Kathy Allbright felt her life slowing down.

After years of long hikes by herself and exercising vigorously without any assistance, her type 1 diabetes was finally starting to limit her activities. It reached a point, Kathy says, that “it felt a little paralyzing.”

Kathy has a condition common among type 1 diabetics: hypoglycemic unawareness. That’s when a person can’t feel a rapid drop in blood sugar until it’s too late—until he or she is overcome by dizziness, stomach pains, confusion, or even a blackout or seizure. Because Kathy loves exercise—hiking, swimming, and cycling—she’s prone to severe blood sugar drops, which can cause terrible physical reactions. Her condition left her feeling less and less excited about doing the things she loved.

Then, one day, Kathy was over at a friend’s house, and a car pulled up to the curb. A woman came out with a black Labrador. Kathy, “a sucker for black labs,” started to pet the dog, but instead of wagging its tail happily, the dog just stared at her intensely. It made a strange motion, jumping into the air and back down, and then kept staring.

“Are you diabetic?” the dog’s owner asked. Kathy said she was and the woman told her that her blood sugar was dropping. “My dog is trained to detect dropping blood sugar.” Although skeptical, Kathy went inside and tested her blood sugar. And sure enough, it was at about 40 mg/dl. (Normal is in the 80 to 100 mg/dl range.)

The lab was a graduate of Dogs4Diabetics— a nonprofit based out of Concord, Calif., that trains dogs to help diabetics manage their condition. Kathy immediately applied for their placement program and soon after was teamed up with Odetta, a loveable Labrador Retriever. That was about a year ago—a year, Kathy says, that she's been at her healthiest.

Dogs vs. Machines

Most diabetics live a yo-yo lifestyle; they’ll have low blood sugar, then drink some fruit juice to compensate. An hour later they’ll be running high and have to take insulin to counteract the juice. Then, their blood sugar will drop again. It turns into a repetitive cycle pretty fast. “With the dog, I walk an even line,” said Kathy. “I don’t experience severe lows, so I don’t have to drink a ton of juice, which causes a spike that requires insulin to compensate. I just stay in the middle.”

There are, of course, medical devices to monitor your blood sugar. Most diabetics monitor their glucose levels using blood glucose meters, which measure glucose levels in a small sample of blood placed on a test strip. Kathy still uses a glucose meter to test her levels multiple times a day, especially after Odetta gives her an alert.

For continuous monitoring, some type 1 diabetics use an additional device called a continuous glucose monitor (CGM). CGMs connect to a diabetic’s insulin pump, signalling an alarm when blood sugar changes quickly in either direction. CGMs are useful; without one, many diabetics would have to test their blood sugar levels all day long.

However, as Kathy explained, these devices often give a delayed response. By the time they go off, you are likely to already be well below a normal blood sugar level and could be experiencing painful and even dangerous symptoms. But Odetta—and other dogs like her—are so in tune with their owners’ bodies that they know when blood sugar starts to drop. “I rarely experience low blood sugar anymore,” Kathy told Healthline. “Odetta alerts me well before I ever get to that point. If I’m asleep and my blood sugar drops, she’ll wake me up. She’ll alert me if I’m driving or when I’m at swim practice. Even being 50 feet away in other rooms, she’ll know and come and tell me.”

It's a Chemical Thing

Most people have heard of—and many even know—dogs trained to help the blind, deaf, or those with physical disabilities. But dogs trained to act as medical assistants to type 1 diabetics were unheard of until just a few years ago.

In 2004, Mark Ruefenacht, a former forensic scientist and part-time guide-dog trainer, was woken from a low blood sugar-induced seizure by a dog he was training at the time. Ruefenacht, a diabetic, forgot to check his blood sugar before going to sleep one night. In the middle of the night, the puppy he was training noticed something was wrong and determinedly woke Ruefenacht up. Confused and feeling sick, Ruefenacht got himself some sugary snacks and eventually felt better. The puppy had spared Ruefenacht an emergency room visit.

Ruefenacht had a hunch that a dog could be trained to smell chemical imbalances in a diabetic. After five years worth of tests, he pinpointed what he believes to be a scent common and specific to type 1 diabetics experiencing low blood sugar. Ruefenacht founded Dogs4Diabetics where he and his volunteers retrain dropouts from the Guide Dogs for the Blind school in San Rafael, Calif., (and other schools) for diabetic alert work. Guide dog standards for the blind and deaf are incredibly high, and those who don't make the grade are still very talented. Their mild shortcomings are not a problem in their gig as a diabetic service dogs.

To this date, Dogs4Diabetics has paired about eighty diabetic service dogs with type 1 diabetics. Kathy and Odetta are one of those pairings.

Miracle Dogs

To Kathy, Odetta is a miracle. Odetta loves to play, but is always on alert. If she's running on the beach and Kathy's blood sugar is dropping, Odetta will stop playing and run over to warn Kathy. Once Kathy's stable, Odetta will go back to having fun. And Odetta is sort of a miracle in the science community as well. Although owners like Kathy will attest to the fact that their dogs are more than 90 percent accurate in detecting dropping blood sugar, researchers still haven’t quite figured out how these dogs could possibly know.

Odetta is so good at detecting low blood sugar that she sometimes alerts other diabetics in the room, just as that stranger’s dog had done for Kathy.

On a recent airplane ride, Odetta grabbed with her mouth the special black cloth strap (called a “bringsel”) that hangs from around her neck, and nudged Kathy—her signal that something was off with Kathy’s blood sugar. Kathy’s blood sugar was fine, but Odetta wouldn’t give up. She started to alert with more urgency, even standing up and walking in the plane aisle to get Kathy’s attention. Something was wrong, so Kathy asked the man sitting next to her if he was a diabetic, and sure enough, he was—and his blood sugar was dropping.  

Beyond the obvious benefits of having a diabetes service dog—having a friend, companion, and lifesaver—there are intangible benefits too. For Kathy, having Odetta as a teammate has turned her condition from “a negative disease that's difficult to manage into something positive.”

There’s a loving, supportive community built around these service dogs—a group of people committed to proactively taking control of their diabetes by living the healthiest lifestyle possible..

“I feel great,” Kathy said. “That’s a very different situation for me than a few years ago. It feels great to not have to do it alone."