# What Is the Role of Diabetic Alert Dogs in Glycemic Monitoring for Individuals with Type 1 Diabetes? A Scoping Review

## TL;DR

This review explores how diabetic alert dogs help monitor blood sugar in people with type 1 diabetes, finding they can detect both high and low levels.

## Contribution

The study systematically maps current evidence on diabetic alert dogs' role in glycemic monitoring and identifies research gaps.

## Key findings

- Most studies found diabetic alert dogs can detect both hypoglycemia and hyperglycemia.
- Sensitivity for hypoglycemia detection was higher than for hyperglycemia.
- Half of the studies reported improved safety, independence, and quality of life with diabetic alert dogs.

## Abstract

Background/Objectives: Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition that requires continuous glycemic monitoring to prevent acute and long-term complications. In recent years, Diabetic Alert Dogs (DADs) have been increasingly used as an adjunctive strategy to assist individuals with T1DM by alerting glycemic fluctuations through olfactory detection of physiological changes. Despite growing interest, the available evidence remains heterogeneous and fragmented. Methods: Therefore, this scoping review was conducted to address the following research question: “What evidence is available regarding the relationship between Diabetic Alert Dogs (DADs) and glycemic monitoring in individuals with T1DM?”, conducted in accordance with the Joanna Briggs Institute methodology and reported following the PRISMA Extension for Scoping Reviews. Results: Searches were performed in PubMed, Scopus, and Web of Science without time restrictions. After duplicate removal (n = 485), 2379 records were screened, of which 24 articles underwent full-text assessment and 10 studies met the predefined inclusion criteria. Regarding glycemic alteration detection, most studies (7/10) reported that DADs could identify both hypoglycemic and hyperglycemic episodes, while the remaining studies focused exclusively on hypoglycemia detection. Sensitivity values were consistently higher for hypoglycemia than for hyperglycemia, and none reported false alert rates exceeding 20%. In addition to glycemic alert performance, improvements in perceived safety, independence, and quality of life were described in half of the included studies (5/10). Conclusions: By systematically mapping the characteristics, outcomes, and methodological approaches of studies involving DADs, this scoping review provides an overview of current evidence and identifies key knowledge gaps in training protocols, outcome standardization, and performance reporting.