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Tera Jurrens, left, introducing two of her dogs trained to alert diabetics to spiking or dropping blood levels.

Dogs trained to alert diabetics about elevated blood sugar

by Andrew Holik
Apr 16, 2013

Dogs can sniff out high blood sugar levels as clearly as you and I can smell the roses, and that means dogs may be able to assist diabetics in maintaining their healthy blood sugar levels.

Tera Jurrens and her Ohio-based company Freedom Paws demonstrated diabetic alert dogs at the American Diabetes Association EXPO in Chicago Saturday.

According to the American Diabetes Association 25.8 million Americans, or 8.3 percent of the population, have diabetes.  Diabetes occurs when either the pancreas does not produce enough insulin, a hormone that regulates metabolism, or cells in the body don’t respond to the insulin produced.  This leads to high blood sugar levels. In cases where the diabetic takes medication without eating, low blood sugar levels can result in dizziness or loss of consciousness.

“When blood sugar levels change, you may have secretions,” said Bruce Riser, a PhD in cell molecular biology who’s not affiliated with Freedom Paws.  “These dogs may have been trained to be able to smell what comes up.”

That's exactly the idea, said Jurrens. She has spent a decade training assistance dogs and holds a degree in animal science, said that was exactly the idea.

Jurrens said patients can fill out an application signifying the type of disability the dog is needed to assist.  After a rigorous series of interviews and medical verifications to ensure the patient’s condition and ability to properly care for the animal, the company will begin training a dog specifically for the client.

The majority of the dogs trained are purchased from shelters within an hour radius of Freedom Paws headquarters in Marysville, Ohio. Jurrens said younger dogs are preferred to maximize socialization, but the company can adopt up to year-old pups.

Jurrens said the best breeds for diabetes alert dogs are Shetland sheepdogs, border collies, and golden and Labrador retrievers.  She said these dogs are very social, but naturally even-keeled so as to not overreact to non-issues.

The dogs are handled from nose to tail during development to help strengthen their smell neurons and given professional training to learn basic commands.

Jurrens said clients are instructed to send samples of their saliva during periods of high and low blood sugar. The samples are then marked and sorted accordingly.

The samples are then swabbed into metal tins where the dogs first pick up the scent. The dogs are shown two tins of saliva, one with a sample of high or low blood sugar and one without issue, and must select the correct tin.  Dogs that select the correct tin are given a snack as positive reinforcement.

In the next step of training tins of saliva with high or low blood sugar are then hidden on Jurrens and other trainers and the dogs must alert the trainers and locate the scent.  

When with the clients, Jurrens said the dogs will frequently smell the owner’s breath and lick the owners face to sense the baseline blood sugar levels in the sweat. Jurrens said the dogs are trained to paw at owners when sensing a rise or drop in blood sugar.

Riser, also the director of research at Baxter Healthcare, said some blood monitors that don't require blood samples are currently in development to perform the same functions as the dogs.

Jurrens said the dogs may be able to sense a change in blood sugar 30-60 minutes before the diabetic may notice the change and test themselves.  She said over time that avoidance of major blood sugar fluctuations could lead to a reduction in hemoglobin A1C, iron-containing proteins in red blood cells that have bonded with sugar and can lead to diabetes complications such as eye and kidney diseases.

Endocrinologist Enrique Caballero of Harvard’s Joslin Medical Center said he's still skeptical about the accuracy of a dog's ability to detect diabetic blood levels.

“I don’t want to stretch it,” he said, “but anything that can help in a quick practical way is helpful, especially for those who can’t monitor themselves.”

Caballero said elderly or severely disabled diabetics who lack the dexterity to handle blood sugar testing strips would benefit the most from the dogs.

“I’ve never seen any studies on it but, anecdotally, I have a lot of patients who tell me the dog always knows, ” Dr. Farah Hasan, endocrinologist with Advocate Medical Group, said.

Jurrens said that the dogs should be used as a supplement to medical devices for diabetics, emphasizing that the animals should not replace the medical protocol the diabetic’s phyiscian has prescribed to manage the disease.

She also said clients are advised to continue weekly saliva sample testing with the dogs to retain the animal’s sense of that specific person’s blood sugar levels.