Losing the ability to sense low blood sugars is one of the scariest things for those of us living with diabetes.
For one college student at Purdue University, that hypoglycemia unawareness led to an average of three ER visits a week (!) Even with a CGM, this young man diagnosed with type 1 at age 5 wasn’t able to avoid the insulin reactions because they came on too quickly. It got to the point where he was close to leaving school, unable to finish his degree in chemistry.
But with the help of a diabetes alert dog named Tippy, that college student cut his ER visits down to zero, pretty much eliminated his insulin reactions, and is now finishing his college degree.
This was the story told recently at the American Diabetes Association’s Scientific Sessions, as this young man and Tippy the dog were the first to be a part of a venture between Eli Lilly and the Indiana Canine Assistant Network (ICAN) in training hypo alert dogs. But more than that, their story is paving the way to providing the first-ever scientific evidence of how training using dogs to help PWDs live better actually works.
That’s right: Eli Lilly researcher Dr. Dana Hardin (with colleagues Dr. Dustin Hillman from Indianapolis and Jennifer Cattet from West Lafayette, IN) presented the first-ever scientific findings about D-Alert Dogs sensing capabilities and how that’s helped people living with diabetes. The data represents a significant step forward in actually proving the benefit of these dogs, something that has historically only been anecdotal but not backed up by research.
Dr. Dana Hardin and Pete
While this initial research was focused on one dog only, as part of a program based in Central Indiana, the results have implications for Diabetes Service Dog programs everywhere, not to mention all the PWDs who have or might need one of these dogs.
“We know that service dogs make a great impact in life, so we decided to show scientifically that this is a real thing,” Hardin said.
We sat down for a few minutes at the Scientific Sessions with Dr. Hardin, a pediatric endo from Ohio that I met in May at the Lilly Diabetes Blogger Summit. On the canine side, we also got to meet and hang out with Pete, a two-year-old black lab fully trained for hypo alert service. Pete was the only D-Alert dog at the Scientific Sessions, and he was happy to get a break while Dr. Hardin and I chatted about what he and his furry friends are doing to help us people with diabetes!
Dr. Hardin seemed excited to talk about how the dogs can sense a hypo better than a CGM — within 15 minutes of it happening — and the fact that the devices often aren’t completely accurate and don’t alert us until a low blood sugar has already started.
We talked about training the dogs and how they alert folks to a low: first they bump you under the arm and then can go find someone else or even dial 911 and fetch an orange juice from the refrigerator! It’s not clear what the dogs actually sense, but it may be a volatile organic acid in a PWD’s body, Hardin says.
Scientific details can be found in the abstract of her ADA presentation (see 381-P), and a bigger study is underway. They are training to determine specifically what the dogs sense.
Hardin says she needs samples of sweat from type 1s, to help train these dogs to sense hypoglycemia. The program needs two types of samples from each PWD: one taken during an in-range reading between 80-110 mg/dL, and one from a low BG between 45-70 mg/dL. Participating is easy enough; all you do is use a specific cotton pad to swipe your forehead and back, and then put them separately into ziplock bags, blowing on them before sealing, and send them back right away.
Those interested in participating can reach out directly to the ICAN program, which will provide more detailed instructions. Hardin actually has a study coming up on July 19, and could use samples by then! So, anyone who’s able to help immediately and get a pair of samples back to Indianapolis by July 13 would be included in that study about what the dogs sense! Potential participants can contact Dr. Hardin at hardin_dana_sue@lilly.com, or ICAN at (317) 250-6450 or by email at Jennifer@icandog.org or ann@icandog.org.
To learn more about these life-saving dogs, have a look at our chat with Dr. Hardin and her friend Pete (excuse the somewhat weak audio – busy conference!):
“Talking Hypo Alert Canines”…here I am thinking that the dogs are shouting blood sugars at you..”Hey, hey, doofus! Your blood sugar is 46! Drink this orange juice!”
Kidding– cool article. I wish I could train my black lab/giant schnauzer to sense lows.
I’ve always wondered: what happens when these dogs have to sleep?
Mike – Thanks for this coverage of these specially trained dogs. I’ve lived with a hypo alert dog for for over two years now. My dog greatly increases the quality of my life. I live alone and the extra layer of safety that he gives me is immeasurable. He’s not 100% accurate but he dependably gives me accurate alerts every day.
One night, while I was fast asleep, my dog jumped up onto my bed and licked my face. That’s his signal to me to test my blood sugar when I’m sleeping. I didn’t feel low and I quickly looked at my CGM and it read something like 89. I then did a fingerstick and was startled to read a 32!
Ten minutes later, as I was gulping down some juice and giving my dog a special night-time peanut butter treat, the CGM sounded – beep, Beep, BEEP! The CGM alarm was delayed due to its inherent 15 minute lag time. Since my blood sugar had fallen very fast, the CGM may not have been able to wake me up in that situation.
I know this is just an anecdotal, n=1, story but my belief in the value of hypo alert dogs was cemented that night. They are wonderful to live with and also mitigate the increased incidence of depression that diabetics experience. I use all the latest technology including a pump and CGM but sometimes low-tech is best!
My Springer Spaniel, Charlie provided alerts for me for close to 15 years. At first I had no idea why he was suddenly bothering me – did he need to go out? Want some attention? Didn’t take me long to figure it out. My other springer spaniel doesn’t have this particular gift. How I miss my Charlie May he be chasing birds in the sky! RIP.
So you think dogs are trainable to alerting low blood glucose episodes? Well, shame on you, because living with me is this amazing, low blood sugar seeking cat. This beautiful calico, named Dolce (Italian for sweet, and she was named by my daughter several years ago when the “D” was living with her-NO I AM NOT KIDDING!) lets me know in no uncertain meows that it’s time to test my BG. In fact, during the overnight hours, Miss D makes enough noise to wake the dead whilst sitting atop my chest! She is 100% correct every single time! Take that, you “trained” dogs of the world! Dolce has never been trained but you must know that I have a close bond to all animals living with me. me?…52+years, t1, and counting. Yeah, counting my blessings>
I just brought home my yellow lab puppy, Roman, this week and am working with a trainer to have him be a Diabetes Alert Dog! So excited!
Hi Anne,
You are at a great starting point. I did not start out to “train” Maggie. The wet shirts, pjs at night are the signal odors for a low blood sugar. It was during my resting, sleeping mode that maggie became really alert. You do not have to worry that the dog will sleep through the event. Maggie never did and it nis the odor of the condition! Check out the book: Inside of a Dog, What Dogs See, Smell, and Know by Alexandra Horowitz.
Some state governments are now issuing Medical Dog designations to help diabetics and you can take them with you.
Hope this helps and as always have a great day.
Dan
I’m really excited to see this. I’ve been training my dog to be a DAD and he’s doing really well. But, its difficult to train something that you can’t see or sense. Approaching this scientifically will help progress this important field. If the identifying properties of the high/low scents can be factored out and reproduced, it would allow more confident training.
I’m intrigued by the use of sweat samples. I use saliva and everything that I’ve read indicates that this is what is commonly used in the training of DADs.
Great story. I hope to hear more about this.
Hi MikeH..
It was good of you to write about this topic. There are tooo many anedotal stories. Mine is a nine plus year history with a dog. Next, a few years back, PBS ran a program about Dogs that changed the world and there is a section on medical dogs. One of which was a documentary of a dog trained to wake parents prior to the young child “falling” into a severe hypoglycemic state. Check my comment on your article regarding your wedding vows. The safety forces of the country have canines which …find the living, find the dead, find crops which people attempt to bring into the country, durgs, and etc. My story involved a puppy, Maggie, which entered our family when I transitioned to an insulin pump. When I did not “smell right” she let me know. It is on a you tube, Dan and Maggie 2. As always have a great day.
Dan