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.
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| 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.
For more information on Diabetes Alert Dogs and a PDF
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