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.

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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?

Zazie Todd, PhD, is the author of Wag: The Science of Making Your Dog Happy. She is the founder of the popular blog Companion Animal Psychology, where she writes about everything from training methods to the human-canine relationship. She also writes a column for Psychology Today and has received the prestigious Captain Haggerty Award for Best Training Article in 2017. Todd lives in Maple Ridge, BC, with her husband and two cats.

Useful links:
Rooney NJ, Morant S, & Guest C (2013). Investigation into the value of trained glycaemia alert dogs to clients with type I diabetes. PloS one, 8 (8) PMID: 23950905

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  1. Type 2 Diabetes can be just as severe, painful and life-threatening as Type 1 Diabetes, and this is something that articles like yours never put across. I have excruciatingly painful feet due to diabetic neuropathy, next week I am having my eyes lasered for the second year running, my blood sugar levels are just as out of control as a Type 1 diabetic and I am on 5 insulin injections daily. Please could you post this comment. Thank you.

  2. Many dogs are taught to recognize and respond to certain stimulus. For some dogs it is seizures, others it's cancer. Some are trained to help those disabled. For the dogs in this study done by Nicole Rooney it is detecting hyperglycaemia or high and hypoglycaemia or low blood sugar levels and warning their owners when this occurs. The conditioned response from the dogs 'might have involved jumping up, licking, nudging, barking and/or staring' at the owner. The conditioned stimulus was sensing the hyperglycaemia and hypoglycaemia in the owner. When combining the conditioned stimulus and response, you have classical conditioning at work. The dogs that are fully trained wear a red jacket as said above to identify them as medical alert dogs. There are other categories that service animals are in and they all have a jacket or badge to identify them as such. This is just one of the many steps in training dogs and other animals to sense different problems. Some naturally can others learn how. It is how you teach them and train them that can make a difference. The results of the study were the majority saw a significant improvement in there way of living. People who have this type of trained dog have 'unstable diabetes' as mentioned in the article above. Overall, teaching to recognize certain things by conditioning takes time and deditication.

  3. can your own pet's be trained as I looked into this year's ago but the lady going to do it never did. I have a 7 year old 2 year old and 8 month old dogs

  4. i think ya The conditioned response from the dogs 'might have involved jumping up, licking, nudging, barking and/or staring' at the owner.

  5. Yes, your own pets can be trained. Several of the dogs that featured in the research project were pet dogs that were trained to become medical alert dogs. I'm not sure what the criteria are, and probably each charity has its own rules. It's worth checking with the organizations near you that provide medical alert dogs, and find out more about it.


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