**2. Tear analysis**

A majority of the recent studies in this field have targeted the area of personalized medicine, endeavoring to develop miniaturized wearable devices featuring real-time glucose monitoring in diabetic patients [12–15]. One great example is contact lens which is an ideal wearable device that can be worn for hours without any pain or discomfort [16]. Integration of glucose biosensors into contact lenses

has recently been demonstrated by several research groups [9, 17, 18]. However, the level of glucose in tear fluid is very low (0.1–0.6 mM), requiring a high sensitivity of the sensor for picking up the signal from expected chemical reaction [3, 19]. Yao et al. [16] have fabricated a contact lens with integrated sensor for continuous tear glucose monitoring with wireless communication system over a distance of several centimeters. The sensor demonstrated a fast response of 20 s with a minimum detection of less than 0.01 mM glucose, which is 10–60 times lower than glucose level in human tear [16].

In addition to glucose, lactate is an important metabolite in the human body, which gets converted into l-lactate under hypoxic condition [20]. l-Lactate levels in tear fluid is about 1–5 mmol L<sup>−</sup><sup>1</sup> , which might increase significantly due to some heath conditions including ischemia, inadequate tissue oxygenation, stroke, and different types of cancer [21]. Thomas et al. [22] demonstrated an invasive detection of lactate in human tear by integrating an amperometric lactate sensor with Pt working (WE) and reference (RE) electrodes as well as a counter electrode (CE) as current drain, on a polymer-based contact lens, measuring lactate in situ in human tears without any need for physical sampling [22].

Very recently, Park et al. [17] reported a novel approach for fabricating fully transparent and stretchable smart contact lens capable of wirelessly monitoring the level of glucose in the tears of diabetic patients. **Figure 1** shows the layout of fabricated devices made of glucose sensors, wireless circuit, and display pixel on soft and transparent contact lens substrate (**Figure 1a** and **b**). The circuit diagram of the device is illustrated in Figure 1a, with radio frequency antenna receiving signals from a transmitter and a rectifier converting the signals to DC (**Figure 1a** and **c**). A continuous network of ultralong Ag nanofibers was used as stretchable electrodes for the antenna and interconnects (**Figure 1d**). In the case of any change in the concentration of glucose in tear, the sensor resistance changes resulting in the light-emitting diode (LED) pixel turning on or off. The device was tested in vitro using a live rabbit, providing substantial finding for smart contact lenses as one of the promising wearable devices in healthcare system [17].

#### **Figure 1.**

*(a) (i) Schematic illustration and (ii) operation of the soft, smart contact lens and (iii) the circuit diagram of the smart contact lens system. The soft, smart contact lens is composed of (b) a hybrid substrate; (c) functional devices including rectifier, LED, and glucose sensor; and (d) a transparent, stretchable conductor for antenna and interconnects [17].*

**5**

**Figure 2.**

*printed circuit connector [28].*

*Introductory Chapter: Wearable Technologies for Healthcare Monitoring*

In addition to tear, sweat electrolyte concentrations and blood serum are related [2, 8]. As one of the most readily accessible human biofluids, a great deal of information about the human body and its physical performance could be obtained via monitoring sweat electrolyte concentrations [23, 24]. Several groups have reported the key biomarkers in human sweat (e.g., sodium level, pH change, lactate concentration) relevant to human health and well-being, for monitoring athletic performance during sporting activities [25]. Jia et al. fabricated a skin-worn tattoo-based sensor for realtime monitoring of lactate in human sweat, offering substantial benefits for biomedical as well as sport applications [25]. In another approach, Curto et al. [26] fabricated a wearable and flexible microfluidic platform capable of monitoring changes in the sweat pH in real time. Anastasova et al. [27] developed a flexible microfluidic device for real-time monitoring of metabolite such as lactate as well as electrolytes such as pH and sodium in human sweat. Recently, Gao et al. [28] developed a flexible and wearable device (**Figure 2**) made of arrays of sensors for real-time monitoring of heavy metals, such as Zn, Cu, and Hg in human sweat. The device fabrication method is presented in **Figure 2a**, showing the deposition and stripping steps on microelectrodes. The sensing mechanism was based on an electrochemical detection of targeted heavy metals through four microelectrodes, including Au and Bi working electrodes, Ag reference electrode, and an Au counter electrode (**Figure 2b** and **c**). The fabricated device demonstrated high stability and selectivity toward heavy metals, providing a great platform to advancing the field of wearable biosensors for healthcare application, via monitoring the level of some heavy metals in human sweat [28]. A balanced level of Zn is necessary in the human body as a low and high Zn concentration can lead to pneumonia and liver damages, respectively [29, 30]. High level of Cu in the human body can lead to several diseases including Wilson's disease and heart, kidney, and liver failures as well as brain diseases [31, 32]. The fabricated device demonstrated high stability and selectivity toward heavy metals, providing a great platform to advancing the field of wearable biosensors for healthcare application [28].

*(a) A schematic showing the concept of deposition and stripping on microelectrodes. (b) A schematic showing the composition of the microsensor array. (c) Optical image of a flexible sensor array interfacing with a flexible* 

*DOI: http://dx.doi.org/10.5772/intechopen.89297*

**3. Sweat analysis**

*Introductory Chapter: Wearable Technologies for Healthcare Monitoring DOI: http://dx.doi.org/10.5772/intechopen.89297*
