Diabetes sniffer dogs? ‘Scent’ of hypos could aid development of new tests

cjb250 — Mon, 27 Jun 2016 08:28:55 +0000

Claire Pesterfield, a paediatric diabetes specialist nurse at Addenbrooke’s Hospital, Cambridge ̽��ֱ�� 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, ̽��ֱ�� 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.

̽��ֱ��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, ̽��ֱ�� 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.”

̽��ֱ��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.

Reference
Neupane, S et al. Exhaled Breath Isoprene rises during Hypoglycemia in Type 1 Diabetes. Diabetes Care; 21 June 2016; DOI: 10.2337/dc16-0461

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 ̽��ֱ�� of Cambridge. ̽��ֱ��finding, published in the journal Diabetes Care, could explain why some dogs can be trained to spot the warning signs in patients.

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

Claire Pesterfield

Blood sugar sniffer dogs? ‘Scent’ of hypos could aid development of new tests

̽��ֱ�� of Cambridge

Claire Pesterfield and Magic

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

Yes

Licence type:

Attribution

Artificial pancreas promise for common diabetes complication

gm349 — Fri, 15 Apr 2011 11:26:10 +0000

Hypoglycaemia (or a ‘hypo’) occurs when the level of glucose in the blood falls too low. If left untreated the person having a hypo can eventually become unconscious after experiencing warning signs as the body tries to raise the blood glucose level. These unpleasant signs often include feeling shaky, sweating, tingling in the lips, heart pounding, and irritability. In extreme cases hypoglycaemia can lead to coma and brain damage, and can sometimes prove fatal.

̽��ֱ��‘artificial pancreas’ or closed-loop insulin delivery system automatically manages a person’s diabetes. ̽��ֱ��device regulates blood glucose levels by releasing insulin when alerted to high levels of glucose, and withholding it when levels are low. Currently people with Type 1 diabetes have to either inject insulin several times a day or wear an insulin pump² which releases the hormone via a cannula inserted under the skin.

̽��ֱ�� of Cambridge researcher Dr Roman Hovorka led two studies to evaluate the performance of the artificial pancreas in 10 men and 14 women, aged 18 to 65, who had used an insulin pump for at least three months.

̽��ֱ��first study monitored 12 participants overnight after consuming a medium-sized meal (60 g carbohydrate) at 7pm. In the second study, the other 12 participants were monitored overnight after consuming a larger meal (100 g carbohydrate) accompanied by alcohol at 8.30pm.

̽��ֱ��studies showed a 22 per cent improvement in the time participants kept their blood glucose levels in a safe range, halving the time they spent with low blood glucose levels and reducing the risk of both short term and long term complications.

Dr Hovorka said: “Hypoglycaemia remains a major challenge, especially during the night, so it’s encouraging to see such promising results from our trial using commercially available devices.

“ ̽��ֱ��study is a stepping stone to testing the artificial pancreas at home and suggests that the artificial pancreas may be suitable in adults as well as in children and adolescents we found previously.”

Diabetes UK Director of Research Dr Iain Frame said: “Although early days, this exciting area of research is a fantastic example of how existing technologies, in this case, insulin pumps and continuous glucose monitors, can be adapted and developed. ̽��ֱ��improvements in glucose control overnight using this new technology are impressive and it is good to see this work develop with the addition of testing the effects following a meal with some wine.

“We now need to see an extension of this study, one which tests larger numbers of people, and then take it out of the hospital and in to the home setting.”

̽��ֱ��research was published in the British Medical Journal today, 15 April.

Cambridge research funded by the health charity Diabetes UK has for the first time successfully demonstrated the potential of an ‘artificial pancreas’ in preventing night-time hypoglycaemia in adults with Type 1 diabetes.

Hypoglycaemia remains a major challenge, especially during the night, so it’s encouraging to see such promising results from our trial using commercially available devices.

Dr Roman Hovorka

Diabetes UK

Artificial pancreas: 1. Glucose levels monitored continuously 2. Required insulin dose calculated 3. Insulin does delivered automatically

This work is licensed under a Creative Commons Licence. If you use this content on your site please link back to this page.

Yes

̽��ֱ�� of Cambridge - hypoglycaemia

Diabetes sniffer dogs? ‘Scent’ of hypos could aid development of new tests

Blood sugar sniffer dogs? ‘Scent’ of hypos could aid development of new tests

Artificial pancreas promise for common diabetes complication