Next-generation nanobiosensors enable dynamic, real-time glucose monitoring for precision diabetes therapy

Abstract Diabetes mellitus is a rapidly growing global health challenge characterized by chronic hyperglycemia resulting from impaired insulin secretion, insulin action, or both. Achieving optimal glycemic control requires continuous, accurate, and real-time glucose monitoring to minimize acute and long-term complications. Conventional glucose monitoring technologies, particularly enzyme-based electrochemical biosensors, have significantly improved diabetes management; however, their widespread clinical application remains limited by enzyme instability, oxygen dependence, biofouling, limited long-term stability, frequent calibration requirements, and restricted performance in complex physiological environments. These limitations have accelerated the development of next-generation nanobiosensors that integrate advanced nanomaterials, including gold nanoparticles, carbon nanotubes, graphene, MXenes, and metal oxides, to enhance sensitivity, selectivity, electron-transfer efficiency, biocompatibility, and operational stability. Furthermore, wearable and minimally invasive biosensing platforms capable of monitoring glucose in sweat, saliva, tears, and interstitial fluid have emerged as promising alternatives, improving patient compliance while supporting continuous glucose monitoring. Recent advances in wireless communication, artificial intelligence, machine learning, and Internet of Things-enabled healthcare have furthered personalised diabetes management through predictive analytics and closed-loop insulin delivery systems. Despite these advances, important challenges remain, including large-scale manufacturing, clinical validation, regulatory approval, standardisation, long-term reliability, and cost-effective commercialization. This review critically summarises recent developments in nanomaterial-enabled glucose biosensors, compares emerging sensing platforms and their analytical performance, discusses current challenges, and highlights future translational opportunities for developing clinically applicable, patient-friendly, and precision medicine-oriented glucose monitoring technologies.