A new wearable wristband could significantly improve diabetes management by continuously tracking not only glucose but also other chemical and cardiovascular signals that influence disease progression and overall health. The technology was published in Nature Biomedical Engineering.

The flexible wristband consists of a microneedle array that painlessly samples interstitial fluid under the skin to measure glucose, lactate and alcohol in real time using three different enzymes embedded within the tiny needles. Designed for easy replacement, the microneedle array can be swapped out to tailor wear periods. This reduces the risk of allergic reactions or infection while supporting longer-term use.

Simultaneously, the wristband uses an ultrasonic sensor array to measure blood pressure and arterial stiffness, while ECG sensors measure heart rate directly from wrist pulses. These physiological signals are key indicators of cardiovascular risk, which is often elevated in people with diabetes but is rarely monitored continuously outside of a clinical setting.

The last two decades have witnessed a dramatic growth of wearable sensor technology, mainly represented by flexible, stretchable, on-skin electronic sensors that provide rich information of the wearer’s health conditions and surroundings. A recent breakthrough in the field is the development of wearable chemical sensors based on surface-enhanced Raman spectroscopy (SERS) that can detect molecular fingerprints universally, sensitively, and noninvasively. However, while their sensing properties are excellent, these sensors are not scalable for widespread use beyond small-scale human health monitoring due to their cumbersome fabrication process and limited multifunctional sensing capabilities. Here, a highly scalable, wearable SERS sensor is demonstrated based on an easy-to-fabricate, low-cost, ultrathin, flexible, stretchable, adhesive, and biointegratable gold nanomesh. It can be fabricated in any shape and worn on virtually any surface for label-free, large-scale, in situ sensing of diverse analytes from low to high concentrations (10–10⁶ × 10⁻⁹ m). To show the practical utility of the wearable SERS sensor, the sensor is tested for the detection of sweat biomarkers, drugs of abuse, and microplastics. This wearable SERS sensor represents a significant step toward the generalizability and practicality of wearable sensing technology.