ETSU doctor studies reliability of diabetes alert dogs

Dr. Evan Los with one of his research participants (Sophia) and her diabetes dog (St. Nick) (Source: East Tennessee State University)

JOHNSON CITY – Dr. Evan Los chose to become a pediatric endocrinologist because he wants to make sure kids with diabetes get the best care possible. With that in mind, Los spent the past couple of years designing and conducting a study that looked into the reliability of diabetes alert dogs.

“I wanted to make sure kids and families affected by diabetes had the best information possible,” said Los, an assistant professor in the East Tennessee State University Quillen College of Medicine’s Department of Pediatrics as well as a practicing physician with Mountain States Health Alliance. “I was trying to answer the question, ‘Are diabetes dogs really doing what patients think they are doing?’”

Diabetes alert dogs are service animals trained to alert their owners in advance of incidents of high or low blood sugar before those levels become dangerous. Los specifically studied the dogs’ abilities to detect low blood sugar, or hypoglycemia, in individuals with type 1 diabetes.

“What we found is, yes, dogs can do this, but they are missing it a lot, too,” he said.

In studying eight patients with diabetes alert dogs, Los found the dogs do have success in detecting low blood sugar, but missed a low blood sugar event more than half the time and also alerted owners when their blood sugar was not low. Additionally, when the dogs did alert, they were typically slower than continuous glucose monitors (CGMs), which are devices approved by the Food and Drug Administration (FDA) and used to alert individuals with diabetes of high and low blood sugar. 

 The dogs also have more variables impacting their abilities to detect and alert hypoglycemia, Los said, noting a dog’s need to eat, use the bathroom and sleep as examples.

 The study found that the dog users were very satisfied and largely confident in their dog’s ability to detect hypoglycemia. “They are overconfident in the dogs’ abilities,” Los said. “This study shows we shouldn’t be putting all of our faith in them. There is already an FDA-approved technological device that is doing a better job, so if you have to choose between the device and the dog, I would recommend choosing the device.”

But that doesn’t mean the dog isn’t worthwhile, Los pointed out. “There is probably a very real psychological benefit to having the dog. The animal could shift the negative feelings about having diabetes and serve as a positive association with the disease,” he said. “If life with a diabetes dog makes living with diabetes better, then by all means, get the dog. Just know they are not going to pick up all low blood sugars.”

Los presented his research earlier this year at a meeting of the American Diabetes Association and his paper on the study was published recently in the Journal of Diabetes Science & Technology.

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