Integration of chemical and physical inputs for monitoring metabolites and cardiac signals in diabetes

The development of closed-loop systems towards effective management of diabetes requires the inclusion of additional chemical and physical inputs that affect disease pathophysiology and reflect cardiovascular risks in patients. Comprehensive glycaemic control information should account for more than a single glucose signal. Here, we describe a hybrid flexible wristband sensing platform that integrates a microneedle array for multiplexed biomarker sensing and an ultrasonic array for blood pressure, arterial stiffness and heart-rate monitoring. The integrated system provides a continuous evaluation of the metabolic and cardiovascular status towards improving glycaemic control and alerting patients to cardiovascular risks. The multimodal platform offers continuous glucose, lactate and alcohol monitoring, along with simultaneous ultrasonic measurements of blood pressure, arterial stiffness and heart rate, to support understanding of the interplay between interstitial fluid biomarkers and physiological parameters during common activities. By expanding the continuous monitoring of patients with diabetes to additional biomarkers and key cardiac signals, our integrated multiplexed chemical–physical health-monitoring platform holds promise for addressing the limitations of existing single-modality glucose-monitoring systems towards enhanced management of diabetes and related cardiovascular risks.