A flexible wristband that simultaneously monitors blood sugar, cardiovascular signals and alcohol levels can change diabetes management by providing comprehensive health data for single glucose monitoring.
The device is developed at San Diego, using painless microneedles to continuously measure glucose, lactic acid and alcohol in the fluid beneath the skin, while an ultrasound sensor tracks blood pressure and arterial stiffness in real time. In tests with healthy participants and those with prediabetes, wristbands matched commercial devices with a precision rate of more than 96%, while revealing a previously hidden link between daily activities and health.
Beyond blood sugar monitoring
“Total management of diabetes requires more than a single glucose reading,” explains An-Yi Chang, a postdoctoral researcher who co-led the development. Diet, exercise, stress, and alcohol all affect blood sugar and heart health in complex ways that traditional monitors cannot capture.
The wristband addresses a key gap: While diabetes significantly increases the risk of cardiovascular disease, current continuous glucose monitors provide no information on heart health. People with diabetes face twice the risk of heart disease, but they rarely conduct continuous cardiovascular monitoring outside the clinical setting.
How technology works
The system integrates multiple sensing technologies on a single flexible platform:
- Microneedle array (800 microns long) penetrates the skin surface to sample interstitial fluid
- Three different enzymes embedded in the needle react with glucose, lactic acid and alcohol
- Ultrasound sensors measure blood pressure by tracking changes in arterial diameter
- Electrocardiogram sensor detects heart rate of wrist pulse
- All sensors transmit data wirelessly to smartphones or computers
The microneedle array can be easily replaced, allowing users to customize wear and minimize skin irritation, a common problem with long-term sensor use.
Real-world performance
During the testing process, the wristband revealed how different activities affect multiple health markers at the same time. When participants consumed sugary beverages, glucose levels rose as expected, but the device also captured increased blood pressure (from 110/62 to 129/78 mmHg) and heart rate (from 58 bpm to 71 bpm).
There was a greater difference between healthy participants and those with prediabetes. After a meal, patients before diabetes not only showed higher glucose spikes, but also showed elevated lactic acid levels, which took 60 minutes to return to baseline, while healthy individuals were associated with 30 minutes. Throughout their daily activities, their blood pressure remains approximately 10 mmHg.
Arterial stiffness: Hidden metrics
A unique feature not found in other wearable devices is the measurement of arterial stiffness through the enhancement index (AIX). This measure is calculated from the blood pressure waveform, indicating vascular health and cardiovascular risk.
The researchers found that fasting improved arterial elasticity (AIX decreased from 0.26 to 0.37), which may reduce cardiovascular risk. Exercise also temporarily reduces arterial stiffness, and its effects vary according to fitness level. These insights can help diabetics understand how lifestyle choices affect their vascular health in real time.
Alcohol monitoring reveals individual changes
The response of alcohol sensors to alcohol consumption showed significant individual differences. After a glass of wine, the non-drinker showed significant cardiovascular changes – fresh pressure increased from 78 to 109 mmHg and heart rate increased from 62 bpm to 70 bpm. The same number has little effect on vital signs of the average drinker.
This personalized response data is critical for diabetics who are at higher risk of hypertension even when drinking moderately.
What is the future
The team envisions expanding the platform to monitor other markers such as insulin and cortisol, while combining machine learning to predict health events. Solar or sweat-powered versions can eliminate battery problems.
For 537 million people with diabetes worldwide, this technology represents a shift from reactive health management. By revealing the hidden connection between daily choice and physiological responses, wristbands can achieve more personalized and effective diabetes care.
The study appeared in Natural Biomedical Engineering.
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