Continuous glucose monitoring transformed diabetes management by turning a snapshot test into a living physiological narrative. The deeper question now is whether the same principle can be extended to the full biochemical complexity of cardiometabolic disease — and this review from Frontiers in Bioengineering and Biotechnology makes a systematic case that the infrastructure, materials science, and clinical rationale are converging fast enough to matter within the next decade.
The review integrates two analytical lenses: a biomarker-centered framework and a device-centered one. On the biomarker side, it catalogues a priority tier of analytes beyond glucose — lactate, ketones, uric acid, electrolytes, renal metabolites, cortisol, catecholamines, cytokines, acute-phase proteins, and selected cardiac markers — each with distinct physiological windows and clinical relevance to conditions like insulin resistance, heart failure, chronic kidney disease, and stress-axis dysregulation. On the device side, it examines sweat patches, microneedle-based interstitial fluid sensors, and fully implantable platforms, assessing their readiness against established CGM benchmarks for analytical validation, regulatory pathways, and clinical adoption. The central argument is that cardiometabolic disease — precisely because it involves interacting metabolic, endocrine, neural, and immune pathways — is the highest-value entry point for next-generation multi-analyte biosensing.
This is a timely and strategically important synthesis. The CGM archetype is genuinely instructive: it demonstrates that continuous biosensing can achieve regulatory approval, reimbursement, and clinical integration when biomarker biology, device performance, and clinical workflows align. The harder challenge for the next tier of analytes is biological interpretability — cortisol and inflammatory cytokines fluctuate on diurnal and stimulus-driven cycles that make threshold-based alerting clinically perilous without robust context. As a narrative review rather than a meta-analysis or trial, this work is necessarily forward-looking rather than evidentiary. Its value lies in framing the research agenda rather than resolving clinical questions. For health-conscious adults, the trajectory is clear: wearable biochemistry panels may soon offer the kind of dynamic, personalized metabolic intelligence that currently requires repeated laboratory visits — though clinical validation at scale remains the essential next step.