Diabetes Alert Dogs

Photo: Mila Atkovska / Shutterstock
Can dogs be trained to alert diabetics when their blood sugar levels fall too low or too high? 

By Zazie Todd, PhD

A new study by Nicola Rooney (University of Bristol) et al investigates the success of just such a program.

Medical Detection Dogs is a charity in the UK that trains dogs to detect disease. For example, they are investigating whether it is possible to train dogs to help with the early diagnosis of cancer, such as detecting prostate cancer from urine samples. They have bedbug detection dogs, who raise money to support the charity, which is reliant on public donations. And they also have medical alert dogs, trained to alert diabetics when their blood sugar becomes dangerously low.
Type 1 diabetes is a serious medical condition in which the pancreas is not able to produce enough insulin. Consequently, there is not enough insulin to get sugar into the cells. The symptoms include increased thirst, hunger, fatigue and blurred vision, as well as many complications that can be life-threatening. People with type 1 diabetes have to monitor their blood sugar levels frequently to ensure they don’t suffer from blood sugar that is too low or too high.
The charity has trained a number of dogs to alert when their owner is at risk of becoming hypoglycaemic (low blood sugar). Many of them are also able to detect hyperglycaemia (high blood sugar), though this is not trained until after the hypoglycaemia detection training is complete.
The dogs wear a high-visibility red jacket that identifies them as medical alert dogs. While the most common breed is Labrador Retriever, other breeds include Golden Retriever, Poodle, Labradoodle, Cocker Spaniel, and a Yorkshire Terrier. Dogs that are trained by the charity typically go their owner at about eighteen months of age.
Seventeen owners of hypoglycaemia alert dogs took part in the research. Nine of the dogs had completed their training, while the remainder were at an advanced stage. Nine of the dogs (a different subset) were trained by the charity and placed with their owners, while the other dogs already lived with their owners and were subsequently trained. The alert behaviour might involve jumping up, licking, nudging, barking and/or staring.
The study asked clients to record occasions when the dog alerted them and whether or not this was accurate. They answered a questionnaire about their experiences, provided data from blood samples, and allowed the researchers to access their medical records so that pre- and post-dog results could be compared. The full dataset was available for ten clients.
All of the people said since they got the dog there was a reduction in at least one of low blood sugar, becoming unconscious, or having to call a paramedic. The majority agreed that “The dog has enhanced my quality of life” and “I am totally satisfied with my dog.” This shows the dogs have made a big difference to their owners' lives.
Comparing blood tests to alert episodes showed that almost all of the dogs successfully identified when blood sugar was out of the normal range. In almost all cases, there was a significant change in glucose levels after they acquired the dog.
The people who have these dogs all have what is known as “brittle” diabetes, in other words it is unstable. The researchers say “their present Quality of Life and Wellbeing are comparable to other populations of non-dog users living with Type I diabetes. This suggests that the benefits of alert-dog ownership reported here have improved the clients’ life quality to levels comparable to the general Type I diabetes population.” This is a huge achievement, and it is beneficial to the individual as well as to society since it will result in lower emergency medical costs.
Most of the owners showed high levels of trust in their dog (remember that some dogs had not quite completed their training yet). Some liked the attention their dogs brought, while others were less keen on it.
The data showed there were differences in the dogs’ detection abilities, and future research is needed to investigate the reasons for this, such as whether some dogs are naturally better at it than others, and whether record-keeping is also a factor.
The researchers also suggest that differences in training may play a role. Future research could investigate any differences between dogs raised by the charity and those that were raised by their owners. There may also be differences in owners’ abilities when it comes to on-going training and rewarding successful alerts, so future research could usefully focus on the relationship between client and dog.
This study shows the dogs have made a big difference to the lives of their owners. Medical Detection Dogs now also trains dogs for other medical alerts, including narcolepsy and nut allergy.
Have you seen a medical assistance dog at work?

Rooney, N. J., Morant, S., & Guest, C. (2013). Investigation into the value of trained glycaemia alert dogs to clients with type I diabetes. PloS one, 8(8), e69921.

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