Abstract
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.
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Data availability
The manuscript includes all the data collected and analysed in the study, and more information is included in the Supplementary Information.
Code availability
The code for decoding the transducer data to blood pressure waveforms is available via GitHub at https://github.com/MuyangLin95/Processing-scripts-for-monitoring-metabolites-and-cardiac-signals-in-diabetes.git (ref. 63).
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Acknowledgements
This research is supported by the UCSD Center for Wearable Sensors (CWS). M.R. received support from the UC-MEXUS-CONAHCYT Doctoral Fellowship. We thank S. Suresh for assistance.
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A.-Y.C., M.L., L.Y., M.R., S.X. and J.W. conceived and designed the research. A.-Y.C., M.L., L.Y. and M.R. conducted the experiments. A.-Y.C., M.L., L.Y., M.R., S.D., R.L., Y.D., A.C., G.P., Z.L., H.L. and N.A. performed the experiments. A.-Y.C., M.L., L.Y. and M.R. analysed the data. A.-Y.C., M.L., L.Y., M.R., S.X. and J.W. wrote the manuscript with valuable feedback and assistance from other co-authors.
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Nature Biomedical Engineering thanks Chi Hwan Lee and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.
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Supplementary Information
Supplementary Discussions 1–10, reference, Figs. 1–32, Tables 1 and 2, and Videos 1–6.
Supplementary Video 1
The BLUE wristband platform was worn on the participants wrist during jumping rope.
Supplementary Video 2
The BLUE wristband platform was worn on the participants wrist while dribbling the basketball.
Supplementary Video 3
The BLUE wristband platform was worn on the participant’s wrist while doing push-ups.
Supplementary Video 4
The BLUE wristband platform on the participant’s wrist was worn in an inverted direction to enhance the microneedle array’s visibility and demonstrate finger contact with the ECG system.
Supplementary Video 5
Demonstrating the installation and disposal of the microneedle array: the microneedle array is assembled and disassembled to the wristband.
Supplementary Video 6
Skin penetration stimulation of the microneedle system.
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Chang, AY., Lin, M., Yin, L. et al. Integration of chemical and physical inputs for monitoring metabolites and cardiac signals in diabetes. Nat. Biomed. Eng (2025). https://doi.org/10.1038/s41551-025-01439-z
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DOI: https://doi.org/10.1038/s41551-025-01439-z
