Nanostructure driven innovation in diabetes: from enhanced biosensing to smart therapeutic delivery

Diabetes mellitus continues to be a global public health concern, owing to its increasing incidence, complex etiology, and the limitations of standard therapy regimens. Conventional therapeutic strategies often face several limitations including poor bioavailability, frequent administration, and absence of real-time blood sugar regulation. Recent advancement of smart nanotechnology has provided new opportunities for prevention, diagnoses, and management of diabetes as a part of smart health concept and precision medicine. This review highlights the recent trends in the design and application of nanotechnology for managing diabetes specifically focusing on two areas, glucose monitoring and drug delivery. Novel drug delivery systems are revolutionizing diabetes treatment, providing better pharmacokinetic control, adherence of patients, reduction of side effects, and target/stimuli responsive therapy. Recent developments in this area include sustained release implants and depots for extended periods of glycemic control; nanoparticles and liposomes for improved oral absorption and protection of insulin against enzymatic hydrolysis; transdermal and microneedles for minimal invasive delivery of insulin and peptides; inhalable dosage forms for faster systemic absorption; and glucose responsive 'smart' devices which deliver drugs only when required due to hyperglycemia. The use of nanotechnology-based biosensors and wearable devices has enabled the development of glucose monitoring based on their improved sensitivity, specificity, and integration into digital healthcare applications. Nanotechnology, coupled with artificial intelligence, and real-world health data, enhances personalized diabetes management through predictive monitoring and adaptive insulin delivery systems. Despite tremendous achievements, still some concerns persist, related to clinical translation, biosafety issues, and regulations. With continued interdisciplinary research that integrates the materials science, bioengineering, and clinical medicine, smart nanotechnology holds substantial promise to shift diabetes care, enabling an improvement in diabetic treatment from symptomatic to a physiologically sounder approach.