Dogs4Diabetics: Service Dogs Alert for Low Blood Sugar

Founder Mark Ruefenacht, a diabetic, pioneered the training for detecting hypoglycemia.


Dizziness. A pounding heart and a racing pulse. Sweating. These are symptoms of severe hypoglycemia (low blood sugar), and for the estimated 3 million Americans living with Type 1 diabetes, preventing it from happening is a life-or-death priority. Unless you check your blood sugar level and take something to raise it, you’re at risk of lapsing into a coma in less than an hour.

Obviously, that’s a lot of stress to live with. But with dogs trained to detect the dreaded sugar low, people with diabetes have an ever-ready, always-reliable ally in managing this disease. Hypoglycemia alert dogs have their best friends’ backs, using their amazing sense of smell to sniff out low blood sugar –- and to warn them (or, if the diabetics are children, their parents) well before it reaches that critical low point.

So, to the list of astonishing things dogs do for human health — lowering blood pressure, reducing stress, detecting cancer — add sniffing out low blood sugar in diabetics. It’s time for an appreciation of these astonishing dogs, who give their people the confidence needed to face everyday challenges most of us don’t think twice about. Driving long distances, for instance, can be hugely stressful for a diabetic, but with a medical-alert dog along for the ride, it’s a different story.

No one appreciates this more than Dogs4Diabetics founder Mark Ruefenacht, who lived in fear for years. But having diabetes didn’t stop him from becoming one of the country’s top forensics technical experts. In his downtime, the lifelong dog lover volunteered as a puppy raiser for Guide Dogs for the Blind, bringing up 20 puppies who would later undergo training as assistance dogs.

As a volunteer group leader, Mark often traveled with dogs-in-training to help prepare them for various situations like crowded airports. In 1999, Mark brought a black Lab named Benton on a business trip to New York City, where he had a hypoglycemic episode at his hotel and Benton was very insistent in helping him get up.

The experience of having his life saved by a pup made Mark wonder how dogs could help diabetics. From that “aha!” moment came his Dogs4Diabetics nonprofit. In the German language of Mark’s Swiss ancestors, his last name means “alert in the night.” He feels privileged to work at a calling that seems fated from birth.

Today, a black beauty named Danielle is Mark’s guardian angel. Here’s how she and her canine colleagues work: When she scents chemical changes in Mark’s breath and sweat, she alerts him by taking the bright-yellow bringsel attached to her collar and holding it patiently in her mouth like a flag until he acknowledges her.

If a minute passes and she goes unnoticed or ignored, the dog doesn’t give up; she’ll nudge him with her snout, and in true “Lassie, get help” spirit, she won’t hesitate to seek out someone else whenever necessary. Hypoglycemia cannot be detected by the human nose, but incredibly, trained dogs can pick up a sugar low from as far away as 20 feet.

The dogs at Dogs4Diabetics come from Guide Dogs for the Blind and Canine Companions for Independence. After 18 months of training, dozens of dogs don’t make the cut; the dealbreaker might be a fear of escalators. Historically, career-change dogs have been adopted out as pets to families on a long waiting list. But advanced training isn’t necessary in a pet dog, who never gets to use it. “We’re taking all that training and building on it, so the effort wasn’t wasted,” Mark says.

D4D dogs are in no way also-rans — in fact, the quirk that disqualifies them from guide work often indicates a great talent for alerting. Take Armstrong, one of the guide Labs Mark raised from puppyhood. “He was assigned to a blind person, but he was returned after a couple of days because he rearranged her shoes, and you can’t do that to a blind person,” he says. However, Armstrong’s playful spirit — his favorite reward was a game of tug — turned out to be an asset. He was Mark’s own medical-alert dog, beloved friend, and the handsome poster boy of D4D until he sadly passed away in February of aggressive nasal cancer.

When dogs arrive at Dogs4Diabetics’ Nylabone Training Center in California, they do about four months of post-graduate study. Developed by Mark, the regimen incorporates elements of clicker, search-and-rescue, and scent-detection training. “It’s all positive-reinforcement, reward-based training,” he emphasizes.

Dogs go through scent-discrimination trials — picture an obstacle course of scents, including human perspiration from actual diabetics plus a range of deliberately distracting smells, from mouthwatering (steak) to aversive (eucalyptus oil). Each time dogs recognize the smell of a sugar low, they get praise, then a treat.

The dogs are trained to detect sweat, but they work off of breath. “Molecularly they are the same components, but with sweat there’s a 15-minute delay,” Mark explains. When a lifestyle match is made (high-energy humans are paired with high-energy dogs, for example), clients come to the training center for a 16-weekend course in handling their new best friend.

By equipping talented animals for a lifetime of service, Mark says he’s achieved his life’s goal of giving back. “I’m not particularly religious,” he concludes, “but I do believe in living a good life so I can get to Labrador heaven!”

A dog saved his life once — now he’s helping save dogs as well as his fellow diabetics. “By taking career-change Guide Dogs and repurposing them, we’re actually promoting shelter-dog adoption, because we’re saying your local animal shelter is the best place to go for a family pet.”

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5 thoughts on “Dogs4Diabetics: Service Dogs Alert for Low Blood Sugar”

  1. I desperately need to find myself a dog like these. I have been a Type 1 diabetic for 29 years and the past five years my health has declined to the point that my children were having to take care of me…….I am a single mom and in a few years my youngest will graduate high school…….it is not right for me to think that they will stay to care for me when they need to go to college and become their own person. I have no idea even where to begin. I am not even sure if I live around any place that trains these amazing animals……..can anyone point me in the right direction???

    1. Hi Angelina,

      Sorry to hear you’re going through this. It looks like you can contact Dogs 4 Diabetics here:
      Even if you’re not in their area, they may have suggestions for organizations local to you.

  2. I have 2 bichon frise that are now 14yrs. old and 1 has been detecting my low blood sugar for a long time and my other 1 joined in on it. This will happen at night when I’m sleeping and he(Riley) wakes my husband up to help me then goes back to sleep and my other 1(Buddy) will stay with me till I’m out of danger. I’m a type 1 brittle diabetic since I was 8yrs. old and I am 66 now, thanks to my family and that includes my furbabies. These dogs were never trained they did it all by themselves. I’m holding my breath and hoping I can find a another one and hope it will do the same thing. What breed or mix breed would you suggest I look for? I was thinking of a mini goldendoodle or beagle what do think? These dogs that help are God’s angels on earth! Thanks for your help.

  3. A. DeeAnna Russell

    In the last year I have developed hypoglycemia. I have numerous knots on my head to prove my point, as well as my boss has video footage of giving myself a black eye hitting my register then going backwards and hitting the counter behind me leaving sore knots on my head. At first, my symptoms were sweating and shaking. Now, I go straight to dizziness and the awakard feeling that comes with it. Next thing, I wake up. I decided to look into a K-9 after reading such success stories.

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