Diabetes Goes to the Dogs, Sniffing Out Hypoglycemia
"Hey, do you smell that? Warning, low sugar!" If diabetes alert dogs could talk, perhaps this is what they would say. For people with type 1 diabetes who are experiencing an episode of hypoglycemia, the warning from a trained dog may be more subtle, yet still effective.
Dogs learn to sniff out low sugar levels
Interest in and research into the ability of dogs to detect changes in individuals with diabetes that signal abnormally low blood sugar levels has been around for several years and is gaining in momentum. In an early study in the Journal of Alternative and Complementary Medicine, for example, researchers from Queen's University Belfast reported on 212 dog owners who had type 1 diabetes.
Of these study participants, 138 (65.1%) said their dog had shown behaviors to at least one of their low sugar episodes, and 31.9% of the dogs had responded to 11 or more episodes. One-third of the individuals said their dogs reacted before they themselves were aware of the hypoglycemic episode.
The dogs responded in a variety of ways, with vocalization being the most common (61.5%) followed by licking their owner (49.2%), staring intently at them (41.3%), and nuzzling (40.6%). Of special interest is that none of these dogs were trained to detect hypoglycemia.
Eli Lilly and ICAN
Only a few organizations are currently working with dogs for the detection of hypoglycemia. Two of them have teamed up--Eli Lilly and Company and ICAN (Indiana Canine Assistance Network)--to research why dogs have an ability to detect severe blood sugar episodes and to identify what it is these dogs can smell.
Dogs possess a highly developed sense of smell. Whereas humans have about 5 million olfactory cells (which provide the ability to smell), dogs have up to 220 million. That super smell sensitivity is believed to give the dogs the edge in sniffing out biochemical changes in people with type 1 diabetes when undergoing a hypoglycemic event.
After about five years, people who have type 1 diabetes can develop hypoglycemia unawareness, which means they are unable to sense when their blood sugar levels have dropped dangerously low. Hypoglycemia is typically characterized by excessive sweating, tremors, irritability, and mental confusion and needs to be addressed immediately because it can quickly lead to seizures, loss of consciousness, and even death.
At the recent American Diabetes Association's 72nd Scientific Sessions, Lilly Diabetes presented the results of a study in which an individual with type 1 diabetes and severe hypoglycemia was matched with a dog trained to detect hypoglycemia. Researchers reported that over a six-week period, the dog was able to accurately detect the onset of hypoglycemia and alert the individual in time to take precautionary measures.
According to Dr. Dana Hardin, medical director and pediatric endocrinologist at Eli Lilly and Company's Indianapolis campus, although experts understand some of the biochemical changes that occur during hypoglycemic episodes, they don't yet know exactly what dogs can sense. "If we can identify what the dogs smell," she said in a company release, "it may be possible to expose them to larger quantities of that compound for faster, more efficient training."
Now a joint effort between ICAN and Lilly employees involves a newly trained group of dogs and looking at reproducing recognition of hypoglycemia using samples in a laboratory setting. Subsequent studies are planned to identify what the dogs can sense and also measure the effect the dogs can have on people with type 1 diabetes.
Training programs for diabetes dogs
Only a few organizations are currently working with dogs for the detection of hypoglycemia. At ICAN, dogs are trained over a two year period by inmates at the Indiana Women's Prison to perform a variety of tasks, such as picking up objects and opening doors.
When the puppies are about 8 months old, they also begin specialized hypoglycemia alert training. Several Lilly employees also work with these dogs during work hours so they can practice their newly learned skills.
Other organizations that have diabetes training programs for dogs:
- Dogs4Diabetes, a nonprofit group in California. The mission of Dogs4Diabetes is, in part, "training, partnering, and supporting dogs and clients to reduce the risks associated with diabetes."
- Pawsitive Perspectives Assistance Dogs (PawPADs), a nonprofit headquartered in Savage, Minnesota, that "primarily focuses on training service dogs for people with physical mobility disabilities, many are also trained as Diabetic Alert dogs."
- Service Dogs of Virginia, a nonprofit, "raises, trains, and places dogs to assist people," including those with physical limitations, diabetes, and autism. The organization serves clients who live in the Commonwealth of Virginia.
In a small but significant way, diabetes is going to the dogs. It appears man's best friend may be helpful in sniffing out hypoglycemia and assisting in the fight against a growing epidemic of diabetes.
Eli Lilly and Company
Wells DL et al. Canine responses to hypoglycemia in patients with type 1 diabetes. Journal of Alternative and Complementary Medicine 2008 Dec; 14(10): 1235-41