Last year I had to decide whether to replace one of my diabetes management plan’s key components. Though equipment substitutions and upgrades are a typical part of living with type 1 diabetes, this felt different.
I wasn’t researching insulin pumps or checking whether my insurance covered switching to the latest continuous glucose monitor (CGM). I was determining whether I wanted to apply for my second diabetic alert dog (DAD).
I partnered with Cody, a gregarious golden retriever, in 2006. Besides being handsome, charismatic, and bursting with joie de vivre, Cody had learned to use his incredible canine sense of smell to detect and alert me to shifts in my blood sugar.
A gentle nose bump on my hand or leg would inform me that my glucose levels were racing up or down.
Like most DADs, he was trained to recognize numbers between 80 and 130 milligrams per deciliter (mg/dL) as safe. He would let me know 10 to 20 minutes before I started to swing to either side of that.
When I applied to have him become my partner, I lived alone and didn’t have a CGM to warn me of impending blood sugar shifts.
I only knew what my numbers were when I checked them on a glucometer with a finger prick, and even then had no reliable way of telling if they were stable or in flux. I was terrified of going to sleep one night and not waking up in time to treat a sharp blood sugar drop.
Cody slept by the side of my bed and would wake me in the middle of the night before I started to experience the incapacitating symptoms associated with acute hypoglycemia.
He’d nudge me in the car if my sugars started to go up or down while I was driving and accompanied me everywhere, politely folding all 83 pounds of himself up under school desks and restaurant tables.
I had never felt safer, and that confidence led to tangible improvements in my health.
Taking an aggressive approach with insulin therapy can feel risky. High blood sugars are uncomfortable and eventually lead to a host of medical problems like major organ failure, but low blood sugar levels can be debilitating in as few as 20 minutes.
Once I trusted Cody to catch impending drops, I was willing to strive for tighter control. My hemoglobin A1C test results dropped from 9.3 percent to 7 percent within half a year of having him — a sign that longer term, the effects of my diabetes were milder.
Before being partnered with Cody, I endured 11 laser eye surgeries for diabetic retinopathy, damage to blood vessels in the eye that results from high blood sugar. With Cody, I didn’t need any surgery.
And the social and emotional benefits were even more dramatic.
Having a gorgeous, exquisitely well-mannered dog accompany me throughout my day obliterated the isolation of living with an otherwise mostly invisible condition.
Everywhere we went, people wanted to know what he did and how he did it.
And though there were days when I wished I could get more than 10 steps without stopping to chat with someone, I couldn’t help but enjoy how warmly people responded to him — and how I suddenly had endless opportunities to share the daily realities of living with type 1 diabetes.
I would tell them how frightening and dangerous it was to never know when the next blood glucose drop was coming. I would tell them about the amazing nose all canines have and how they use their sense of smell to make sense of the world.
I’d tell them about positive reinforcement training techniques and how alerting me became a game for Cody, one he was eager to play and for which he’d be rewarded with small treats. A strong bond has been tied to
And I’d tell people how much happier and safer he made me feel.
When Cody passed away after 12 incredible years as my constant companion, I was devastated.
Over that decade, I’d gotten married and acquired a CGM — I was no longer alone in an apartment without any way to discern my blood sugar trends, so I told everyone who asked that I wasn’t planning on applying for another DAD.
I was still volunteering for the organization that helped train and certify Cody, though. In addition to my own experience, I’d seen the dogs that Early Alert Canines placed transform the lives of individuals and families with young diabetic children.
There was no question in my mind that I would continue fostering as a volunteer.
My family and I enjoyed every one of the seven dogs we fostered last year, but we only fell in love with one of them. Jada, a demure black Labrador with long lashes and a soulful brown-eyed stare, officially became my second DAD last February.
Though I had convinced myself, after losing Cody, that I no longer needed a DAD, it took only a few months living with Jada to realize how wrong I’d been.
Though my CGM can now predict impending shifts in my blood sugar levels, Jada beats its warnings by 3 to 15 minutes every time, allowing me to treat rises and drops well before becoming symptomatic.
Her dainty paw taps are infinitely more endearing than the loud, flat beeps of the CGM and, unlike my CGM, she never malfunctions or gets confused when I take acetaminophen.
Jada encourages my regime of daily walks and keeps me connected both to the community of fellow DAD owners at Early Alert Canines and to a stream of friendly strangers who inquire after her when we’re out in public.
Perhaps most critically, as long as she’s with me, I never feel alone with the exhausting burden of chronic illness.
I’m grateful for every resource I have to help me manage life with type 1 diabetes. But I only love one of them.
Devin Grayson is an award-winning fiction writer best known for her work in comics and graphic novels. A type 1 diabetic since the age of 14, she is also a devoted client of and volunteer for the Bay Area nonprofit Early Alert Canines, which trains and provides medical alert assistance dogs to insulin-dependent diabetics.