication of electrode structures, are entirely avoided, in contrast to all modern electrochemical glucose biosensors. Assay calibration showed a response linearity up to 500 μM, with a sensitivity of about 1.3 nA/μM. Selectivity tests excluded signals from sugars other than glucose, and glucose quantifications with recovery rates close to 100% were reached with a model sample and a beverage. Easy use of elementary physicochemical phenomena and a satisfactory performance are assets of the proposed non-amperometric glucose biosensing strategy. Assay integration into a planar dual electrode platform, with or without microfluidic application option, is feasible because of the simplicity of the sensor readout and suggests a route to affordable glucose analysis in beverage, food, and body fluid samples.

Recent advances in biosensors based on metal-oxide semiconductors system-integrated into bioelectronics

Metal-oxide semiconductors (MOSs) have emerged as pivotal components in technology related to biosensors and bioelectronics. Detecting biomarkers in sweat provides a glimpse into an individual's metabolism without the need for sample preparation or collection steps. The distinctive attributes of this biosensing technology position it as an appealing option for biomedical applications beyond the scope of diagnosis and healthcare monitoring. This review encapsulates ongoing developments of cutting-edge biosensors based on MOSs. Recent advances in MOS-based biosensors for human sweat analyses are reviewed. Also discussed is the progress in sweat-based biosensing technologies to detect and monitor diseases. Next, system integration of biosensors is demonstrated ultimately to ensure the accurate and reliable detection and analysis of target biomarkers beyond individual devices. Finally, the challenges and opportunities related to advanced biosensors and bioelectronics for biomedical applications are discussed.

Smartphone-enabled flow injection amperometric glucose monitoring based on a screen-printed carbon electrode modified with PEDOT@PB and a GOx@PPtNPs@MWCNTs nanocomposite

This study presents a modified screen-printed carbon electrode (SPCE) to determine glucose in a custom-built flow injection system. The biosensor was constructed by immobilizing glucose oxidase on porous platinum nanoparticles decorated on multi-walled carbon nanotubes (GOx@PPtNPs@MWCTNs). The fabrication of the biosensor was completed by coating the GOx@PPtNPs@MWCTNs nanocomposite on an SPCE modified with a nanocomposite of poly(3,4-ethylenedioxythiophene) and Prussian blue (GOx@PPtNPs@MWCTNs/PEDOT@PB/SPCE). The fabricated electrode accurately measured hydrogen peroxide (H2O2), the byproduct of the GOx-catalyzed oxidation of glucose, and was then applied as a glucose biosensor. The glucose response was amperometrically determined from the PB-mediated reduction of H2O2 at an applied potential of -0.10 V in a flow injection system. Under optimal conditions, the developed biosensor produced a linear range from 2.50 μM to 1.250 mM, a limit of detection of 2.50 μM, operational stability over 500 sample injections, and good selectivity. The proposed biosensor determined glucose in human plasma samples, achieving recoveries and results that agreed with the hexokinase-spectrophotometric method (P > 0.05). Combining the proposed biosensor with the custom-built sample feed, a portable potentiostat and a smartphone, enabled on-site glucose monitoring.

A dried sweat spot paper (DSSP) method based on novel mass spectrometry probe labeling for detection and resolution of DL-lactate enantiomers as potential biomarkers for diabetes mellitus

BACKGROUND

Human sweat can be collected non-invasively with low infectivity; however, its application as a determination method has been challenged due to the presence of trace amounts of chiral metabolites. Moreover, its application as a biological fluid for disease diagnosis has not been previously reported. In this study, the human dried sweat spot paper (DSSP) method was proposed for the derivatization of a novel mass spectrometric chiral probe, N-[1-Oxo-5-(triphenylphosphonium) pentyl]-(S)-3-aminopyrrolidine (OTPA), determination and resolution of DL-lactic acid (DL-LA) enantiomers in human elbow sweat.

RESULTS

The methodological validation revealed the resolution (Rs) as 1.78, the limit of detection (S/N = 3) as 20.83 fmol, good linearity (R2 ≥ 0.9996), and the intra-day and intra-day stability with RSD ranging from 0.53 to 10.85 %, while the average recovery rate of D-LA and L-LA were 104.00 % ± 4.68 % and 107.41 % ± 8.34 %, respectively, with high accuracy. In addition, the method was applied for the determination of DL-LA in the sweat on elbow of 10 healthy volunteers and 30 diabetic patients. The results demonstrated that the D/L ratio and L/D ratio were significantly different (p < 0.0001). In addition, a moderate positive linear correlation between the D/L-LA ratio in human sweat and fasting blood glucose level (r = 0.7744, p < 0.0001) was observed, thereby suggesting that the D/L ratio of lactate in human sweat correlate the glucose level in human fasting blood.

SIGNIFICANCE AND NOVELTY

The D/L lactate ratio in human sweat could be used as a potential biomarker for diabetes screening. The method can be used to screen for diabetes by providing a dry sweat paper to test equipment and has the potential to be a non-invasive early-warning diagnostic tool for diabetes.

Self-assembly of cascade nanoenzyme glucose oxidase encapsulated in copper benzenedicarboxylate for wearable sweat-glucose colorimetric sensors with smartphone readout

BACKGROUND

With the advent of personalized medical approaches, precise and tailored treatments are expected to become widely accepted for the prevention and treatment of diabetes. Paper-based colorimetric sensors that function in combination with smartphones have been rapidly developed in recent years because it does not require additional equipment and is inexpensive and easy to perform. In this study, we developed a portable, low-cost, and wearable sweat-glucose detection device for in situ detection.

RESULTS

The sensor adopted an integrated biomimetic nanoenzyme of glucose oxidase (GOx) encapsulated in copper 1, 4-benzenedicarboxylate (CuBDC) (GOx@CuBDC) through a biomimetic mineralization process. CuBDC exhibited a peroxide-like effect, cascade catalytic effect with the encapsulated GOx, and increased the enzyme stability. GOx@CuBDC and 3,3,5,5-tetramethylbenzidine were combined to form a hybrid membrane that achieved single-step paper-based glucose detection.

SIGNIFICANCE AND NOVELTY

This GOx@CuBDC-based colorimetric glucose sensor was used to quantitatively analyze the sweat-glucose concentration with smartphone readings. The sensor exhibited a good linear relationship over the concentration range of 40-900 μM and a limit of detection of 20.7 μM (S/N = 3). Moreover, the sensor performed well in situ monitoring and in evaluating variations based on the consumption of foods with different glycemic indices. Therefore, the fabricated wearable sweat-glucose sensors exhibited optimal practical application performance.

Aptamer-based biosensors for the detection of neonicotinoid insecticides in environmental samples: A systematic review

Neonicotinoids, sometimes abbreviated as neonics, represent a class of neuro-active insecticides with chemical similarities to nicotine. Neonicotinoids are the most widely adopted group of insecticides globally since their discovery in the late 1980s. Their physiochemical properties surpass those of previously established insecticides, contributing to their popularity in various sectors such as agriculture and wood treatment. The environmental impact of neonicotinoids, often overlooked, underscores the urgency to develop tools for their detection and understanding of their behavior. Conventional methods for pesticide detection have limitations. Chromatographic techniques are sensitive but expensive, generate waste, and require complex sample preparation. Bioassays lack specificity and accuracy, making them suitable as preliminary tests in conjunction with instrumental methods. Aptamer-based biosensor is recognized as an advantageous tool for neonicotinoids detection due to its rapid response, user-friendly nature, cost-effectiveness, and suitability for on-site detection. This comprehensive review represents the inaugural in-depth analysis of advancements in aptamer-based biosensors targeting neonicotinoids such as imidacloprid, thiamethoxam, clothianidin, acetamiprid, thiacloprid, nitenpyram, and dinotefuran. Additionally, the review offers valuable insights into the critical challenges requiring prompt attention for the successful transition from research to practical field applications.

SPOOC (Sensor for Periodic Observation of Choline): An Integrated Lab-on-a-Spoon Platform for At-Home Quantification of Choline in Infant Formula

Choline is an essential micronutrient for infants' brain development and health. To ensure that infants receive the needed daily dose of choline, the U.S. Food and Drug Administration (FDA) has set requirements for choline levels in commercialized infant formulas. Unfortunately, not all families can access well-regulated formulas, leading to potential inadequacies in choline intake. Economic constraints or difficulties in obtaining formulas, exacerbated by situations like COVID-19, prompt families to stretch formulas. Accurate measurement of choline in infant formulas becomes imperative to guarantee that infants receive the necessary nutritional support. Yet, accessible tools for this purpose are lacking. An innovative integrated sensor for the periodic observation of choline (SPOOC) designed for at-home quantification of choline in infants' formulas and milk powders is reported. This system is composed of a choline potentiometric sensor and ionic-liquid reference electrode developed on laser-induced graphene (LIG) and integrated into a spoon-like device. SPOOC includes a micro-potentiometer that conducts the measurements and transmits results wirelessly to parents' mobile devices. SPOOC demonstrated rapid and accurate assessment of choline levels directly in pre-consuming infant formulas without any sample treatment. This work empowers parents with a user-friendly tool for choline monitoring promoting informed nutritional decision-making in the care of infants.

Biosensors for Public Health and Environmental Monitoring: The Case for Sustainable Biosensing

Climate change is a profound crisis that affects every aspect of life, including public health. Changes in environmental conditions can promote the spread of pathogens and the development of new mutants and strains. Early detection is essential in managing and controlling this spread and improving overall health outcomes. This perspective article introduces basic biosensing concepts and various biosensors, including electrochemical, optical, mass-based, nano biosensors, and single-molecule biosensors, as important sustainability and public health preventive tools. The discussion also includes how the sustainability of a biosensor is crucial to minimizing environmental impacts and ensuring the long-term availability of vital technologies and resources for healthcare, environmental monitoring, and beyond. One promising avenue for pathogen screening could be the electrical detection of biomolecules at the single-molecule level, and some recent developments based on single-molecule bioelectronics using the Scanning Tunneling Microscopy-assisted break junctions (STM-BJ) technique are shown here. Using this technique, biomolecules can be detected with high sensitivity, eliminating the need for amplification and cell culture steps, thereby enhancing speed and efficiency. Furthermore, the STM-BJ technique demonstrates exceptional specificity, accurately detects single-base mismatches, and exhibits a detection limit essentially at the level of individual biomolecules. Finally, a case is made here for sustainable biosensors, how they can help, the paradigm shift needed to achieve them, and some potential applications.

Sweat as a source of non-invasive biomarkers for clinical diagnosis: An overview

Sweat has excellent potential as one of the sources of non-invasive biomarkers for clinical diagnosis. It is relatively easy to collect and process and may contain different disease-specific markers and drug metabolites, making it ideal for various clinical applications. This article discusses the anatomy of sweat glands and their role in sweat production, as well as the history and development of multiple sweat sample collection and analysis techniques. Another primary focus of this article is the application of sweat detection in clinical disease diagnosis and other life scenarios. Finally, the limitations and prospects of sweat analysis are discussed.

Biocompatible Gold Nanoparticles-Modified Fluorine Doped Tin Oxide Electrode for the Fabrication of Enzyme-Free Glucose Sensor

This work demonstrates the use of jute stick extract as a reducing and stabilizing agent for the synthesis of spherical gold nanoparticles (AuNPs). In UV-Vis spectroscopy, peak at 550 nm was used to confirm the formation of AuNPs. The spherical surface morphology of AuNPs was determined through SEM and TEM analysis. While XRD investigation revealed the crystallinity of the prepared AuNPs. To ensure the biocompatibility of synthesized AuNPs, a bacterial investigation was conducted with negative results towards bacterial strain. The, modified FTO with AuNPs were able to detect glucose in CV analysis and the constructed sensor displayed a wide linear range of 50 μM to 40 mM with a detection limit of 20 μM. Scan rate analysis was performed to determine the charge transfer coefficient (0.42) and Tafel slope (102 mV/decade). Furthermore, the interfacial surface mechanism is illustrated to understand the interaction of glucose with the electrode surface in an alkaline medium and the product formation through the dehydrogenation and hydrolysis process. The prepared sensor also showed good stability, reproducibility, and anti-interference capabilities. In the case of real sample analysis, we used a blood serum sample. A low RSD value (<10 %) suggests the practical use of AuNPs/FTO in real-life applications.

Abiotic, Hybrid, and Biological Electrocatalytic Materials Applied in Microfluidic Fuel Cells: A Comprehensive Review

This article provides an overview of the work reported in the past decade in the field of microfluidic fuel cells. To develop appropriate research, the most commonly used electrocatalytic materials were considered and a new classification was proposed based on their nature: abiotic, hybrid, or biological. This classification allowed the authors to discern the information collected. In this sense, the types of electrocatalysts used for the oxidation of the most common fuels in different environments, such as glucose, ethanol, methanol, glycerol, and lactate, were presented. There are several phenomena presented in this article. This information gives an overview of where research is heading in the field of materials for electrocatalysis, regardless of the fuel used in the microfluidic fuel cell: the synthesis of abiotic and biological materials to obtain hybrid materials that allow the use of the best properties of each material.

Improving biosensor accuracy and speed using dynamic signal change and theory-guided deep learning

False results and time delay are longstanding challenges in biosensing. While classification models and deep learning may provide new opportunities for improving biosensor performance, such as measurement confidence and speed, it remains a challenge to ensure that predictions are explainable and consistent with domain knowledge. Here, we show that consistency of deep learning classification model predictions with domain knowledge in biosensing can be achieved by cost function supervision and enables rapid and accurate biosensing using the biosensor dynamic response. The impact and utility of the methodology were validated by rapid and accurate quantification of microRNA (let-7a) across the nanomolar (nM) to femtomolar (fM) concentration range using the dynamic response of cantilever biosensors. Data augmentation and cost function supervision based on the consistency of model predictions and experimental observations with the theory of surface-based biosensors improved the F1 score, precision, and recall of a recurrent neural network (RNN) classifier by an average of 13.8%. The theory-guided RNN (TGRNN) classifier enabled quantification of target analyte concentration and false results with an average prediction accuracy, precision, and recall of 98.5% using the initial transient or entire dynamic response, which is indicative of high prediction accuracy and low probability of false-negative and false-positive results. Classification scores were used to establish new relationships among biosensor performance characteristics (e.g., measurement confidence) and design parameters (e.g., inputs and hyperparameters of classification models and data acquisition parameters) that may be used for characterizing biosensor performance.

Wearable biosensors for human health: A bibliometric analysis from 2007 to 2022

Objective

This study aimed to determine the status of scientific production on biosensor usage for human health monitoring.

Methods

We used bibliometrics based on the data and metadata retrieved from the Web of Science between 2007 and 2022. Articles unrelated to health and medicine were excluded. The databases were processed using the VOSviewer software and auxiliary spreadsheets. Data extraction yielded 275 articles published in 161 journals, mainly concentrated on 13 journals and 881 keywords plus.

Results

The keywords plus of high occurrences were estimated at 27, with seven to 30 occurrences. From the 1595 identified authors, 125 were consistently connected in the coauthorship network in the total set and were grouped into nine clusters. Using Lotka's law, we identified 24 prolific authors, and Hirsch index analysis revealed that 45 articles were cited more than 45 times. Crosses were identified between 17 articles in the Hirsch index and 17 prolific authors, highlighting the presence of a large set of prolific authors from various interconnected clusters, a triad, and a solitary prolific author.

Conclusion

An exponential trend was observed in biosensor research for health monitoring, identifying areas of innovation, collaboration, and technological challenges that can guide future research on this topic.

Simultaneous detection of urea and lactate in sweat based on a wearable sweat biosensor

Urea and lactate are biomarkers in sweat that is closely associated with human health. This study introduces portable, rapid, sensitive, stable, and high-throughput wearable sweat biosensors utilizing Au-Ag nanoshuttles (Au-Ag NSs) for the simultaneous detection of sweat urea and lactate. The Au-Ag NSs arrays within the biosensor's microfluidic cavity provide a substantial surface-enhanced Raman scattering (SERS) enhancement effect. The limit of detection (LOD) for urea and lactate are 2.35 × 10-6 and 8.66 × 10-7 mol/L, respectively. This wearable sweat biosensor demonstrates high resistance to compression bending, repeatability, and stability and can be securely attached to various body parts. Real-time sweat analysis of volunteers wearing the biosensors during exercise demonstrated the method's practicality. This wearable sweat biosensor holds significant potential for monitoring sweat dynamics and serves as a valuable tool for assessing bioinformation in sweat.

Advances in Non-Electrochemical Sensing of Human Sweat Biomarkers: From Sweat Sampling to Signal Reading

Sweat, commonly referred to as the ultrafiltrate of blood plasma, is an essential physiological fluid in the human body. It contains a wide range of metabolites, electrolytes, and other biologically significant markers that are closely linked to human health. Compared to other bodily fluids, such as blood, sweat offers distinct advantages in terms of ease of collection and non-invasive detection. In recent years, considerable attention has been focused on wearable sweat sensors due to their potential for continuous monitoring of biomarkers. Electrochemical methods have been extensively used for in situ sweat biomarker analysis, as thoroughly reviewed by various researchers. This comprehensive review aims to provide an overview of recent advances in non-electrochemical methods for analyzing sweat, including colorimetric methods, fluorescence techniques, surface-enhanced Raman spectroscopy, and more. The review covers multiple aspects of non-electrochemical sweat analysis, encompassing sweat sampling methodologies, detection techniques, signal processing, and diverse applications. Furthermore, it highlights the current bottlenecks and challenges faced by non-electrochemical sensors, such as limitations and interference issues. Finally, the review concludes by offering insights into the prospects for non-electrochemical sensing technologies. By providing a valuable reference and inspiring researchers engaged in the field of sweat sensor development, this paper aspires to foster the creation of innovative and practical advancements in this domain.

Adoption of Wearable Insulin Biosensors for Diabetes Management: A Cross-Sectional Study

BACKGROUND

Wearable insulin biosensors represent a novel approach that combines the benefits of real-time glucose monitoring and automated insulin delivery, potentially revolutionizing how individuals with diabetes manage their condition.

STUDY PURPOSE

To analyze the behavioral intentions of wearable insulin biosensors among diabetes patients, the factors that drive or hinder their usage, and the implications for diabetes management and healthcare outcomes.

METHODS

A cross-sectional survey design was adopted in this study. The validated questionnaire included 10 factors (Performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, trust, perceived privacy risk, and personal innovativeness) affecting the acceptance of wearable insulin sensors. A total of 248 diabetic patients who had used wearable sensors participated in the study.

RESULTS

Performance expectancy was rated the highest (Mean = 3.84 out of 5), followed by effort expectancy (Mean = 3.78 out of 5), and trust (Mean = 3.53 out of 5). Statistically significant differences (p < 0.05) were observed with respect to socio-demographic variables including age and gender on various influencing factors and adoption intentions. PE, EE, and trust were positively associated with adoption intentions.

CONCLUSION

While wearable insulin sensors are positively perceived with respect to diabetes management, issues like privacy and security may affect their adoption.

Mini review about metal organic framework (MOF)-based wearable sensors: Challenges and prospects

Among many types of wearable sensors, MOFs-based wearable sensors have recently been explored in both commercialization and research. There has been much effort in various aspects of the development of MOF-based wearable sensors including but not limited to miniaturization, size control, safety, improvements in conformal and flexible features, improvements in the analytical performance and long-term storage of these devices. Recent progress in the design and deployment of MOFs-based wearable sensors are covered in this paper, as are the remaining obstacles and prospects. This work also highlights the enormous potential for synergistic effects of MOFs used in combination with other nanomaterials for healthcare applications and raise attention toward the economic aspect and market diffusion of MOFs-based wearable sensors.

Review of Noninvasive Continuous Glucose Monitoring in Diabetics

For diabetics, taking regular blood glucose measurements is crucial. However, traditional blood glucose monitoring methods are invasive and unfriendly to diabetics. Recent studies have proposed a biofluid-based glucose sensing technique that creatively combines wearable devices with noninvasive glucose monitoring technology to enhance diabetes management. This is a revolutionary advance in the diagnosis and management of diabetes, reflects the thoughtful modernization of medicine, and promotes the development of digital medicine. This paper reviews the research progress of noninvasive continuous blood glucose monitoring (CGM), with a focus on the biological liquids that replace blood in monitoring systems, the technical principles of continuous noninvasive glucose detection, and the output and calibration of sensor signals. In addition, the existing limits of noninvasive CGM systems and prospects for the future are discussed. This work serves as a resource for further promoting the development of noninvasive CGM systems.

Perspective on the development of synthetic microbial community (SynCom) biosensors

Synthetic microbial community (SynCom) biosensors are a promising technology for detecting and responding to environmental cues and target molecules. SynCom biosensors use engineered microorganisms to create a more complex and diverse sensing system, enabling them to respond to stimuli with enhanced sensitivity and accuracy. Here, we give a definition of SynCom biosensors, outline their construction workflow, and discuss current biosensing technology. We also highlight the challenges and future for developing and optimizing SynCom biosensors and the potential applications in agriculture and food management, biotherapeutic development, home sensing, urban and environmental monitoring, and the One Health foundation. We believe SynCom biosensors could be used in a real-time and remote-controlled manner to sense the chaos of constantly dynamic environments.

Non-invasive, ultrasensitive detection of glucose in saliva using metal oxide transistors

Transistor-based biosensors represent an emerging technology for inexpensive point-of-care testing (POCT) applications. However, the limited sensitivity of the current transistor technologies hinders their practical deployment. In this study, we developed tri-channel In2O3/ZnO heterojunction thin-film transistors (TFTs) featuring the surface-immobilized enzyme glucose oxidase to detect glucose in various biofluids. This unusual channel design facilitates strong coupling between the electrons transported along the buried In2O3/ZnO heterointerface and the electrostatic perturbations caused by the interactions between glucose and surface-immobilized glucose oxidase. The enzyme selectively binds to glucose, causing a change in charge density on the channel surface. By exploring this effect, the solid-state biosensing TFT (BioTFT) can selectively detect glucose in artificial and real saliva over a wide range of concentrations from 500 nM to 20 mM with limits of detection of ∼365 pM (artificial saliva) and ∼416 nM (real saliva) in less than 60 s. The specificity of the sensor towards glucose has been demonstrated against various interfering species in artificial saliva, further highlighting its unique capabilities. Moreover, the BioTFTs exhibited good operating stability upon storage for up to two weeks, with relative standard deviation (RSD) values ranging from 2.36% to 6.39% for 500 nM glucose concentration. Our BioTFTs are easy to manufacture with reliable operation, making them ideal for non-invasive POCT applications.

Screen-Printed Wearable Sweat Sensor for Cost-Effective Assessment of Human Hydration Status through Potassium and Sodium Ion Detection

Human sweat is intricately linked to human health, and unraveling its secrets necessitates a substantial volume of experimental data. However, conventional sensors fabricated via complex processes such as photolithography offer high detection precision at the expense of prohibitive costs. In this study, we presented a cost-effective and high-performance wearable flexible sweat sensor for real-time monitoring of K+ and Na+ concentrations in human sweat, fabricated using screen printing technology. Initially, we evaluated the electrical and electrochemical stability of the screen-printed substrate electrodes, which demonstrated good consistency with a variation within 10% of the relative standard deviation (RSD), meeting the requirements for reliable detection of K+ and Na+ in human sweat. Subsequently, we employed an "ion-electron" transduction layer and an ion-selective membrane to construct the sensors for detecting K+ and Na+. Comprehensive tests were conducted to assess the sensors' sensitivity, linearity, repeatability, resistance to interference, and mechanical deformation capabilities. Furthermore, we evaluated their long-term stability during continuous monitoring and storage. The test results confirmed that the sensor's performance indicators, as mentioned above, met the requirements for analyzing human sweat. In a 10-day continuous and regular monitoring experiment involving volunteers wearing the sensors, a wealth of data revealed a close relationship between K+ and Na+ concentrations in human sweat and hydration status. Notably, we observed that consistent and regular physical exercise effectively enhanced the body's resistance to dehydration. These findings provided a solid foundation for conducting extensive experiments and further exploring the intricate relationship between human sweat and overall health. Our research paved a practical and feasible path for future studies in this domain.

Screen-Printed Textile-Based Electrochemical Biosensor for Noninvasive Monitoring of Glucose in Sweat

Wearable sweat biosensors for noninvasive monitoring of health parameters have attracted significant attention. Having these biosensors embedded in textile substrates can provide a convenient experience due to their soft and flexible nature that conforms to the skin, creating good contact for long-term use. These biosensors can be easily integrated with everyday clothing by using textile fabrication processes to enhance affordable and scalable manufacturing. Herein, a flexible electrochemical glucose sensor that can be screen-printed onto a textile substrate has been demonstrated. The screen-printed textile-based glucose biosensor achieved a linear response in the range of 20-1000 µM of glucose concentration and high sensitivity (18.41 µA mM^-1 cm^-2, R² = 0.996). In addition, the biosensors show high selectivity toward glucose among other interfering analytes and excellent stability over 30 days of storage. The developed textile-based biosensor can serve as a platform for monitoring bio analytes in sweat, and it is expected to impact the next generation of wearable devices.

Insight into continuous glucose monitoring: from medical basics to commercialized devices

According to the latest statistics, more than 537 million people around the world struggle with diabetes and its adverse consequences. As well as acute risks of hypo- or hyper- glycemia, long-term vascular complications may occur, including coronary heart disease or stroke, as well as diabetic nephropathy leading to end-stage disease, neuropathy or retinopathy. Therefore, there is an urgent need to improve diabetes management to reduce the risk of complications but also to improve patient's quality life. The impact of continuous glucose monitoring (CGM) is well recognized, in this regard. The current review aims at introducing the basic principles of glucose sensing, including electrochemical and optical detection, summarizing CGM technology, its requirements, advantages, and disadvantages. The role of CGM systems in the clinical diagnostics/personal testing, difficulties in their utilization, and recommendations are also discussed. In the end, challenges and prospects in future CGM systems are discussed and non-invasive, wearable glucose biosensors are introduced. Though the scope of this review is CGMs and provides information about medical issues and analytical principles, consideration of broader use will be critical in future if the right systems are to be selected for effective diabetes management.

Electrochemiluminescence (ECL) biosensor based on tris(2,2'-bipyridyl)ruthenium(II) with glucose and lactate dehydrogenases encapsulated within alginate hydrogels

Two dehydrogenase enzymes (glucose, GDH, and lactate, LDH, dehydrogenases) encapsulated within alginate hydrogels were deposited on glassy carbon electrodes. The as-prepared enzyme modified alginate hydrogels were utilized as electrochemiluminescence (ECL)-based biosensors for the indirect detection of glucose and lactic acid upon reaction between NADH and tris(2,2'-bipyridyl) ruthenium (II) [Ru(bpy)₃]²⁺. The ECL response was obtained from the redox reaction between the substrate, the cofactor NAD⁺ and the encapsulated enzyme. The production of NADH resulting from the enzymatic reaction led to the ECL emission upon reaction with [Ru(bpy)₃]²⁺. The biosensors showed good stability and repeatability, with linear range between 0.56 and 4.2 µM and limit of detection of 0.84 µM for glucose, and linear range between 5 and 30 µM with a limit of detection of 2.52 µM for lactic acid. These ECL-based biosensors showed good sensitivity when tested in the presence of common interfering species. These biosensors were utilized in artificial sweat and were characterized by good reproducibility and repeatability. The results herein presented suggest that the dehydrogenases encapsulated within alginate hydrogels have potential for the development of biocompatible sensors for detection of glucose and lactic acid in physiological fluids.

Microfluidic Electrochemical Glucose Biosensor with In Situ Enzyme Immobilization

The development and characterization of a microfluidic electrochemical glucose biosensor are presented herein. The transducer part is based on thin-film metal electrodes on a glass substrate. The biological recognition element of the biosensor is the pyrroloquinoline quinone-glucose dehydrogenase (PQQ-GdhB) enzyme, selectively in situ immobilized via microcontact printing of a mixed self-assembling monolayer (SAM) on a gold working electrode, while the microfluidic part of the device comprises microchannel and microfluidic connections formed in a polydimethylsiloxane (PDMS) elastomer. The electrode properties throughout all steps of biosensor construction and the biosensor response to glucose concentration and analyte flow rate were characterized by cyclic voltammetry and chronoamperometry. A measurement range of up to 10 mM in glucose concentration with a linear range up to 200 μM was determined. A detection limit of 30 µM in glucose concentration was obtained. Respective biosensor sensitivities of 0.79 nA/µM/mm² and 0.61 nA/µM/mm² were estimated with and without a flow at 20 µL/min. The developed approach of in situ enzyme immobilization can find a wide number of applications in the development of microfluidic biosensors, offering a path towards continuous and time-independent detection.

Conformational-switch biosensors as novel tools to support continuous, real-time molecular monitoring in lab-on-a-chip devices

Recent years have seen continued expansion of the functionality of lab on a chip (LOC) devices. Indeed LOCs now provide scientists and developers with useful and versatile platforms across a myriad of chemical and biological applications. The field still fails, however, to integrate an often important element of bench-top analytics: real-time molecular measurements that can be used to "guide" a chemical response. Here we describe the analytical techniques that could provide LOCs with such real-time molecular monitoring capabilities. It appears to us that, among the approaches that are general (i.e., that are independent of the reactive or optical properties of their targets), sensing strategies relying on binding-induced conformational change of bioreceptors are most likely to succeed in such applications.

Colorimetric Determination of Glucose in Sweat Using an Alginate-Based Biosystem

Glucose is an analyte of great importance, both in the clinical and sports fields. Since blood is the gold standard biofluid used for the analytical determination of glucose, there is high interest in finding alternative non-invasive biofluids, such as sweat, for its determination. In this research, we present an alginate-based bead-like biosystem integrated with an enzymatic assay for the determination of glucose in sweat. The system was calibrated and verified in artificial sweat, and a linear calibration range was obtained for glucose of 10-1000 µM. The colorimetric determination was investigated, and the analysis was carried out both in the black and white and in the Red:Green:Blue color code. A limit of detection and quantification of 3.8 µM and 12.7 µM, respectively, were obtained for glucose determination. The biosystem was also applied with real sweat, using a prototype of a microfluidic device platform as a proof of concept. This research demonstrated the potential of alginate hydrogels as scaffolds for the fabrication of biosystems and their possible integration in microfluidic devices. These results are intended to bring awareness of sweat as a complementary tool for standard analytical diagnosis.

A Highly Sensitive Non-Enzymatic Sensor for the Determination of Glucose Based on Aniline-2-sulfonic acid-Modified Cu Electrode

Herein, the copper-based electrodes were successfully synthesized with galvanostatic electrodeposition method. The effect of materials obtained at different concentrations of ASA and anodization times on glucose sensing ability was investigated. During the anodization of copper foil in the presence of ASA molecules, it formed a tree branch-like structure connected to each other while decorating the electrode surface. The Cu(30)/ASA(0.02) electrode exhibited a relatively wide linear range (0.2 – 10.0 mM) and a low detection limit (0.826 µM). These excellent activities were mainly attributed to the surface morphology, which functions as highly active sites and enhanced electronic conductive pathways with the addition of ASA. In addition, the stability obtained together with the excellent sensing ability in beverages makes the electrodes useful for practical applications.

Epidermal Wearable Biosensors for Monitoring Biomarkers of Chronic Disease in Sweat

Biological information detection technology is mainly used for the detection of physiological and biochemical parameters closely related to human tissues and organ lesions, such as biomarkers. This technology has important value in the clinical diagnosis and treatment of chronic diseases in their early stages. Wearable biosensors can be integrated with the Internet of Things and Big Data to realize the detection, transmission, storage, and comprehensive analysis of human physiological and biochemical information. This technology has extremely wide applications and considerable market prospects in frontier fields including personal health monitoring, chronic disease diagnosis and management, and home medical care. In this review, we systematically summarized the sweat biomarkers, introduced the sweat extraction and collection methods, and discussed the application and development of epidermal wearable biosensors for monitoring biomarkers in sweat in preclinical research in recent years. In addition, the current challenges and development prospects in this field were discussed.

A Noninvasive Sweat Glucose Biosensor Based on Glucose Oxidase/Multiwalled Carbon Nanotubes/Ferrocene-Polyaniline Film/Cu Electrodes

Diabetes remains a great threat to human beings' health and its world prevalence is projected to reach 9.9% by 2045. At present, the detection methods used are often invasive, cumbersome and time-consuming, thus increasing the burden on patients. In this paper, we propose a novel noninvasive and low-cost biosensor capable of detecting glucose in human sweat using enzyme-based electrodes for point-of-care uses. Specifically, an electrochemical method is applied for detection and the electrodes are covered with multilayered films including ferrocene-polyaniline (F-P), multi-walled carbon nanotubes (MWCNTs) and glucose oxidase (GOx) on Cu substrates (GOx/MWCNTs/F-P/Cu). The coated layers enhance the immobilization of GOx, increase the conductivity of the anode and improve the electrochemical properties of the electrode. Compared with the Cu electrode and the F-P/Cu electrode, a maximum peak current is obtained when the MWCNTs/F-P/Cu electrode is applied. We also study its current response by cyclic voltammetry (CV) at different concentrations (0-2.0 mM) of glucose solution. The best current response is obtained at 0.25 V using chronoamperometry. The effective working lifetime of an electrode is up to 8 days. Finally, to demonstrate the capability of the electrode, a portable, miniaturized and integrated detection device based on the GOx/MWCNTs/F-P/Cu electrode is developed. The results exhibit a short response time of 5 s and a correlation coefficient R² of 0.9847 between the response current of sweat with blood glucose concentration. The LOD is of 0.081 mM and the reproducibility achieved in terms of RSD is 3.55%. The sweat glucose sensor is noninvasive and point-of-care, which shows great development potential in the health examination and monitoring field.

Advances in layered double hydroxide based labels for signal amplification in ultrasensitive electrochemical and optical affinity biosensors of glucose

Since the development of enzyme electrodes, the research area of glucose biosensing has seen outstanding progress and improvement. Numerous sensing platforms have been developed based on different immobilization techniques and improved electron transfer between the enzyme and electrode. Interestingly, these platforms have consistently used innovative nanostructures and nanocomposites. In recent years, layered double hydroxides (LDHs) have become key tools in the field of analytical chemistry owing to their outstanding features and benefits, such as facile synthesis, cost-effectiveness, substantial surface area, excellent catalytic performance, and biocompatibility. LDHs are often synthesized as nanomaterial composites or manufactured with specific three-dimensional structures. The purpose of this review is to illustrate the biosensing prospects of LDH-based glucose sensors and the need for improvement. First, various clinical and conventional approaches for glucose determination are discussed. The definitions, types, and various synthetic methodologies of LDHs are then explained. Subsequently, we discuss the various research studies regarding LDH-based electrochemical and optical assays, focusing on modified systems, improved electron transfers pathways (through developments in surface science), and different sensing designs based on nanomaterials. Finally, a summary of the current limitations and future challenges in glucose analysis is described, which may facilitate further development and applications.

Wearable Healthcare Monitoring Based on a Microfluidic Electrochemical Integrated Device for Sensing Glucose in Natural Sweat

Wearable sweat sensors offer the possibility of continuous real-time health monitoring of an individual at a low cost without invasion. A variety of sweat glucose sensors have been developed thus far to help diabetes patients frequently monitor blood glucose levels through sweat glucose as a surrogate marker. The present study demonstrates the development and characterization of a three-dimensional paper-based microfluidic electrochemical integrated device (3D PMED) for measuring glucose concentration in sweat in real-time via simple, non-invasive, capillary-action-based sample collection. The device was selective for glucose, and it detected glucose accurately in the clinically relevant range (0~2 mM) in an off-body setup. To the best of our knowledge, this is the first time NEXAR™ has been used for biosensing applications. Further, the developed glucose sensor has acceptable sensitivity of 16.8 µA/mM/cm2. Importantly, in an on-body setup, the device achieved a significant amperometric response to sweat glucose in a very short amount of time (a few seconds). With detailed investigations, this proof-of-concept study could help further the development of sensitive and selective sweat-based glucose sensing devices for real-time glucose monitoring in diabetes patients.

Role of Nanomaterials in the Fabrication of bioNEMS/MEMS for Biomedical Applications and towards Pioneering Food Waste Utilisation

bioNEMS/MEMS has emerged as an innovative technology for the miniaturisation of biomedical devices with high precision and rapid processing since its first R&D breakthrough in the 1980s. To date, several organic including food waste derived nanomaterials and inorganic nanomaterials (e.g., carbon nanotubes, graphene, silica, gold, and magnetic nanoparticles) have steered the development of high-throughput and sensitive bioNEMS/MEMS-based biosensors, actuator systems, drug delivery systems and implantable/wearable sensors with desirable biomedical properties. Turning food waste into valuable nanomaterials is potential groundbreaking research in this growing field of bioMEMS/NEMS. This review aspires to communicate recent progress in organic and inorganic nanomaterials based bioNEMS/MEMS for biomedical applications, comprehensively discussing nanomaterials criteria and their prospects as ideal tools for biomedical devices. We discuss clinical applications for diagnostic, monitoring, and therapeutic applications as well as the technological potential for cell manipulation (i.e., sorting, separation, and patterning technology). In addition, current in vitro and in vivo assessments of promising nanomaterials-based biomedical devices will be discussed in this review. Finally, this review also looked at the most recent state-of-the-art knowledge on Internet of Things (IoT) applications such as nanosensors, nanoantennas, nanoprocessors, and nanobattery.

Straw-sheaf-like Co3O4 for preparation of an electrochemical non-enzymatic glucose sensor

3D straw-sheaf-like cobalt oxide (SS-Co₃O₄) was prepared via the hydrothermal method and inert gas calcination of precursors without the assistance of any template or surfactant. It was composed of numerous nanoneedles with a length of ~ 8 µm and a diameter of ~ 30 nm strongly tied in the center. The SS-Co₃O₄ exhibited high crystallinity, a large surface area (39.01 m².g^-1), a smaller pore size (6 nm), and lower charge transfer resistance (R_ct = 9.35 Ω) at the electrode/electrolyte interface. A non-enzymatic glucose oxidizing electrode fabricated with SS-Co₃O₄ showed a high sensitivity (669 µA.mM^-1.cm^-2), wide linear range (0.04-4.85 mM), low limit of detection (0.31 µM), good selectivity, fast response time (5 s), and high reproducibility with a relative standard deviation of 2.25%. In addition, its robust structure demonstrated excellent electrochemical stability by retaining 83.8% of the initial sensitivity when its current density vs. time response was measured for 75 min in bare electrolytes prior to the glucose-sensing test. Furthermore, it demonstrated excellent repeatability performance by retaining 87.0% of the initial sensitivity when a single electrode was tested for 4 cycles. The proposed robust structured 3D SS-Co₃O₄ electrode successfully responds to the content of glucose in human saliva, which substantially proves its suitability in practical application. The synthesis technique is advantageous to prepare other metal oxides with interesting morphology and robust structure for the development of more reliable non-enzymatic glucometers and other electrochemical devices.

A Framework for Biosensors Assisted by Multiphoton Effects and Machine Learning

The ability to interpret information through automatic sensors is one of the most important pillars of modern technology. In particular, the potential of biosensors has been used to evaluate biological information of living organisms, and to detect danger or predict urgent situations in a battlefield, as in the invasion of SARS-CoV-2 in this era. This work is devoted to describing a panoramic overview of optical biosensors that can be improved by the assistance of nonlinear optics and machine learning methods. Optical biosensors have demonstrated their effectiveness in detecting a diverse range of viruses. Specifically, the SARS-CoV-2 virus has generated disturbance all over the world, and biosensors have emerged as a key for providing an analysis based on physical and chemical phenomena. In this perspective, we highlight how multiphoton interactions can be responsible for an enhancement in sensibility exhibited by biosensors. The nonlinear optical effects open up a series of options to expand the applications of optical biosensors. Nonlinearities together with computer tools are suitable for the identification of complex low-dimensional agents. Machine learning methods can approximate functions to reveal patterns in the detection of dynamic objects in the human body and determine viruses, harmful entities, or strange kinetics in cells.

Microfluidic wearable electrochemical sweat sensors for health monitoring

Research on remote health monitoring through wearable sensors has attained popularity in recent decades mainly due to aging population and expensive health care services. Microfluidic wearable sweat sensors provide economical, non-invasive mode of sample collection, important physiological information, and continuous tracking of human health. Recent advances in wearable sensors focus on electrochemical monitoring of biomarkers in sweat and can be applicable in various fields like fitness monitoring, nutrition, and medical diagnosis. This review focuses on the evolution of wearable devices from benchtop electrochemical systems to microfluidic-based wearable sensors. Major classification of wearable sensors like skin contact-based and biofluidic-based sensors are discussed. Furthermore, sweat chemistry and related biomarkers are explained in addition to integration of microfluidic systems in wearable sweat sensors. At last, recent advances in wearable electrochemical sweat sensors are discussed, which includes tattoo-based, paper microfluidics, patches, wrist band, and belt-based wearable sensors.

Adaptation and Psychometric Evidence of the ARABIC Version of the Diabetes Self-Management Questionnaire (A-DSMQ)

(1) Background: Diabetic patients must engage in self-care practices in order to maintain optimal glycemic control, hence reducing the likelihood of developing complications, and enhance the overall quality of their lives. The Diabetes Self-care Management Questionnaire (DSMQ) is a tool for assessing self-management habits that may be used to predict glycemic control in people with diabetes. However, no Arabic language version of the instrument has been found. Therefore, we adapted an Arabic language version of the instrument in Tunisia. The purpose of the current research aimed to assess the psychometric features of the Tunisian version of the DSMQ in patients with type 2 diabetes. (2) Method: Two samples including both genders, one exploratory (n = 208, mean age 53.2 ± 8.3) and one confirmatory (n = 441, mean age 53.4 ± 7.4), completed an adapted Arabic language version of the DSMQ, a sociodemographic questionnaire and information about their HbA1C levels. (3) Results: The exploratory factor analysis revealed that the 15 items of the A-DSMQ fit well with the data. Likewise, the alpha coefficients for the A-DSMQ factors were above 0.80: for "Glucose Management" (GM), "Dietary Control" (DC), "Physical Activity" (PA), and "Heath-Care Use" (HU). The fit indices for the CFA were good, and the four-factor solution was confirmed. The Average Variance Extracted values and Fornell-Larcker criterion established the convergent and discriminant validity, respectively. The concurrent validity of the tool was established through the statistically significant negative relationships between the A-DSMQ factors and HbA1C, in addition to its positive association with the practice of physical activity measured by the IPAQ. (4) Conclusions: Given the high EFA factor loadings, the CFA fit indices, the correlation matrix, the sensitivity analysis, the convergent validity, and the excellent internal consistency of the A-DSMQ, it can be concluded that the A-DSMQ is an effective psychometric tool for diabetes self-management in Tunisia.

Low-Denaturazing Glucose Oxidase Immobilization onto Graphite Electrodes by Incubation in Chitosan Solutions

In this work, glucose oxidase (GOx) has been immobilized onto graphite rod electrodes through an assisted-chitosan adsorption reaching an enzyme coverage of 4 nmol/cm2. The direct and irreversible single adsorption of the Flavine Adenine Dinucleotide (FAD) cofactor has been minimized by electrode incubation in a chitosan (CH) solution containing the enzyme GOx. Chitosan keeps the enzyme structure and conformation due to electrostatic interactions preventing FAD dissociation from the protein envelope. Using chitosan, both the redox cofactor FAD and the protein envelope remain in the active form as demonstrated by the electrochemistry studies and the enzymatic activity in the electrochemical oxidation of glucose up to a concentration of 20 mM. The application of the modified electrodes for energy harvesting delivered a power density of 119 µW/cm2 with a cell voltage of 0.3 V. Thus, chitosan presents a stabilizing effect for the enzyme conformation promoted by the confinement effect in the chitosan solution by electrostatic interactions. Additionally, it facilitated the electron transfer from the enzyme to the electrode due to the presence of embedded chitosan in the enzyme structure acting as an electrical wiring between the electrode and the enzyme (electron transfer rate constant 2.2 s−1). This method involves advantages compared with previously reported chitosan immobilization methods, not only due to good stability of the enzyme, but also to the simplicity of the procedure that can be carried out even for not qualified technicians which enable their easy implementation in industry.