Overview Hypoglycemia unawareness is a common — and dangerous — condition that can develop in those with type 1 diabetes. This condition means you don’t experience the symptoms most people do when their blood sugar gets too low. Normal symptoms of low blood sugar include sweating, shaking, or confusion. At very low levels, you may experience seizures, or go into a coma if your blood sugar is too low for too long. One of the solutions for this condition is man’s best friend: a diabetes service dog. Dogs have a naturally heightened sense of smell that makes them excellent hunters. Professional trainers have learned to harness these skills by training dogs to recognize certain smells. These could include the fruity smelling ketones a person’s body produces when they are experiencing a hyperglycemic episode when blood sugar is too high, or the unique scent a person gives off during a hypoglycemic episode when blood sugar is too low. A diabetes service dog isn’t a replacement for checking blood sugar levels. However, it is a safeguard for those who experience episodes low or high blood sugar, especially if they do not have warning symptoms.

Who trains service dogs? There are several service dog-training programs across the country. Examples include the National Institute for Diabetic Alert Dogs (NIDAD) and Diabetic Alert Dog University. These organizations train a dog to recognize the difference between certain scents. This includes the scent a person releases when their blood sugar is high or low. According to Dogs 4 Diabetics, there are two different levels of service dogs for people with diabetes. Medical response dogs for diabetes are trained to respond to signs that an owner may be experiencing low blood sugar levels, once they have become symptomatic. A diabetic alert dog, on the other hand, is trained to recognize changes in a person’s blood chemistry, which often allows the dog to alert the person or the caregivers to take action in the important window of time 15 to 30 minutes before symptoms occur. Dog breeds trained to perform diabetic alert dog duties can include: golden retrievers

Labrador retrievers

mixed sporting dog breeds

poodles If a person has a dog they wish to train to become a diabetes alert dog, they can submit it for testing to determine if the dog has the temperament and scenting ability required. Most service dogs are between 1 and 2 years old when they are placed with their owners according to the NIDAD. Dogs are trained to react in different ways to an owner who is having a high or low blood sugar episode. Examples include: holding a particular toy in their mouth as a signal

jumping on the owner

sitting and staring at the owner

touching the owner with the its nose Dogs may also perform other activities in addition to alerting their owners about changes in blood sugar. These can include: alerting other family members if an owner needs assistance

bringing needed objects, such as medications

retrieving a cell phone for assistance

in some instances, dial 911 using a special device, if assistance is needed Dogs 4 Diabetics, a provider of diabetic service dogs, estimates the cost of breeding, raising, and training a dog that can recognize diabetic emergencies at around $35,000. There are also nonprofit agencies that provide diabetic service dogs at low cost, and sometimes even for free, but their waiting lists tend to be long.

How do you get a service dog? You can contact a professional organization such as Assistance Dogs International, to find out more about programs in your area that may train diabetes service dogs. You may also ask your endocrinologist for recommendations for potential dog-training organizations. You can also contact organizations that train service dogs directly. Many of them have online applications where a person who is interested in obtaining a service dog can begin to find out more. Many organizations will ask for: your medical history

letter(s) of reference, which may be personal or professional

application form with information on your address, age, etc. The selection and match process can vary based on the organization. The selection process can be extensive and often requires that a potential owner meet with a dog several times before the dog is specifically trained to recognize the owner’s specific scent.

What should you consider before getting a service dog? Not all people with diabetes may benefit from, or need, a diabetes service dog. Examples of people who could benefit from service dogs include: those with hypoglycemia unawareness

those who control their blood sugar using an insulin pump or injections

those who experience low blood sugar levels frequently

children who require frequent blood sugar testing at night

college students who are now living away from home and require additional support If you or a loved one do not experience frequent episodes of hypoglycemia or you’re able to control your blood sugar with oral medications, you may not need the added expense and responsibility of a service dog. In terms of expenses, insurance companies may pay for the costs associated with a diabetes service dog. However, their owners are often required to carry health insurance for the dog as well as provide for food and other veterinary expenses associated with caring for the dog. Having a diabetes service dog is an investment in time and funds, and is a relationship that will ideally last at least a decade for the dog and owner.

What are some challenges of having a service dog? Having a service dog is a commitment on the part of the owner to take the time necessary to build a bond with a service dog to ensure they can work well together. A dog may be “working” with its owner, but developing a loving bond is also very important. An owner must also care for their dog by feeding, bathing, exercising, and maintaining regular veterinary appointments. For those who were not able to receive a service dog from insurance coverage, they may also be responsible for significant costs in obtaining the dog as well.