San Rafael Guide Dogs washouts find new life detecting low blood-sugar levels in diabetics

This article reprinted from the Marin Independent Journal.

By Richard Halstead

February 3, 2007

Dogs that have washed out of San Rafael's Guide Dogs for the Blind program are finding new employment - saving lives by sniffing out low blood sugar in Type 1 diabetics.

Sometimes referred to as juvenile diabetes because it is frequently diagnosed in childhood, Type 1 diabetes is an autoimmune disease that occurs when the pancreas stops producing insulin. Insulin is a hormone necessary for the body's cells to use glucose, or blood sugar, for energy. Over time, the high blood sugar levels can be toxic to virtually every system of the body.

To prevent this from happening, Type 1 diabetics inject themselves with insulin several times a day. They must be careful, however, not to take too much insulin. If blood glucose levels fall too low, brain damage and death can result. This is a danger particularly at night when the diabetic is sleeping.

That is how Mark Ruefenacht, 45, got the idea of training dogs to detect low blood sugar in diabetics.

Ruefenacht, a Type 1 diabetic since he was 29, injected himself with insulin before going to sleep on a business trip seven years ago, because he had eaten a doughnut and drunk hot chocolate before going to bed. What he forgot to calculate was that he had been physically active that day. As a result, his blood sugar fell dangerously low.

Fortunately for him, a dog he was training for Guide Dogs for the Blind woke him up.

"Otherwise, who knows if I'd be alive today," Ruefenacht said.

Ruefenacht works for Heusser Neweigh, a Concord-based company that supplies measurement instruments to crime labs. He knew that Breathalyzers are able to distinguish between diabetics who are disoriented because of low blood sugar and people who are drunk. Prior to the development of Breathalyzers, hypoglycemic diabetics were sometimes assumed to be drunk and died in jail cells, he said.

"It made me think this was probably something you could train into a dog," Ruefenacht said.

His dogs are trained to pick up the scent that the body emits when its blood sugar level is low, and alert their owners. As it turns out, the scent is similar enough in each person for the dogs to recognize it.

"When the body senses that the blood sugar is falling, it puts out this chemical," Ruenfenacht said. "We actually don't know what the chemical is."

So far, Dogs4Diabetics, the Concord nonprofit that Ruefenacht created in 2004, has provided 10 trained dogs to diabetics and is training another 10 dogs. The organization supplies its dogs only to people with Type 1 diabetes, because the condition is more acute than Type 2 diabetes.

Genetics may play a role in causing Type 1 diabetes, but the disease has no proven cause. Obesity is a known risk factor for Type 2 diabetes.

The International Diabetes Federation estimates that 70,000 children under the age of 15 develop Type 1 diabetes every year, while Type 2 also affects children as young as 8.

A 2001 survey of 5,000 Marin residents over 18 found that 3 percent suffered from either Type 1 or Type 2 diabetes, said Rochelle Ereman, an epidemiologist with the Marin County Department of Health and Human Services.

Dogs4Diabetics gets its dogs from Guide Dogs for the Blind, Ruefenacht said.

"We don't have to raise puppies. We don't have to train a dog how to be a good service dog. All of that is built into them," Ruefenacht said.

There are many reasons why a dog might not be suitable for working with the blind, said Joanne Ritter, director of marketing for Guide Dogs for the Blind.

quot;It requires a lot of focus and a willingness to work and an ability to be easily controlled, and then to sit under a desk for a long period of time quietly," Ritter said. "Not every dog is cut out for it."

Sniffing for low blood sugar is just one of the tasks for which Guide Dogs' canines have been trained. Five dogs - three Labradors and two Portuguese water dogs - participated in a recent study that demonstrated their ability to detect lung cancer in the breath of cancer sufferers with 99 percent accuracy. The study was conducted by the Pine Street Foundation based in San Anselmo.

Canines that have flunked out of the Guide Dog program have also gone on to careers in law enforcement - sussing out bombs, drugs and injured people in need of rescue with their educated schnozzes.

Ruenfenacht and some of his dogs met recently with members of Marin Families of Children with Diabetes, a local support group for parents. Interest in the dogs is high. Lisa Shenson, the group's founder, said approximately 80 people attended the meeting.

Ruefenacht said the blood sugar of juvenile diabetics rises and falls rapidly because of their small body mass. Children are also more active than adults. As result, they are more likely to become hypoglycemic, he said.

The parents of Type 1 diabetics often monitor their child's blood sugar several times during the night for this reason, Shenson said. That is why many parents are eager to get one of Ruefenacht's dogs, she said.

One of those parents is Jennifer Gammon of San Anselmo, whose 8-year-old daughter, Hannah, was diagnosed with Type 1 diabetes when she was 2.

Gammon and her husband usually check Hannah's blood sugar at 11 p.m. before they go to bed and then again at 2 a.m. There are rare occasions, however, when they sleep through the alarm and wake up in a panic.

"We will have the security of having the dog sleep in her room and knowing that - heaven forbid if she were to go low - the dog would notify us. I think it would put our mind at ease," Gammon said.

TO LEARN MORE
• Dogs4Diabetics: www.Dogs4Diabetics.com.
• Marin Families of Children with Diabetes: Call Lisa Shenson at 328-3452. The group meets quarterly.

This article reprinted from The Marin Independent Journal.