Gonder-Frederick Linda A, Grabman Jesse H, Shepard Jaclyn A
Behavioral Medicine Center, University of Virginia, Charlottesville, VA 22908, USA.
Behavioral Medicine Center, University of Virginia, Charlottesville, VA 22908, USA.
Diabetes Res Clin Pract. 2017 Dec;134:121-130. doi: 10.1016/j.diabres.2017.09.009. Epub 2017 Sep 30.
To test the accuracy of Diabetes Alert Dogs (DADs) by comparing recorded alerts to continuous glucose monitoring (CGM) device readings during waking and sleeping hours.
14 individuals (7 adults with type 1 diabetes and 7 youth with type 1 diabetes/parents) who owned DADs for ≥6 mos wore masked CGM devices over a several-week period while recording DAD alerts electronically and in paper diaries.
During waking hours, sensitivity scores across participants were 35.9% for low BG events and 26.2% for high BG events. DAD accuracy was highly variable with 3/14 individual dogs performing statistically higher than chance. Sensitivity scores were lower during sleep hours of the person with diabetes (22.2% for low BG events and 8.4% for high BG events). DAD accuracy during sleeping hours was also highly variable, with 1/11 individual dogs performing statistically better than chance. Rate of change analyses indicated that DADs were responding to absolute BG level, rather than rapid shifts in glucose levels.
In this study the majority of DADs did not demonstrate accurate detection of low and high BG events. However, performance varied greatly across DADs and additional studies are needed to examine factors contributing to this variability. Additionally, more research is needed to investigate the significant gap between the positive experiences and clinical outcomes reported by DAD owners and the mixed research findings on DAD accuracy.
通过比较清醒和睡眠期间糖尿病预警犬(DAD)记录的警报与持续葡萄糖监测(CGM)设备读数,测试糖尿病预警犬的准确性。
14名拥有糖尿病预警犬≥6个月的个体(7名1型糖尿病成年患者和7名1型糖尿病青少年/家长)在数周时间内佩戴隐蔽式CGM设备,同时以电子方式和纸质日记记录糖尿病预警犬的警报。
在清醒时间,参与者对低血糖事件的敏感度评分为35.9%,对高血糖事件的敏感度评分为26.2%。糖尿病预警犬的准确性差异很大,14只犬中有3只在统计学上表现高于随机水平。糖尿病患者睡眠期间的敏感度评分较低(低血糖事件为22.2%,高血糖事件为8.4%)。睡眠期间糖尿病预警犬的准确性也差异很大,11只犬中有1只在统计学上表现优于随机水平。变化率分析表明,糖尿病预警犬对血糖绝对水平做出反应,而非葡萄糖水平的快速变化。
在本研究中,大多数糖尿病预警犬并未准确检测出低血糖和高血糖事件。然而,不同糖尿病预警犬的表现差异很大,需要更多研究来探讨导致这种差异的因素。此外,还需要更多研究来调查糖尿病预警犬主人报告的积极体验与临床结果之间的显著差距,以及关于糖尿病预警犬准确性的混合研究结果。