A young black Lab named Pete sleeps at the feet of Dr.
As a hypoglycemia alert dog, Pete is also part of research Lilly began in June to better understand why dogs are able to sense severe blood sugar events in their owners and to identify the compound or compounds they smell as part of those events.
Hypoglycemia Alert Dogs — A Furry Blood Sugar Testing Back-up System
For years, people with vision and hearing impairments, as well as other disabilities, have benefited from the help and companionship of trained assistance dogs. Only recently, however, have hypoglycemia alert dogs been available to help people with diabetes, typically those with type 1, which is usually diagnosed in children or young adults. These dogs are trained to identify low levels of blood sugar and alert their owners by nudging or making contact with them in some specific way.
This training and application is important for many living with type 1 diabetes, as over time (approximately five years), people can develop "hypoglycemia unawareness," in which the body loses the ability to sense an impending low blood sugar event.[i] This type of event is usually characterized by tremors, sweating, confusion and irritability, feelings that would normally cause someone with diabetes to check their blood sugar. If left unchecked for too long, dangerously low levels of blood sugar can cause seizures, loss of consciousness and in some cases, death.
"When people who have had diabetes for a number of years lose their ability to sense an oncoming low blood sugar event, the consequences can be severe," said Dr. Hardin. "Considering children under the age of 15 are at greatest risk for developing type 1 diabetes, this 'unawareness' is happening in children who are very young. For a caregiver, this is a constant, everyday fear that doesn't go away."
Currently, it is unclear how the dogs are able to sense hypoglycemia in humans, but some think the dogs are reacting to scents created by chemical changes related to low blood sugar.
The Nose Knows —
The ability to smell is based on the number of olfactory cells adapted to receive smell molecules — the more olfactory cells there are, the more acute the sense of smell.[ii] Compared to humans, who have approximately five million olfactory cells, dogs may possess up to 220 million.[iii] That means, depending on the compound being detected, a dog's nose may actually be more than 1,000 times more sensitive than humans.[iv]
For someone with diabetes, the sensitivity of a trained dog's nose can mean peace of mind, especially during the overnight hours, and at its extreme, can be life saving. Lilly Diabetes recently examined this remarkable sense of smell and presented corresponding data at the
The study examined the frequency and severity of hypoglycemic events as well as the emotional response in one person with severe hypoglycemia in the two weeks prior to receiving a trained dog and in the six weeks post-dog placement.[v] Data showed a clear correlation between the number of alerts the dog gave and the number of hypoglycemic states that were detected and thus prevented over the duration of the study.[vi] Ultimately, the dog accurately detected the onset of hypoglycemia and alerted the subject so steps could be taken to restore normal blood sugar levels.[vii]
"We understand some of the biochemical changes which occur with hypoglycemia, but we do not yet have a full picture of the timing of these changes, nor do we understand what exactly the dog is sensing," said Hardin. "The scent seems to be very specific, in fact, dogs are trained to their owner's individual scent. So if we can identify what the dogs smell, it may be possible to expose them to larger quantities of that compound for faster, more efficient training. But, what's exciting still is how that may apply to finding a practical treatment solution for people with diabetes. That's at the heart of everything we do."
Earlier this month, as a result of a Lilly supported Innovation Day for Global Statistical Sciences,
Unique Approach to On the Job Training
While the need for dogs to assist people with diabetes is growing, training a single alert dog can cost up to
This unique arrangement is part of Lilly's commitment to the organization and serving people with diabetes in the local community. Currently, seven employees are trained to work with
However, that can be a challenge, because while dogs in training thrive on routine, Lilly operates a mobile work environment — on any given day, an employee may sit at a different work station among a variety of co-workers. The company has employed this philosophy to promote more active collaboration.
To marry the two, Lilly Diabetes volunteers proactively created an additional level of support so that they can establish routine for the animals and still maintain a productive work environment. Activities include regular in-person and e-mail check-ins so lessons learned can be shared. The group also meets prior to any new dog's arrival to review how to handle difficult situations, tips on handling people with allergies or fear of dogs, and how to maintain the dog in a busy work setting.
"Lilly Diabetes has taken our training a step further to fit the unique needs of their organization," said
About Lilly Diabetes
Lilly has been a global leader in diabetes care since 1923, when we introduced the world's first commercial insulin. Today we work to meet the diverse needs of people with diabetes through research and collaboration, a broad and growing product portfolio and a continued commitment to providing real solutions—from medicines to support programs and more—to make lives better. For more information, visit www.lillydiabetes.com.
[i] "Hypoglycemia Unawareness." Diabetes Self-Management.
[ii] "Olfactory System — Anatomy and Physiology." Macalaster College Extension. http//:www.macalaster.edu. Accessed:
[iii] "The Dog's Sense of Smell." Alabama Cooperative Extension System. June, 2011. http//:www.aces.edu. Accessed:
[iv] Lindsay, SR., Handbook of Applied Dog Behavior And Training, Adaptation and Learning. Vol 1, 2000. p.138.
[v] Hardin, DS., Hillman, D., Cattet, J. "Hypoglycemia Alert Dogs — Innovative Assistance For People with Type 1 Diabetes." Abstract presented at the
[viii] Dogs for Diabetics. Frequently Asked Questions. http//:www.dogs4diabetics.com. Accessed:
[ix] Indiana Canine Assistance Network. Frequently Asked Questions. http//:www.icandogs.org. Accessed:
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