Reliability of Trained Dogs to Alert to Hypoglycemia in Patients With Type 1 Diabetes

Los, Evan; Ramsey, Katrina; Guttmann‐Bauman, Ines; Ahmann, Andrew J.

doi:10.1177/1932296816666537

Cited by 30 publications

(36 citation statements)

References 29 publications

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“…In fact, our results for hypoglycemia sensitivity during waking hours (35.9% across DADs) were near identical to those reported by Los et al in their study comparing DAD alerts to CGM data (36%). 6 Hyperglycemia sensitivity scores for waking hours were lower than those for hypoglycemia. Although these results replicated our previous finding that DAD accuracy is highly variable across individual dogs, 5 in this study fewer DADs (3/14) performed at levels statistically higher than chance during waking hours.…”

Section: Discussionmentioning

confidence: 91%

“…As a comparative analysis (and as done by Los et al, 2016), 6 we graphed the proportion of DAD alerts at each CGM value, and contrasted this with proportions of all CGM readings at these values (Figure 2). As indicated by higher bars on the graph, DADs alerted more frequently during hypo- and hyperglycemia than would be expected by participants’ total proportion of readings in these ranges.…”

Section: Resultsmentioning

confidence: 99%

“…Another recent study tested accuracy in eight trained dogs by comparing owner-recorded alerts to glucose levels recorded using a CGM device with readings masked to participants. 6 The study lasted one week and, during this period, collected a total of 45 hypoglycemic events. Although DADs alerted 3 times more often during hypoglycemia as compared to euglycemia, they alerted in a timely manner to only 36% of events, and showed a high rate of false positives.…”

Section: Introductionmentioning

confidence: 99%

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Diabetes Alert Dogs (DADs): An assessment of accuracy and implications

Gönder-Frederick

Grabman

Shepard

2017

Diabetes Research and Clinical Practice

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Aims To test the accuracy of Diabetes Alert Dogs (DADs) by comparing recorded alerts to continuous glucose monitoring (CGM) device readings during waking and sleeping hours. Methods 14 individuals (7 adults with type 1 diabetes and 7 youth with type 1 diabetes/parents) who owned DADs for ≥ 6 mos wore masked CGM devices over a several-week period while recording DAD alerts electronically and in paper diaries. Results During waking hours, sensitivity scores across participants were 35.9% for low BG events and 26.2% for high BG events. DAD accuracy was highly variable with 3/14 individual dogs performing statistically higher than chance. Sensitivity scores were lower during sleep hours of the person with diabetes (22.2% for low BG events and 8.4% for high BG events). DAD accuracy during sleeping hours was also highly variable, with 1/11 individual dogs performing statistically better than chance. Rate of change analyses indicated that DADs were responding to absolute BG level, rather than rapid shifts in glucose levels. Conclusions In this study the majority of DADs did not demonstrate accurate detection of low and high BG events. However, performance varied greatly across DADs and additional studies are needed to examine factors contributing to this variability. Additionally, more research is needed to investigate the significant gap between the positive experiences and clinical outcomes reported by DAD owners and the mixed research findings on DAD accuracy.

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Section: Discussionmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diabetes Alert Dogs (DADs): An assessment of accuracy and implications

Gönder-Frederick

Grabman

Shepard

2017

Diabetes Research and Clinical Practice

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“…This prompts the patient to test their blood glucose level, and to take appropriate action (e.g., insulin administration or eating) to retain appropriate glucose levels. While some organisations train all dogs to a generic range (see [5]), others train individual dogs to best meet the specific needs of the individual client [6].…”

Section: Introductionmentioning

confidence: 99%

How effective are trained dogs at alerting their owners to changes in blood glycaemic levels?: Variations in performance of glycaemia alert dogs

Rooney

Guest²,

Swanson³

et al. 2019

PLoS ONE

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AimsDomestic dogs are trained to a wide variety of roles including an increasing number of medical assistance tasks. Glycaemia alert dogs are reported to greatly improve the quality of life of owners living with Type 1 diabetes. Research into their value is currently sparse, on small numbers of dogs and provides conflicting results. In this study we assess the reliability of a large number of trained glycaemic alert dogs at responding to hypo- and hyper-glycaemic (referred to as out-of-range, OOR) episodes, and explore factors associated with variations in their performance.MethodsRoutine owner records were used to assess the sensitivity and specificity of each of 27 dogs, trained by a single UK charity during almost 4000 out-of-range episodes. Sensitivity and positive predictive values are compared to demographic factors and instructors’ ratings of the dog, owner and partnership.ResultsDogs varied in their performance, with median sensitivity to out-of-range episodes at 70% (25th percentile = 50, 75th percentile = 95). To hypoglycaemic episodes the median sensitivity was 83% (66–94%) while to hyperglyaemic episodes it was 67% (17–91%). The median positive predictive value (PPV) was 81% (68–94%), i.e. on average 81% of alerts occurred when glucose levels were out of target range. For four dogs, PPV was 100%. Individual characteristics of the dog, the partnership and the household were significantly associated with performance (e.g., whether the dog was previously a pet, when it was trained, whether its partner was an adult or child).ConclusionsThe large sample shows that the individual performance of dogs is variable, but overall their sensitivity and specificity to OOR episodes are better than previous studies suggest. Results show that optimal performance of glycaemic alert dogs depends not only on good initial and ongoing training, but also careful selection of dogs for the conditions in which they will be working.

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“…Although the evidence demonstrating DADs’ ability to accurately detect hypoglycemia is limited and inconclusive, studies indicate that there are positive psychosocial outcomes, including decreased worry [ 49 , 50 ]. The first study to evaluate the objective reliability of DADs in a real-world environment found that despite the 12% positive predictive value, using DADs was feasible and participants were very satisfied with their dog [ 51 ]. One vulnerable population with a long-term health condition that may benefit from AAIs with pet dogs is PLHIV.…”

Section: Introductionmentioning

confidence: 99%

A Web-Based Study of Dog Ownership and Depression Among People Living With HIV

Muldoon¹,

Kuhns²,

Supple³

et al. 2017

JMIR Ment Health

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BackgroundPeople living with human immunodeficiency virus (PLHIV) are approximately twice as likely to be depressed compared with HIV-negative individuals. Depression is consistently associated with low antiretroviral therapy (ART) adherence, an important step within the HIV care continuum related to HIV disease progression and overall health. One factor that may have positive psychosocial benefits and promote ART adherence is dog ownership. Research indicates that dog ownership is associated with lower depression, and initial evidence suggests its positive impact on psychosocial outcomes for PLHIV.ObjectiveThe aim of our study was to expand the existing research by examining the relationship between current dog ownership and depression for a sample of PLHIV while controlling for demographic characteristics and other potential confounders.MethodsParticipants aged 18 years or older and who self-reported an HIV diagnosis were recruited via social media into When Dogs Heal, a cross-sectional Web-based survey to collect data among adult PLHIV. The research visit was conducted via a Web-based survey, and there was no in-person interaction with the participant. Primary outcome measures included demographic questions (age, race, ethnicity, gender, and sexual orientation), pet ownership (type of pet owned and current dog ownership), depression (Center for Epidemiologic Studies Depression Scale, 10 items), and resilience (Resilience Research Centre Adult Resilience Measure, 28 items).ResultsA total of 252 participants were enrolled into the study in January 2016, with a final analytic sample of 199 participants. Mean age was 49 years, 86.4% (172/199) of participants were male, and 80.4% (160/199) were white. Current dog ownership was prevalent among the sample (68.3%, 136/199). Bivariate analysis indicated that there was no significant relationship between depression and demographic characteristics (age, race, ethnicity, gender, and sexual orientation), with P>.05. The multivariate logistic regression, including age, race, ethnicity, gender, resilience, and current dog ownership, was significant, with P<.001. Of the 6 predictor variables, only 2 were statistically significant: dog ownership and resilience. Noncurrent dog owners had 3 times higher odds of depression in comparison with current dog owners: odds ratio 3.01; 95% CI 1.54-6.21.ConclusionsGrowing evidence suggests that dog ownership reduces the likelihood of depression and, therefore, may confer long-term health benefits on PLHIV. Future studies should explore whether dog-specific interventions are a feasible and efficacious intervention to improve outcomes among PLHIV.

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Reliability of Trained Dogs to Alert to Hypoglycemia in Patients With Type 1 Diabetes

Cited by 30 publications

References 29 publications

Diabetes Alert Dogs (DADs): An assessment of accuracy and implications

Diabetes Alert Dogs (DADs): An assessment of accuracy and implications

How effective are trained dogs at alerting their owners to changes in blood glycaemic levels?: Variations in performance of glycaemia alert dogs

A Web-Based Study of Dog Ownership and Depression Among People Living With HIV

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