Thinking of getting a #Diabetes Alert Dog? What to look for before signing a contract

Diabetes – Science has proven that dogs can really help - #diabetesalertdogs

Over the past few years, a number of service dog organizations have started to train dogs for diabetes alert. Type 1 diabetes patients are at risk of medical complications when their blood glucose levels drop as they often cannot feel the change until it’s too late. These often restrict their lifestyle and activities to avoid the risk of hypoglycemic episodes, reducing at the same time their quality of life and wellbeing. Specifically trained dogs can put their nose to work and provide the much needed help.

I worked with a young man in his thirties, with Type 1 diabetes, who had lost the vision in one eye as well as his ability to walk without crutches after a dramatic drop in his glucose level, sent him to the hospital. Concerned about his recurring life threatening episodes, his family convinced him to get a diabetes alert dog. With the help of the dog, alerting to most of the changes in his glucose levels, he was able to monitor his sugar levels before they reached extreme levels. Over time, his hypo and hyperglycemia episodes were less frequent and less severe and his overall health was greatly improved.

Like him, many have benefited from the assistance of a dog. But what dog trainers and diabetes alert dog (DAD) owners have know for years, has finally been demonstrated scientifically. Dogs can smell a drop in blood glucose levels, significantly helping patients, increasing wellbeing and quality of life.

One study presented 4 dogs with samples collected from diabetes patients while they were experiencing a hypoglycemic episode (Harding& al., 2013). When placed amongst 6 other samples (3 from the patients while in normal range, 3 blanks), the dogs were capable of identifying the Low sample, proving their ability to detect a particular smell associated with the change in blood glucose levels.

A second study investigated whether such trained dogs truly provided health and psychological benefits to diabetes patients (Rooney &al., 2013). Dogs can be trained to nudge, paw, lick, jump or vocalize to alert the person when their glucose levels are lower than normal. Seventeen diabetes patients were surveyed about the reliability and efficiency of their diabetes alert dogs. The researchers recorded the incidences of nocturnal hypoglycemic episodes before and after receiving a dog.

All clients reported a reduction in either the number of hypoglycemic events, the number of unconscious episodes, or the number of emergency calls after receiving a dog. Eight people stated that they had not called the emergencies or been unconscious at all since receiving a dog (when they had previously). Most patients reported more independence and increased quality of life once they had a diabetes alert dog.

When measuring the impact of diabetes alert dogs on the patient’s health, the researchers found a significant change after dog placement. These measures confirmed what the patients had stated; most clients experienced improvement in their glycaemic control.

Dogs have shown the ability to alert to both lows and highs, but it’s still unclear what chemical compound they’re responding to. We know they smell a change, but more research will be needed to find out what exactly they smell. Over time, as dogs identify patterns of behavior associated with the change in blood glucose levels, they may also pick up on behavior cues that can confirm the onset of a hypo or hyperglycemic event.

Overall, what these studies show, is that dogs can be effectively trained to help Type 1 diabetes patients better monitor their glucose levels. They contribute to not only improving their sense of wellbeing, but also to their overall health by helping to keep the blood glucose levels in more normal ranges.

Jennifer Cattet Ph.D.

MedicalMutts.com

New Study confirms the ability of dogs to smell changes in glucose levels in diabetes patients

According to the American Diabetes Association, 8.3% of the US population suffers from diabetes. Close to 20 million people have already been diagnosed and 79 million are pre-diabetic. Health complications from diabetes range from heart disease, stroke, high blood pressure, blindness, kidney disease, neuropathy and gangrene, leading to amputation. Those who developed the disease early in their life are at a higher risk for Type 1 Diabetes. Over the years, these patients may loose the ability to feel the impending drop in blood sugar, such as tremors, sweating, confusion or irritability and are at greater risk of dangerous health complications.

Until now, regular testing of blood glucose levels throughout the day is the only way to know whether changes are needed in diet or insulin. Changes, however, could occur in between tests and go unnoticed until symptoms of severe hypoglycemia develop (stupor, seizure, unconsciousness). Dogs could provide the much needed warning by detecting the change in glucose levels through smell. Until recently, this ability was only anecdotal. New research has now proven that dogs are indeed capable of smelling the occurrence of a hypoglycemic episode.

Dogs have up to 220 million olfactory cells while people only have approximately 5 million. From the detection of bombs, drugs, and cancer to search and rescue missions, dogs have been putting their noses to work to save many human lives year after year. Today, dogs have shown the ability to assist people in a new and innovative way: alerting them when their blood glucose level changes.

Lupine Lens Photography

Dana Hardin MD (endocrinologist), Wes Anderson, Zachary Skrivanek (statisticians) and myself (Jennifer Cattet, Ph.D., ethologist/dog behaviorist and trainer), aware of the potentially life threatening characteristics of Type 1 diabetes, decided to test the dog’s ability to smell a drop in glucose levels. Four dogs were trained to alert whenever presented with gauze containing breath and skin secretions from patients. They were then presented with a test, in which a hypoglycemic sample was loaded in one of the seven identical containers on a scent wheel. Three other containers were loaded with euglycemic (samples collected from the patient while in the normal blood sugar range) and the last three with blank gauze. None of the handlers knew the location of the hypoglycemic sample during the test so the dogs had to rely only on their nose to find it.

The results of this study demonstrated that the dogs were capable of finding the hypoglycemic sample amongst the seven samples presented, confirming the existence of a particular smell associated with the episode. It’s probable that what they’re detecting is an increased concentration of ketones. When there isn’t enough insulin to convert glucose into energy, the body starts burning fat instead. This process leads to the build-up of ketones in the bloodstream. The accumulation of ketones is what will cause most of the symptoms and complications described above. Although more research will be needed to fully understand the biochemical changes that occur with hypoglycemia, we now have more evidence that dogs may provide additional help to patients in avoiding the dangerously low glucose levels.

Dogs have the ability to alert a patient of a change in glucose levels when the body’s warning signals no longer kick in, and may therefore provide an additional tool to better monitor the constant ups and downs typical of Type 1 diabetes. They are not machines however and their reliability is not 100%. As living creatures, they can be distracted at times from their alerting duties. But even with a little variability, patients with such dogs have reported experiencing a significant improvement of their overall health through better monitoring of their glucose levels, coupled with reduced stress levels.

The training of Diabetes Alert Dogs (DAD) requires specific qualities of the dog and expertise in this particular field from the trainer. This type of training is very different than other scent detection tasks. The dog needs to be attentive to the person at all times, highly social and capable of working in a variety of public settings. When the presence or absence of the scent is imperceptible to the human trainer and doesn’t disappear from the patient after the episode, there are added challenges to training that can have life consequence for the patient. Training requirements are intensive and as they go through puberty, the dogs can develop behaviors that could limit their ability to work. With only a small fraction of dogs that make it as service dogs, even when carefully bred for that purpose, diabetes alert dogs are typically placed between 18 and 24 months old.

To date, dozens of dogs have been placed with diabetic patients and are helping them monitor their sugar level more effectively. More then a medical device, they also provide companionship and peace of mind.

Jennifer Cattet Ph.D.

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copy of the study, visit www.MedicalMutts.com.