Since their son, Jack, 3, was diagnosed 17 months ago with Type 1 diabetes, Jaclyn and Daniel Smith have had to adapt to a lot of changes. Tiptoeing into his room with a flashlight throughout the night to prick his finger and test his blood sugar levels while he sleeps tops the list.
But the most unnerving aspect is trying to prevent the unexpected highs and lows of Jack's blood sugar, which can swing wildly, often with no indication from his outward appearance or actions.
Until now, there was little to predict these fluctuations. But research in the past decade has found that dogs can smell changes in blood sugar levels before they become dangerous.
The Smiths hope to buy one of these specially trained dogs to help clue them in and keep Jack safe.
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Researchers have discovered that high and low blood sugar levels give off very distinct scents. Humans, who have around 5 million nose receptors, can't smell them, but dogs, who have close to 250 million nose receptors, can.
"When we go high, we smell very sweet. We smell very fruity. We smell very cotton-candyish," said Dan Warren. He's a diabetic who runs Guardian Angel Service Dogs and Warren Retrievers, two organizations that assist people with invisible disabilities in their quests to purchase service dogs. "Going low, we smell very acetone, almost like fingernail polish remover."
In October, both Warren Retrievers and Guardian Angel Service Dogs (a charitable extension of Warren Retrievers that assists families with fundraising to buy their dogs) won the endorsement of the Juvenile Diabetes Research Foundation.
Warren's Labrador retrievers have been known to pick up abrupt changes in owners' blood sugar levels 20 to 45 minutes before glucometers register them.
"At the very beginning of a fluctuation that occurs, high or low, there's a chemical imbalance emitted or secreted by the body," said Warren. "The dog is actually sensing that chemical imbalance."
Doctors aren't positive what causes Type 1 diabetes, once known as juvenile diabetes. Research links it to possibly a virus and most likely a tie with genetics.
Unlike Type 2 diabetes, which can sometimes be brought on and then managed by diet and exercise, Type 1 sufferers must deliver insulin into their bodies for the rest of their lives to stay alive, no matter how healthy their lifestyle.
The wild fluctuations in blood sugar that occur unexpectedly can have dangerous consequences. Lows can cause coma, seizure and death. Frequent highs can lead to kidney failure, amputations and blindness later in life.
Jack relies on his parents to keep watch of fluctuations in his blood sugar and to administer insulin through a pump several times a day.
Often the fluctuations give no warning.
"Sometimes we'll get some signs. He'll kind of get pale, kind of get a redness to the whites of his eyes," said Jaclyn, a pediatric nurse.
"But then there's been other times that have completely knocked us, which is why we're really excited about this diabetes dog, for those times that come out of left field and don't make any sense."
Diabetic alert dogs are not cheap, costing between $19,000 and $25,000. So far, the Smiths have relied on good friends, businesses, church yard sales and even a celebrity or two to raise the money. "Jeff Gordon signed a crew shirt the other day," said Daniel. "We raffled it off."
They have a little more than $10,000 toward the dog, Charlie.
Once they've raised enough, one of Warren's trainers will fly with their 3 1/2-month-old puppy to the Smiths' home in Pressley Downs to begin more training.
Charlie will be taught to alert Jack and his parents with a nose nudge or a high five when Jack's blood sugar is starting to change. At night, he'll sleep on Jack's bed and alert the people with a bark.
Both parents are looking forward to the day when they can sleep with less worry.
"You'll wake up in the middle of the night and look at the clock and realize it's been three hours, and you get this nervous reaction," said Daniel.
"It's peace of mind," said Warren. "It's having that guardian angel."