Wearable textile sensors for continuous glucose monitoring

Diabetes and cardiovascular disease are interlinked chronic conditions that necessitate continuous and precise monitoring of physiological and environmental parameters to prevent complications. Non-invasive monitoring technologies have garnered significant interest due to their potential to alleviate the current burden of diabetes and cardiovascular disease management. However, these technologies face limitations in accuracy and reliability due to interferences from physiological and environmental factors. This review investigates electronic textiles (e-textiles) that integrate biomedical sensors into wearable fabrics that can enable a multimodal platform for non-invasive continuous glucose monitoring (CGM). Current advancements in e-textiles show the potential of four key methods for glucose monitoring: optical, biochemical, biomechanical, and thermal sensing techniques. Biochemical sensing through sweat-based glucose detection has demonstrated potential for accurate and non-invasive monitoring but still faces numerous challenges. While optical, biomechanical and thermal sensing are less explored in e-textiles, they offer additional physiological and environmental insights that can improve the precision of glucose readings by providing cross-validation of data. This review proposes that integrating multiple sensing modalities into a single multimodal e-textile wearable can address the accuracy and reliability challenges by providing cross-validation of data. The development of such multimodal e-textiles has the potential to revolutionise diabetes and cardiovascular disease management by providing continuous, accurate, and holistic monitoring in real-time, which could significantly improve patient outcomes and quality of life. Further research and development are crucial to fully realise the potential of these integrated systems in clinical and everyday settings.