CGMs That Measure Alternative Biofluids Show Potential in Diabetes Care

Biosensor technology offers promising improvements in both the enhancement of quality of life in patients with diabetes and the capabilities of glucose monitoring devices, write authors of research published in Talanta. They explained that, although blood-based measurements remain the “gold standard,” the investigation of alternative biofluids holds potential for future continuous glucose monitoring (CGM) methods.¹

According to Cleveland Clinic, CGM devices help patients with diabetes manage their condition with fewer fingerstick checks. The device measures glucose levels in the interstitial fluid—the fluid in the spaces around a patient’s cells—for 24 hours a day, and its transmitter sends results to a smartphone or wearable device, allowing patients to track any changes in glucose level in real time. All CGMs have 3 basic components: a sensor that measures real-time glucose levels in the interstitial fluid; a transmitter that wirelessly sends glucose data to another device; and a smartphone app, receiver, or insulin pump that displays both real-time and previous glucose levels.²

The Talanta review discussed novel advancements in glucose biosensors, particularly wearable, real-time, and noninvasive sensors. The investigators emphasized that new biosensing platforms, such as enzyme electrochemical sensors, microneedles, and flexible electronics, have allowed for other biofluids (eg, interstitial fluid, saliva, sweat, and tears) to be used to continuously monitor glucose levels. These biosensors, according to the authors, are more comfortable, simple to access, and provide continuous feedback.¹

However, the investigators explained that problems of biofouling, calibration difficulty, sensor lifespan, and interference by molecules other than the target are debated, as well as possible solutions including antifouling coating, nanozymes, and calibration built into the system. Multianalyte sensing, for example, which determines glucose, insulin, lactate, ketones, cortisol, and catecholamines together, is presented as a new way of addressing diabetes in an integrated fashion. The integration of such biosensors with wireless, smartphone-based platforms is a step towards personalized health care.¹

“In the last decade, artificial intelligence (AI) has surfaced as a revolutionary technology to improve the performance, dependability, and customizability of CGM biosensors,” the authors added. “AI technologies are being used more and more within diabetes care platforms to enable immediate decision support, pattern detection, and predictive insights, hence improving the management of the disease.”¹

In order to make such next-generation biosensors more cost-effective, accurate, and accessible, and to enhance the clinical outcome and quality of life for patients with diabetes, research and technical advancement in an interdisciplinary fashion must be conducted.¹

“Biosensor technology reflects promising strides toward enhancing both the quality of life for diabetic patients and the functional capabilities of glucose monitoring devices. While blood-based glucose measurement remains the clinical gold standard, the exploration of alternative biofluids—such as saliva, tears, sweat, and interstitial fluid—for noninvasive and continuous glucose monitoring holds significant potential for the future,” the authors concluded.¹

As the next-generation glucose biosensors evolve toward more personalized, real-time care, the pharmacist’s role is crucial. As frontline medication and chronic disease experts, pharmacists can help patients understand how wearable, noninvasive sensors work, interpret their data, and integrate device feedback into daily self-management. They are also well-positioned to identify potential issues related to calibration, device interference, or sensor lifespan and to guide patients in troubleshooting or seeking appropriate follow-up.

Additionally, with the growing integration of AI into biosensor platforms, pharmacists can help patients navigate AI-driven insights and ensure that technology is used safely, accurately, and in alignment with evidence-based diabetes management. Pharmacists can advocate for equitable access, assist in selecting appropriate devices based on a patient’s clinical needs, educate on multianalyte monitoring, and collaborate with other health care workers or specialists to optimize care plans. As biosensors continue to advance, pharmacists remain essential in bridging innovative technology with practical, patient-centered diabetes management.

REFERENCES

1. Singh R, Nema P, Purohit A, et al. Advancements in glucose biosensors: Innovations for wearable and real-time monitoring. Talanta. 2026;299:129045. doi:10.1016/j.talanta.2025.129045

2. Cleveland Clinic. Continuous Glucose Monitoring (CGM). Accessed December 4, 2025. https://my.clevelandclinic.org/health/articles/continuous-glucose-monitoring-cgm