Diabetes, which affects over 450 million people worldwide, requires continuous and accurate glucose monitoring to prevent serious health issues. Traditional methods, like frequent finger pricking, are uncomfortable and often lead to poor adherence to monitoring regimens. While current continuous glucose monitoring (CGM) systems alleviate some of these issues, they still face challenges such as high costs, limited sensor lifespan, and potential tissue irritation due to the invasiveness of electrode insertion. Now, a new CGM system has been developed to overcome these limitations by combining an insertable glucose biosensor with a phosphorescence lifetime imager (PLI) and sophisticated machine learning algorithms, providing a more reliable and economical option for real-time glucose monitoring.

A collaborative research effort involving the University of California, Los Angeles (UCLA, Los Angeles, CA, USA) has led to the development of a new CGM system that uses a biocompatible phosphorescence-based biosensor implanted subcutaneously. Unlike traditional CGMs that depend on electrochemical reactions, this new system measures glucose levels by detecting changes in the phosphorescence signals emitted from the biosensor. These signals, which have a significantly longer lifetime than tissue autofluorescence, are captured non-invasively through the skin by the compact PLI. A major advancement of this system is its ability to maintain accuracy despite sensor misalignment, a common issue with wearable devices. The PLI's neural network model analyzes phosphorescence lifetime images not only to determine glucose levels but also to identify misalignments, alerting users to adjust the device if necessary. This ensures accurate and reliable glucose readings even during physical activities or movements that could displace the sensor.

In the research published in ACS Nano, in vitro testing showed the PLI accurately classified glucose levels in normal, low, and high ranges with 88.8% accuracy and detected misalignments with 100% accuracy. This demonstrates that the system could greatly enhance glucose monitoring quality, potentially reducing the frequency of recalibrations and offering a smoother user experience. Cost-effectiveness is another key feature of the new CGM system. The smaller, more durable biosensor has a stable phosphorescence response for up to 12 weeks and maintains enzyme activity for over four weeks, significantly extending its lifespan and reducing the need for frequent replacements, a major cost factor in existing CGM systems. Additionally, the PLI’s compact and affordable design enhances its appeal for widespread use.

The broader potential applications for the PLI system include multiplexed sensing, allowing for simultaneous monitoring of multiple biomarkers. This could vastly expand the capabilities of wearable diagnostics, positioning the system as a versatile tool for real-time health monitoring across various conditions. This breakthrough in CGM technology represents a major advancement in diabetes management, combining advanced technology with patient-focused design to improve comfort, reduce costs, and ultimately enhance the quality of life for millions globally. 

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