Seeing eye dogs were the first type of service dogs in the U.S., supporting the blind community. Gradually, our understanding of dogs’ service abilities expanded, and in 1975, Bonnie Bergan coined the term “service dogs” and started the first service dog non-profit, Canine Companions for Independence. To this day, CCI trains dogs to support people with a wide range of disabilities and places them with those in need.
As research on what dogs are capable of providing became more concrete, the Americans with Disabilities Act expanded the definition of service dogs in 1990 to include “any guide dog, signal dog, or other animals individually trained to provide assistance to an individual with a disability.” This allowed for the expansion and support of formalized dog training to serve a wide community of people dealing with various disabilities and special needs in the U.S. Among these are diabetics.
Nowadays, thousands of service dogs are being trained around the country to alert diabetics who show signs of abnormal blood sugar levels as well as to communicate to a third party if an emergency situation arises. Read on for a comprehensive guide to the research and the organizations involved.
Diabetes is an Illness that Affects Millions
In the U.S. today, diabetes impacts over 30 million people with another 84 million who are prediabetic based on the National Diabetes Statistics Report. Each year the number of people impacted continues to grow, and there are over 7 million people who are living with diabetes but are undiagnosed. While this illness can be managed with a healthy diet, exercise, the correct dose of insulin, and medication, the risk of hypoglycemia (abnormally low blood sugar) or hyperglycemia (abnormally high blood sugar) is a daily battle. Other conditions or complications may also develop including heart disease or stroke.
Over 14 million emergency room visits were reported in 2014 with diabetes as the diagnosis, and over 200,000 of these cases were those suffering a hypoglycemic crisis. Hypoglycemia is caused by a low level of sugar in the blood. The initial symptoms include tiredness, hunger, shakiness, irritability, heart palpitations, sweating, and more. As hypoglycemia worsens, many experience confusion and irrational behaviour, and others may even have seizures or lose consciousness. A hypoglycemic crisis situation may even be life-threatening. In fact, diabetes was the 7th leading cause of death in the U.S. in 2015.
Hyperglycemia can also occur for those dealing with diabetes when the blood sugar level is abnormally high. These symptoms including increased thirst or a need to urinate often and can lead to hospitalization if no action is taken.
Prevention and Support for Diabetic Patients
The constant nature of this illness requires close attention to preventing an abnormally low or high level of sugar in the blood. Prevention includes a routine check of glucose levels, exercise, regular meals, and being prepared for the symptoms of hypoglycemia or hyperglycemia.
In addition to the normal prevention protocol, diabetic alert dogs are an invaluable support to those who deal with this illness. Dogs are trained through their sense of smell to detect a cue in human breath that their companion is showing signs that the blood sugar level is abnormal.
Dogs are trained to detect a cue in human breath that the blood sugar level is abnormal.
Researchers in the U.K. have found that isoprene, a volatile organic compound in exhaled breath, shows up at elevated levels when the blood sugar is low. Researchers haven’t proven that this is exactly what dogs are detecting when they alert their companions, but it may be part of the equation. Dr Mark Evans, who leads the research and lectures at University of Cambridge, told NPR in a 2016 interview: “I suspect that dogs respond to a combination of cues including [volatile organic compounds in exhaled breath], but also subtle behavioural cues.”
Diabetic alert dogs offer an early warning so their human friends can test their blood sugar levels. For a diabetic, this gift not only provides stress-free living, but it allows them to take immediate action and avoid severe symptoms of low or high glucose levels and visits to the hospital.
It should be noted that some in the research community debate this. Evan Los, a pediatric endocrinologist at Oregon Health & Science University, has studied diabetic alert dogs and is suspicious of their accuracy and effectiveness. In his studies, service dogs gave many false alerts of abnormal blood sugar levels, and he asserts there is still a lot to be proven about what these service dogs are detecting.
Even though the research is still underway, Los is clear that diabetic patients who have an alert dog are highly satisfied. For families with diabetic alert dogs, the benefits involve more than 100% accuracy in identifying blood sugar levels.
Benefits of a Dog Trained to Alert
For most people dealing with diabetes, a service dog means security and provides peace of mind in everyday living. These dogs are trained to detect abnormal levels of blood sugar in their human friend using their sense of smell and can be trained to do a variety of tasks including:
- Informing their companion with their paws, nose, or other signals that it’s time to test their glucose level
- Retrieving and alerting someone nearby (i.e. family) if their companion is not able to help themselves or needs attention
- Retrieving food, medication, the blood meter, or a phone
- Dialling 911 using a special device
One woman suffering from Type 1 Diabetes reported that before she owned a service dog she experienced severe hypoglycemia weekly. However, in the last two and half years of having her service dog, Magic, she hasn’t experienced a severe hypoglycemic attack. Magic has alerted her over 2,000 times in the last several years, so she can take action before there’s a problem where she can’t help herself. She no longer has to test her blood sugar every hour to ensure her glucose level is normal because Magic has been so effective in letting her know when it’s time to take a test.
One of the major benefits for her and many others is having a service dog provide overnight care. Going to bed can be a stressful time when blood sugar levels can drop without notice. For those dealing with type I diabetes, the body can’t detect abnormal blood sugar levels by itself. However, a service dog is trained to wake up their companions when they detect a problem. These dogs can and do save lives. They ultimately act as a co-pilot for those they are matched within the diabetic community.
The benefits of having a service dog truly go beyond the medical support. For many people who live with diabetes, there are limits to what they can and can’t do. A service dog provides a new life for people so they’re free to do the same activities, attend social events, and travel without feeling trapped or concerned they are risking their lives. These dogs reduce the stress and anxiety that develops with the ongoing anticipation of hypoglycemia or hyperglycemia.
It’s also important to understand that a service dog is not a replacement for the usual practices of regularly checking blood sugar levels and maintaining a healthy routine for preventing severe attacks.
Resources Around the Country
Owning a service dog is a real commitment that should be thought through based on your lifestyle and individual needs. There are several organizations around the country that train service dogs for diabetic alert including Service Dogs by Warren Retrievers, Diabetic Alert Dogs of America, Dogs4Diabetic, and many more. Each organization has its own training program, requirements, and matching process. Below is a basic summary of a few of the programs that are currently available.
Service Dogs by Warren Retrievers (SDWR) is a nonprofit that breeds and trains dogs for a wide range of service work including diabetic alert, seizure response, autism support, and PTSD services. SDWR trains certain breeds of dogs that are a fit for their own training techniques. At four months, puppies are selected based on their temperament and sense of smell to begin training. After 18 months, puppies are matched with a family, and SDWR staff works closely with the family to train the dog to respond to the specific needs of this family. SDWR returns every 2 years to follow-up and ensures the relationship is working. If there’s any problem with the service dog or issues with bonding, SDWR will find another dog that’s a better match.
University of Virginia researchers reported that SDWR alert dogs are over 90% accurate in alerting handlers of highs or lows in their blood sugar. These dogs have benefitted their handlers in numerous ways including an increased ability to enjoy physical activities without worry. With a commitment to being as accessible as possible, SDWR brings the dog to you. Handlers are not required to travel, so there are no geographical limits on who can participate. SDWR also has a commitment that families don’t directly pay for receiving their service dog, and families are responsible for raising money and bringing awareness to this need in our communities.
Diabetic Alert Dogs of America is a member of the Better Business Bureau and provides many similar services to SDWR. They will deliver a service dog to you and work with your family to ensure the dog is trained and ready to serve you. However, there are costs involved which vary based on your personal needs. Payment plans and financial assistance are also available as the company is committed that finances do not limit your ability to receive the care of a service dog. After submitting a request form and completing a purchase agreement, the matching process begins and is based on an individual’s lifestyle, personality, and needs.
Diabetic Alert Dogs also offers the Starter School Program which is a 12-week program designed to train your family dog to be your service dog if your dog meets the qualifications and passes an evaluation test. This is an intense 700 hour Service Dog Training including beginning skills in obedience training, public access training, and scent detection. This training is only the foundation of what must be practised and maintained by the dog owner.
Dogs4Diabetics (D4D) is a nonprofit in California that has a different approach involving 100 hours of training for individuals who want an alert dog. The training happens both in the classroom and in the field over 3-4 months. During this time clients get to know and work with many different service dogs. The training includes working with clients to learn the etiquette of working with an assistance dog, workplace and school accommodation laws, how to take care of your service dog, how to work with your service dog in public places, and much more. After the class is complete, a client is matched with a service dog on a trial basis for up to a year. During this time the client and dog have work to do to develop their relationship as well as practice consistent alert procedures so the dog and client have a successful partnership. There are specific and expected targets that must be met to ensure the service dog is progressing and providing the right care for the client. When these targets are met, a dog is permanently placed with the client. Each year, a D4D client must be recertified to continue the success of the care provided.
While service dogs may not be appropriate for everyone who deals with diabetes, there are many success stories from those who have dealt with severe cases of diabetes and whose lives have been saved by diabetic alert dogs.
For the mother of Luke Nuttall, having a diabetic alert dog saved Luke’s life in the middle of the night when his glucose level dropped to a dangerous level. While the Nuttall family takes all the usual precautions to check Luke’s blood sugar level regularly both day and night, their alert dog, Jedi, provided the necessary protection to detect there was an issue with Luke before anyone else. As a 7-year-old boy with type I diabetes, Luke is lucky to have Jedi as a constant companion, and their bond is indestructible.
Michelle was diagnosed with type I diabetes in 1984, and after struggling for more than 20 years, she decided it was time to take action and get additional support. She contacted Service Dogs by Warren Retrievers to begin the process of being matched with a service dog. Michelle doesn’t naturally experience the symptoms of low or high blood sugar and having her dog has enabled her to treat herself before her glucose level drops to a dangerous level. While she used to experience the regular threat of having a seizure or losing consciousness if she didn’t detect a problem in time, now her service dog has provided immeasurable support in reducing this possible outcome.
We have an ongoing interest in how people dealing with diabetes can benefit from service dogs. For additional information, check out How Service Dogs Help Humans with Diabetes. Each year there is more research being done to understand how diabetic alert dogs can assist individuals and families, and the success stories continue to spread.