Inquiring about about diabetic trained dog

meanmaryjean, DNP, RN · May 16, 2015

We actually know a kid who has one. But your friend sounds more like he needs some intensive diabetes education (and perhaps some counseling to come to terms with his diagnosis) first. He sounds poorly controlled and a service dog cannot replace knowledge and optimal self-management. Does he check glucometry 4-6 times/ day? Does he religiously count and cover carbs? Dos he record every glucose level and see his endocrinologist regularly? Because until he does all of these things for at LEAST a year - he will not qualify for one of these (very, VERY expen$ive) service animals.

My 15-year-old grandson has diabetes. He does karate, is in marching band and has a side job cutting grass for his dad's rental properties all summer. He is also (and I say this as someone who loves him dearly) not the sharpest tool in the box. He is able to self-manage and so can your friend.

andrea4_2005 · May 16, 2015

Yes he's finally caring about himself now, back then no. He counts carbs all the time. An checks everything as far as labels and when eating. Ummm blood sugar is checked four times a day and as needed the only time it is really dropping is at night and it is dangerously low (47/48 two nights a go) and that is a big concern when he lives alone. He won't go to counseling. He is very very educated on his diabetes. I've encouraged him to switch to my endocrinologist. I realize service dogs are pricey. Money isn't an issue here. Would you have any information or links? His diabetes his controlled just with exercise an activity it plumits fast and others ARENT educated and maybe not need a service dog maybe a training program for dogs in general that someone might know of??? I'm just trying to do research for him. He's a man he won't do it :)

KatieMI, BSN, MSN, RN · May 16, 2015

Patient who is in denial, who "fights" the diagnosis and himself and doesn't master basic monitoring yet for all probabilities will not benefit from service animal. Dogs sniff for certain molecules named "olfactors of stress", produced by quick upsurge of adrenalin caused by acute stress of hypoglycemia, and smell of a-oxybutirate and similar ketones as sign of ketoacidosis. It may be useful for patients who either do not feel hypoglycemia and/or ketones surging, or those who cannot express what they feel like very young children. Using service animal doesn't mean that the dog will come and say in human voice "hi, buddy, your sugar goes down again, here is your sugar pill and meter, use it now and again in 15 min." It means that the patient and those around need to correlate between the animal behavior, patient's perceptions and blood sugar measuresments and then act accordingly.

I agree that patient in question needs a lot of education, and even more of support. Did you think about insulin pump?

andrea4_2005 · May 16, 2015

Patient who is in denial, who "fights" the diagnosis and himself and doesn't master basic monitoring yet for all probabilities will not benefit from service animal. Dogs sniff for certain molecules named "olfactors of stress", produced by quick upsurge of adrenalin caused by acute stress of hypoglycemia, and smell of a-oxybutirate and similar ketones as sign of ketoacidosis. It may be useful for patients who either do not feel hypoglycemia and/or ketones surging, or those who cannot express what they feel like very young children. Using service animal doesn't mean that the dog will come and say in human voice "hi, buddy, your sugar goes down again, here is your sugar pill and meter, use it now and again in 15 min." It means that the patient and those around need to correlate between the animal behavior, patient's perceptions and blood sugar measuresments and then act accordingly.
I agree that patient in question needs a lot of education, and even more of support. Did you think about insulin pump?

Im looking for information or links to just simply research those kind of those items. I should've rephrased my wording, he is controlled more so now. Then he once was 5 years ago. He cannot help that his blood sugar plumits so fast with any physical activity and makes him tired I know there are resources out there,didn't know if anybody on here knew of training programs that we could send one of the dogs through to better assist him. For instance the other night while he was asleep his blood sugar dropped to 47 and his dog was asleep next to him and the breed is Weimaraner and he kept pawing/tugging at his arm until he woke up and checked his sugar. Thank you so much for al the input :)

andrea4_2005 · May 16, 2015

He's had a it of education and has taken the time to educate. I'm a nurse and he's educated me even more and I'm very thankful for it. I am going to talk to him once again about the pump. Sadly, his family hasn't been very supportive an that as we all know as nurses is very difficult

KatieMI, BSN, MSN, RN · May 16, 2015

AFAIK, you cannot send any animal of your own to be trained, you need to accept the one you are given by the program.

(I was researching the field for my own needs a few years ago, and that looked like an universal rule. In support group I participate, some families would like to use allergen sniffing animals for children, and I'd heard quite a few refusing it because they had to accept a dog or a mini piggy instead of training their own).

jamisaurus · May 16, 2015

It's called have a snack before you work out and check your sugar more often. Plenty of adults and even children manage their diabetes correctly on their own, a grown man can do it too without needing a dog. Save the dogs for people who really need them.

andrea4_2005 · May 16, 2015

Thank you! you KatieMI. is AFAIK, what I can look up ?

andrea4_2005 · May 16, 2015

If only just having the many snacks that he does eat, carbs, that he already does try at the age of 27 would work for him before these activities would work. Then obviously I wouldn't be asking for others input on this topic. He needs a dog in case he where to PASS OUT or come close to that to ALERT him hey get your butt up! from out of the bed, or stop the lawn mower go check sugar now! Unfortunately there are so many people out in the community that are very uneducated and if he had a trained animal he could enjoy the things he once did like you and I do and someone wouldn't be stabbing him and potentially put him into a diabetic coma/seizure d/t giving him his Humalog. He's the one that is educated, it's the community that isn't. so if he was to hit the floor d/t hypoglycemia happening so fast someone else might not know what to do. I just wanted information on a program for service animals. Like I mentioned I seen not to long ago on Facebook where these animals can sense like the lady above had commented certain changes in the body. let me see if I can find the video on facebook

KatieMI, BSN, MSN, RN · May 16, 2015

AFAIK =As Far As I Know

Here is something for you to start from

FAQ :: Dogs4Diabetics

But, as it was mentioned already, brittle diabetes is manageable without training animal, and even without anything save for an 'ol good meter and lots of stripes. You really need someone to work with long and hard so the patient could understand what exactly is going on and manage his condition and his life.

EllieMD · May 16, 2015

I'm not a nurse but I'm a physician, I am 31 years old and I have been living with type 1 for 30 years. I use a pump and CGM and I am extremely athletic. I have a few comments here.

He sounds like the perfect candidate for a continuous glucose monitor (CGM). I use the dexcom which is pretty widely regarded as the best. The cost would be significantly less than a diabetes service dog. Something like 98% of type 1s can get them covered by insurance. I pay a $25 a month copay for sensors. It alarms when blood sugar goes above or below a certain level which the patient sets. I keep mine at 60 and 200 but it is the patient's choice. The previous generations of CGMs were less accurate (though I still found great success with them) but the most recent dexcom algorithm is excellent and nearly as accurate as glucose meters in comparison to lab results. You can easily find youtube videos of the insertion, just search "dexcom g4."

The dexcom also allows you (or anyone he authorizes) to monitor his blood sugars from an iphone using the share feature. I don't have this newest model but apparently people love it. You can check out the "dexcom" and "CGM in the cloud" groups on facebook.

Additionally, the information provided by a CGM will help him to adjust insulin doses to avoid drops during exercise. He may do a lot better on a pump though for the varying basal rates. It also allows you to set a temp basal (so decrease basal to a percent of the normal dose) during exercise and afterwards to prevent hypoglycemia since you are only using fast acting insulin. The evidence is pretty conclusive that CGM reduces the risk of severe hypoglycemia significantly.

Good luck!