Tag Archives: diabetes

Medical detection dogs help diabetes patients regulate insulin levels

New research by the University of Bristol in collaboration with Medical Detection Dogs has found that the best trained alert dogs have the potential to vastly improve the quality of life of people living with Type 1 diabetes.

As reported in PLOS One, on average trained dogs alerted their owners to 83 per cent of hypoglycaemic episodes in over 4,000 hypo- and hyper-glycaemic episodes that were examined. A hypoglycaemic episode is where blood sugar drops dangerously low and if left untreated, can lead to unconsciousness or even death.

medical alert assistance dog

Claire Pesterfield holding her dog Magic’s paw. He’s a medical alert assistant dog and has been trained to detect a minute shift in Claire’s blood sugar levels. She thinks he’s alerted and potentially saved her life 4,500 times in the five years they’ve been together. Photo by Trevor Martin

The findings confirm that alert dogs can help Type 1 patients regulate their blood sugars in a non-invasive way and avoid the risks of hypoglycaemic episodes and hyperglycaemia.

Lead author Dr Nicola Rooney from the Bristol Veterinary School, said: “We already know from previous studies that patients’ quality of life is vastly improved by having a medical detection dog. However, to date, evidence has come from small scale studies. Our study provides the first large-scale evaluation of using medical detection dogs to detect hypoglycaemia.”

In this study, researchers from Bristol, assessed the reliability of 27 trained glycaemia alert dogs, whose owners provided six to 12 weeks continual worth of blood records detailing every time the dog was alerted.

Medical Detection Dogs train pet dogs to respond to respond to the odour of human disease and help owners live with life-threatening diseases. Familiar with their owners, dogs are conditioned to respond with alerting behaviours when their owners’ blood sugar levels fall outside a target range.

Encouraged by the alerting behaviour of their pet dog, if such out-of-range (OOR) episodes occur, the patient can take appropriate action, usually by administering insulin or eating to retain the right glucose levels.

Dr Rooney, Teaching Fellow in Animal Welfare and Behaviour, added: “Our research shows a dog’s effectiveness is affected by the individual dog and its connection with its human partner. Since the usage of such dogs is growing, it’s important that any dogs used for these purposes are professionally trained, matched and monitored by professional organisations like Medical Detection Dogs.  It’s also vital that research continues both to assess true efficacy and determine ways to optimise their performance.”

Dr Claire Guest, Chief Executive and co-founder of Medical Detection Dogs, said: “The findings are fantastic news for all those who are living with Type 1 diabetes and other conditions. Medical detection dogs primarily serve patients looking for more effective and independent ways of managing their condition.

“Our dogs also serve the wider medical community by offering proactive solutions that are natural, non-invasive and have been shown to provide countless psychological benefits.

“As our natural companions, and with a highly refined sense of smell, why shouldn’t they be able to detect changes in our personal health?”

Paper:

How effective are trained dogs at alerting their owners to changes in blood glycaemic levels?: variations in performance of  glycaemia alert dogs by Nicola J Rooney, Claire M Guest, Lydia CM. Swanson, Steve V. Morant in PLOS One [open access]

Source:  University of Bristol media release

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New type 1 diabetes therapy shows promise for long-term reversal in both humans, dogs

What if instead of daily insulin injections or wearing pumps, just getting a shot every few months could reverse Type 1 diabetes for you – or your dog?

It might take ushering in healthy pancreatic cells like a Trojan horse.

The Trojan horse, in this case, would be collagen, a protein that the body already makes for building muscles, bones, skin and blood vessels. A collagen formulation mixed with pancreatic cells, developed by Purdue University researchers in collaboration with the Indiana University School of Medicine, is the first minimally invasive therapy to successfully reverse Type 1 diabetes within 24 hours and maintain insulin independence for at least 90 days, a pre-clinical animal study shows.

For diabetic pets, the next step is a pilot clinical study in dogs with naturally occurring Type 1 diabetes, which will be conducted in collaboration with Purdue’s College of Veterinary Medicine.

“We plan to account for differences from mouse to human by helping dogs first. This way, the dogs can inform us on how well the treatment might work in humans,” said Clarissa Hernandez Stephens, first author on the work and a graduate researcher in Purdue’s Weldon School of Biomedical Engineering. Findings appear in early view for a forthcoming issue of the American Journal of Physiology – Endocrinology and Metabolism.

“With giving my dog shots twice a day, I have to constantly be thinking about where I am and when I need to be home. It greatly affects my work and my personal life,” said Jan Goetz, owner of a diabetic dog named Lexi. “Not having to give these shots would mean freedom.”

Type 1 diabetes affects about one in every 100 companion animals in the U.S., including dogs and cats, and approximately 1.25 million American children and adults.

David Taylor, an Indiana resident, has struggled with Type 1 diabetes for almost 50 years.

“A Type 1 diabetes diagnosis was my 18th birthday present, and since that first insulin injection, managing diabetes has been my ‘other’ full time job,” Taylor said. “Treatment methods have improved enormously over 50 years, but they still permit no time off for the patient. Receiving an injection every few months would restore the near-normal life to me that I haven’t had as an adult – and I could retire from that full-time diabetes management job.”

Because diabetes in dogs happens similarly in humans, treatment has so far been largely the same: Both need their glucose to be monitored throughout the day and insulin to be administered after meals.

This also means that dogs and humans could potentially benefit from the same cure: A new set of pancreatic cells to replace the clusters of cells, called islets, that aren’t releasing insulin to monitor blood glucose levels.

Still, 20 years of research and clinical trials hasn’t produced an effective islet transplantation therapy because multiple donors are needed, the current method of delivering islets through the portal vein of the liver is too invasive and the human immune system tends to destroy a large percentage of transplanted islets.

Purdue researchers simply changed how the islets were packaged – first, within a solution containing collagen, and second, as an injection through the skin instead of all the way at the liver, saving patients from a nasty procedure.

“Traditionally, we transplant islets in the liver of the animal and never do it under the skin, in large part because the skin doesn’t have the blood flow that the liver has for transporting insulin released by islets. And there are a lot of immune cells in the skin, so chances of rejection are high,” said Raghu Mirmira, professor of pediatrics and medicine and director of the Diabetes Research Center at the Indiana University School of Medicine.

The team removed the need for transplanting in the liver by thoroughly mixing mouse islets, provided by Mirmira’s lab, with the collagen solution. Upon injection just under the skin, the solution solidifies, the body recognizes the collagen and supplies it with blood flow to exchange insulin and glucose.

“It’s minimally invasive; you don’t have to go to the operating room and have this infusion into the portal vein. It’s as easy as it comes, just like getting a shot,” said Sherry Voytik Harbin, Purdue professor of biomedical engineering and basic medical sciences.

The researchers tested the effects of the solution between mouse twins and non-twins to check for discrepancies. Initial studies showed if the mouse donor were a twin to the recipient, the diabetic mouse could go at least 90 days without needing another shot. If not twins, the mouse would have normal blood sugar levels for at least 40 days. Nearly all transplanted islets survived either scenario, removing the need for multiple donors to compensate for those killed off by the immune system.

As they transition to testing the formulation in naturally diabetic dogs, the researchers will explore the feasibility of transplanting pig islets or stem cells programmed to produce insulin, in hopes that either method will further increase donor availability.

The islet transplantation therapy might also have implications for better treating severe pancreatitis.

Source:  Purdue University media statement

How dogs can sniff out diabetes

A chemical found in our breath could provide a flag to warn of dangerously-low blood sugar levels in patients with type 1 diabetes, according to new research from the University of Cambridge. The finding, published in the journal Diabetes Care, could explain why some dogs can be trained to spot the warning signs in patients.

Claire Pesterfield, a paediatric diabetes specialist nurse at Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust has type 1 diabetes, which requires insulin injections to manage blood sugar levels. She also has a golden Labrador dog that has been trained by the charity Medical Detection Dogs to detect when her blood sugar levels are falling to potentially dangerous levels.

“Low blood sugar is an everyday threat to me and if it falls too low – which it can do quickly – it can be very dangerous,” says Claire. “Magic is incredible – he’s not just a wonderful companion, but he’s my ‘nose’ to warn me if I’m at risk of a hypo. If he smells a hypo coming, he’ll jump up and put his paws on my shoulders to let me know.”

Hypoglycaemia – low blood sugar – can cause problems such as shakiness, disorientation and fatigue; if the patient does not receive a sugar boost in time, it can cause seizures and lead to unconsciousness. In some people with diabetes, these episodes can occur suddenly with little warning.

Given the reports of dogs alerting owners to blood glucose changes, researchers at the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, believed that certain naturally-occurring chemicals in exhaled breath might change when glucose levels were low. In a preliminary study to test this hypothesis, the scientists gradually lowered blood sugar levels under controlled conditions in 8 women, all around their forties, and all with type 1 diabetes. They then used mass spectrometry – which look for chemical signatures – to detect the presence of these chemicals.

The researchers found that levels of the chemical isoprene rose significantly at hypoglycaemia – in some cases almost doubling. They believe that dogs may be sensitive to the presence of isoprene, and suggest that it may be possible to develop new detectors that can identify elevated levels of isoprene in patients at risk.

“Isoprene is one of the commonest natural chemicals that we find in human breath, but we know surprisingly little about where it comes from,” says Dr Mark Evans, Honorary Consultant Physician at Addenbrooke’s Hospital, University of Cambridge. “We suspect it’s a by-product of the production of cholesterol, but it isn’t clear why levels of the chemical rise when patients get very low blood sugar.

“Humans aren’t sensitive to the presence of isoprene, but dogs with their incredible sense of smell, find it easy to identify and can be trained to alert their owners about dangerously low blood sugar levels. It provides a ‘scent’ that could help us develop new tests for detecting hypoglycaemia and reducing the risk of potentially life-threatening complications for patients living with diabetes. It’s our vision that a new breath test could at least partly – but ideally completely – replace the current finger-prick test, which is inconvenient and painful for patients, and relatively expensive to administer.”

The research was funded by the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre with support from the Cambridge NIHR Wellcome Trust Clinical Research Facility.

Source:  University of Cambridge media release

The underlying cause of canine diabetes

In a new effort, researchers from the University of Pennsylvania and Baylor College of Medicine have used advanced imaging technology to fill in details about the underlying cause of canine diabetes, which until now has been little understood. For the first time, they’ve precisely quantified the dramatic loss of insulin-producing beta cells in dogs with the disease and compared it to the loss observed in people with type 1 diabetes.

Diabetic dogs had a sharp loss of insulin-producing beta cells compared to non-diabetic dogs

Diabetic dogs had a sharp loss of insulin-producing beta cells compared to non-diabetic dogs

“The architecture of the canine pancreas has never been studied in the detail that we have done in this paper,” said Rebecka Hess, professor of internal medicine at Penn’s School of Veterinary Medicine and an author on the study.

Despite important differences between the disease in dogs and humans, the study also identified key similarities that suggest investigating diabetes in dogs may yield valuable insights into treating humans.

The research was led by Emily Shields, currently a graduate student in Penn’s Perelman School of Medicine, who completed much of the work as a high school and then college student in labs at Penn and Baylor.

The study was published in PLOS ONE.

Canine diabetes can be managed with insulin, similar to type 1 diabetes in humans. But, unlike the human version of the disease, dogs typically develop diabetes in middle or old age, while people with type 1 diabetes are typically diagnosed during childhood. In addition, while type 1 diabetes is known to be an autoimmune condition, researchers haven’t found conclusive evidence that the same is true in dogs.

To learn more about the factors that contribute to canine diabetes, the researchers made use of a repository of donated tissue samples from dogs — 23 with diabetes and 17 without — who had been treated at Penn Vet’s Ryan Hospital.

The team used robotic microscopes that can rapidly move around a slide taking images of pancreas tissue samples, which were analyzed by computer to determine the contents.

“In a larger view we could look at the entire cross-section of pancreas to determine how many islets there were and how big they were,” Shields said. “Then we could zoom in to differentiate beta cells, which produce insulin, from alpha cells, which produce glucagon.”

They found that beta cells dropped off in dramatic fashion in diabetic dogs, reduced 13-fold compared to non-diabetic animals. They also found that non-diabetic canine islets contained a large percentage of beta cells, comprising about 80 percent of endocrine cells. In contrast, beta cells comprise slightly more than 50 percent of endocrine cells in non-diabetic human islets. The researchers noted that this may mean that dogs need to lose more beta cells before experiencing symptoms of diabetes. The observation could explain why dogs develop a form of diabetes that is similar to type 1 diabetes, but do so later in life, compared to humans.

They also identified features of the islets and pancreatic structures that were different in dogs than in humans.

“In sharp contrast to human diabetes, in which there are a lot of islets still present but none contains insulin, we found in dogs that only a few beta cells were present and the islets were incredibly small,” Kushner said.

While the researchers had hoped to be able to visualize immune cells infiltrating the pancreas and attacking beta cells, they failed to do so.  While other signs point to canine diabetes being an autoimmune condition, this study did not find a “smoking gun.”

Though the work highlights differences between canine and human diabetes, it also points to a number of similarities that distinguish the two from diabetes in rodents, which are often used as models to study the disease.

For example, the scientists observed that dogs’ beta cells were distributed throughout the islets, as beta cells in humans are. In rodents, beta cells are concentrated in the center of the islet.

“Now that we know more about the disease in dogs and in particular how they are similar to humans in ways that rodents are not, it makes them more appealing as a model,” Kushner said.

At Penn, Hess is currently working to look for genetic markers in dogs that heighten a dog’s risk of developing diabetes.

“My hope is that with genetic screening we can eventually identify pre-clinical diabetic dogs, potentially making breeding recommendations that could decrease the incidence and prevalence of the disease in dogs,” Hess said.

Source:  Penn News media release

Cranberries and urinary tract infections

Many holistic veterinarians are now recommending the use of cranberries in the long-term treatment of pets who are susceptible to urinary tract infections, or UTI.

Diabetic dogs, in particular, seem to develop UTI more regularly than the normal dog population.  Spayed females are also more susceptible to infections.

Cranberries

When a dog has a UTI, they often struggle to eliminate urine or, when they do pee, not much comes out.  Sometimes blood is seen in the urine, the urine may smell stronger, or it has a dark colour.  If your dog has a UTI, then seeing your veterinarian for antibiotics is essential.  A urinary tract infection left untreated means your dog is uncomfortable and in pain and if the infection travels to the kidneys, then your dog is in serious trouble.

Cranberries can assist when your dog is being treated for a UTI because cranberries help to acidify the urine which helps to prevent bacteria growth.

But what about prevention?  This is where the cranberries come into their own.  Not only does the cranberry acidify the urine, but studies show that they have the ability to prevent bacteria from sticking to the walls of the bladder and urinary tract and so they minimise the chance of an infection recurring.

Some owners treat their dog with cranberry powder because the juice is tart and unpalatable.  Owners must be careful because lots of cranberry juices are full of sugar (that’s a warning for humans as well as pets).

I’m working on a wheat-free cranberry biscuit recipe now that will feature as the January/February special.  I’ve just perfected my recipe and the latest batch is looking great – with the added benefit of no artificial colours!

Dog peeing

In order to prevent recurring urinary tract infections, it’s also really important to ensure your dog has lots of fresh, clean water to drink and has lots of opportunities to go outside and pee.  For diabetic dogs, care must be given to their daily diet to manage their blood sugars (another reason to watch the sugar content of any cranberry supplements).

Another reason to keep your dog fit and trim

University of Liverpool researchers have found that obese dogs can experience metabolic syndrome, a condition that describes multiple health issues that occur in the body at the same time.  Obese humans suffer from the same syndrome.

The condition occurs when a number of health problems, such as increased blood glucose and increased cholesterol levels, develop together, with the potential to increase the risk of other diseases, such as cardiovascular disease and diabetes.

In a study of 35 obese dogs, 20% had metabolic syndrome.  These dogs had increased blood insulin which suggests that the pancreas is working harder than normal.  Blood adiponectin, a protein produced by fat cells that helps control sugars and fats, was also at lower levels than normal.

The metabolic abnormalities improved when the dogs successfully lost weight.

The research team admits that they have to study the impacts in more detail to understand the health implications of metabolic syndrome.

However, why wait for more studies?  If your dog is overweight we already know that their quality of life improves with weight loss.

Source: University of Liverpool media release