Diabetes, a chronic disease affecting over half a billion people globally, causes dangerously high blood sugar levels and is notoriously difficult to manage. In the U.S. alone, nearly 40 million people live with the condition, and many more remain undiagnosed. The disease often requires continuous monitoring and personalized treatment, yet current methods are invasive, painful, and cannot adjust as a patient’s physiology changes. Most treatments follow a one-size-fits-all approach, which overlooks individual differences in drug absorption, metabolism, and response—posing risks such as hypoglycemia and drug side effects. One of the key challenges has been the inability to continuously and non-invasively monitor both glucose and medication levels in real time. Now, researchers have developed a wearable system that tracks disease and drug markers non-invasively and provides personalized treatment recommendations.

The wearable platform, created through a collaboration by researchers from the Technion-Israel Institute of Technology (Haifa, Israel) and Sun Yat-sen University (Guangzhou, China), uses 3D-printed microneedles combined with nano-enzyme-based sensors, smartphone connectivity, and a dedicated app. These microneedles painlessly penetrate the upper layer of the skin and monitor biomarkers found in the interstitial fluid—specifically glucose and the diabetes drug metformin. The system operates in a closed loop, transmitting signals via Bluetooth to a smartphone app that performs real-time pharmacokinetic and pharmacodynamic analyses. The app then generates individualized drug profiles, recommends dosage adjustments, and provides immediate alerts to patients or caregivers in response to significant changes in biomarkers. This dynamic system enables tailored treatment that adapts to the user’s physiology throughout the day.

In a validation study published in Nature Communications, the researchers demonstrated the system’s reliability in both laboratory (in vitro) and animal (in vivo) settings. In trials with diabetic mice, the wearable system’s readings correlated strongly with conventional tests such as glucose meters and ELISA, and it even detected fluctuations that existing systems failed to identify. The platform also enabled researchers to construct personalized pharmacokinetic models, illustrating how the same drug dose impacted individuals differently based on factors like age, weight, and metabolism. This breakthrough supports safer and more effective diabetes care, particularly by preventing complications such as lactic acidosis. Looking ahead, the researchers plan to expand the system’s capabilities to monitor other chronic conditions such as heart disease and epilepsy by modifying the sensor chemistry.

“Through continuous monitoring of both the disease state and the treatment agent, the system allows unprecedented real-time control of treatment,” said Prof. Hossam Haick, lead developer of the wearable system. “It opens new avenues not only for diabetes but also for any chronic disease that depends on a narrow therapeutic window. The compact and user-friendly system is therefore suitable for personalized, real-time disease management. This innovation aligns with the vision of smart medicine that combines wearable biological sensors, artificial intelligence, and pharmacology.’

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