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Diabetes Goes to the Dogs, Sniffing Out Hypoglycemia

Dogs can sniff 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.

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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

Image: Morguefile



I have a Rat Terrier, Jazman, that is 6 years old and I am a Type 1 diabetic. If I have a low spell at night she always wakes my husband up by jumping around on the bed, barking or sitting on his chest until he wakes up. It's amazing how she knowes. She has never been trained for this either, she just automatically knows. She is my DRD; Diabetic Rescue Dog. My hero!
Thank you for sharing this wonderful story. Be sure to give Jazman a big hug from me! I hope more people like yourself who have such great rescue dogs will share your stories with anyone who will listen: not just family, friends, and neighbors, but also healthcare providers, diabetes experts, other individuals with diabetes. Anecdotally, it seems there are many dogs who have a natural talent for sniffing out hypoglycemia, and there is likely lots of talent out there that is going unnoticed, unappreciated, and underutilized. Best to you and Jazman (and your husband for losing a little sleep)!
I was on a walk with my son in our neighborhood complex talking to the neighborhood dog walkers whe I started feeling the effects oof a low blood sugar episode. All of a sudden all 6 dogs came running towards me. Some licking, some staring and standing closely. I love these dogs and they love me but I knew instantaneously that they knew what was going on. One of my neighbors asked me if I was having a BG episode which I admitted to; then I was able to go get the sugar I needed. Those dogs helped me b/c I was not interrupting the conversation to do what was most important. They made sure I did :) My neighbors knew that dogs were capable of this but I had no clue until that moment.
Thanks for posting about your Jasman! My 2 yr old rescue Basset Hound, Halo, alerts me, too, but only in the middle of the night or if I am napping. He's not trained either. My 3 yr old English Bulldog has not shown the same ability. I had a cat for 14 years that was never wrong when he awakened me in the middle of the night by standing on my chest and patting my face with his paw. Animals are true blessings, aren't they? :-)
Yes, they are a blessing! Thank you for sharing your story. I have a cat who pats my face with his paw, but I don't have diabetes---he just does it when he wants me to get up early to feed him!
For the second time my Basset Hound Axel has jumped up and jumped off the bed and jumped back upon it to wake me up. Both times my blood sugar was either low or getting low. He has never been trained but it has happened more than these two times I think but I just didn't get it until last night. Basset's I know have an incredible sense of smell and he is always smelling my mouth. Type 1 diabetics have a fruity breath smell so I thought that is what is was. He sleeps in between me and husband, Of course it takes a tornado to wake him up and we don't have them where I live405. Thanks to my beautiful Basset boy.
Joy: Love your story! Thank you for sharing it with us. I hope it encourages more people with diabetes to pay attention to their four-legged companions and their potential to help as an alarm system!