Insulin detection in diabetes mellitus: challenges and new prospects

Advancements in achieving tight glycaemic control in diabetes mellitus have been significant, primarily through frequent or continuous glucose measurements. However, accurate insulin dosing for patients requiring insulin needs to consider various factors that affect insulin sensitivity. The need for real-time insulin measurements is crucial to track insulin concentration and optimize dosing. Traditional centralized insulin testing lacks timely measurements required for this purpose. This Perspective explores the progress and challenges in transitioning from laboratory-based assays to decentralized insulin testing in point-of-care and home settings. Promising technologies discussed include disposable test strips, mobile systems, and wearable real-time insulin-sensing devices. Additionally, future prospects for continuous insulin monitoring and integrated multisensor-guided closed-loop artificial pancreas systems are considered.