Acetone Gas Sensors for Noninvasive Diabetes Diagnosis: A Comprehensive Review

The development of sensors for monitoring breath acetone, a key biomarker for ketosis in diabetes mellitus, represents a critical frontier in medical diagnostics, promising a painless alternative to invasive blood tests. This review provides a comprehensive and critical evaluation of the state-of-the-art in acetone gas sensing technologies, including chemiresistive, optical, electrochemical, conductometric, and microwave platforms. We focus specifically on recent breakthroughs driven by advanced materials, analyzing how novel nanostructures from two-dimensional (2D) materials such as MXenes to porous metal-organic frameworks (MOFs) are engineered to push performance to clinically relevant parts-per-billion (ppb) sensitivity. Despite these advances, we identify the persistent, multifaceted challenges that impede widespread adoption: the technical trade-offs between sensitivity and stability, the physiological complexities of the biomarker itself, and the significant gap between laboratory performance and real-world clinical validation. Looking forward, we outline the essential research trajectories required to bridge this bench-to-bedside gap, emphasizing the development of intelligent sensor arrays, the application of machine learning (ML) for interference compensation, and the urgent need for standardized protocols to enable the large-scale clinical trials that are currently lacking. By synthesizing performance data with critical analysis of underlying challenges, this review provides a comprehensive roadmap for materials scientists, engineers, and clinicians working to realize the potential of non-invasive diabetes monitoring.