Intelligent microneedle patches as an integrated therapeutic strategy for diabetes: enabling closed-loop glucose...

Diabetes mellitus and its severe complications, notably diabetic foot ulcers (DFUs), pose a significant global healthcare burden. Conventional therapies, such as subcutaneous insulin injections and traditional wound dressings, often face limitations due to poor patient compliance, procedural discomfort, pain, and insufficient efficacy in modulating the pathological diabetic microenvironment. Recently, intelligent microneedle (MN) patches have emerged as a transformative, minimally invasive platform to address these challenges. This review highlights intelligent MN patches as an integrated therapeutic interface for diabetes care, with particular emphasis on their potential to enable closed-loop glucose regulation and whole-course diabetic wound management. We first provide an overview of the current applications and design principles of intelligent microneedles (MNs) in diabetes management, highlighting the technological foundations that support their therapeutic functions. More importantly, we propose that the future of microneedle-based diabetes therapy should move beyond isolated sensing or drug delivery toward coordinated closed-loop systems. For systemic glycemic control, MNs may integrate interstitial fluid glucose sensing, abnormal glucose recognition, algorithm-assisted decision-making, and on-demand insulin or glucagon delivery into a "detect-decide-deliver-monitor" loop. For diabetic chronic wounds, this concept can be further extended into a "monitor-respond-remodel-repair" framework, in which pathological changes in the wound microenvironment are continuously monitored to guide stage-specific therapeutic interventions and promote tissue regeneration. Finally, we discuss the major challenges and future perspectives for translating intelligent MN platforms into clinically applicable closed-loop and whole-course diabetes management systems.