Doggone Diabetes

School of Nursing project enlists canine companions to combat prevalent metabolic disease

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Diabetes was the seventh leading cause of death in the United States in 2017, based on the 83,564 death certificates in which diabetes was listed as the underlying cause of death.

According to the Centers for Disease Control (CDC) National Diabetes Statistics Report for 2020, cases of diabetes have risen to an estimated 34.2 million. An estimated 26.8 million people (10.2% of the population) had diagnosed diabetes, and approximately 7.3 million more people have diabetes but have not yet been diagnosed.

Diabetes mellitus, commonly known as diabetes, impacts all social, economic and ethnic backgrounds. Diabetes is a metabolic disease that causes high blood sugar (glucose). The spike in blood glucose is the result of the body’s inability to create or effectively use its own insulin, which is produced by islets of Langerhans found in the pancreas. Insulin helps regulate blood glucose levels — providing energy to body cells and tissues. Many people with type 2 diabetes can control their blood glucose by following a healthy meal plan and a program of regular physical activity, losing excess weight and taking medications.

Auburn University’s School of Nursing (AUSON) is conducting a pilot research study, Doggone Diabetes, to increase physical activity among people living with diabetes or prediabetes through a walking program implemented with therapy dogs. The Caring Foundation of Blue Cross and Blue Shield of Alabama has provided funds for the School to support the study, which is expected to continue for six months.

“The American Diabetes Association recommends that people living with diabetes mellitus and prediabetes should participate in 150 minutes of moderate to vigorous exercise each week spread over at least three days,” said Dr. Caralise Hunt, associate dean of academic affairs at AUSON, and principal investigator of the study. “Current literature indicates that many people do not achieve that goal. The Centers for Disease Control reports that only 52% of Americans get the recommended amount of aerobic activity per week,” Hunt added.

The research project, led by Hunt, includes Drs. Morgan Yordy, Stuart Pope (AUSON) and Chih-Hsuan Wang (College of Education, Educational Foundations, Leadership and Technology department) as co-investigators. According to Hunt, Yordy and Pope will be involved in all aspects of the study such as planning, recruitment, enrollment, walking with dogs and participants and evaluation of data.

Hunt has worked in diabetes management throughout her career. “The numbers for Alabama are even worse,” Hunt added. “Approximately 610,458 people in Alabama (15.2% of the adult population) have diabetes. In 2017, the American Diabetes Association estimated that 1,334,000 people in Alabama (37% of the adult population) had prediabetes.”

Hunt believes that this study is important to the citizens of Alabama and beyond as the rates of type 2 diabetes and obesity continue to steadily increase. Pope, Yordy, and Hunt began a conversation about how people enjoy being around the dogs and wanted to investigate whether the dogs would be a motivator for people with prediabetes and diabetes to increase their physical activity. The research hypothesizes that incorporating animal-assisted therapy dogs into a walking program will encourage increased physical activity.

“Our primary goals for this pilot study are to implement a walking program and increase and sustain physical activity (walking) in study participants to 150 minutes per week.

“The plan is to recruit adults 19 and older living with prediabetes or diabetes from the campus and the Auburn-Opelika community. We will use a crossover design so that for one month, participants will walk with the dogs from AUSON animal-assisted therapy, and the following month they will walk with the group without dogs. This will allow us to study the effect of this therapy.

“If the intervention is effective, we would like to continue and expand the program. Our primary study outcome is minutes of physical activity per week. Secondary outcomes include evaluations of hemoglobin A1C, weight, BMI, waist circumference, blood pressure and heart rate,” Hunt said.

“This study is very important in light of the [COVID-19] pandemic. People with diabetes face a higher chance of experiencing serious complications from the virus. The risk of developing severe sickness and complications from COVID-19 is lower if diabetes is well-managed. When people with diabetes do not manage their condition and experience fluctuating blood glucose values, they are generally at risk for several diabetes-related complications,” Hunt added.