For those living with a chronic disease, every new day can bring a new challenge. For those like Chris Gardner, 33, from Swinton, the difficulties of coping with type one diabetes used to be overwhelming.
Chris said: “I was diagnosed ten years ago when I was 23 and I was refused for a full pancreas transplant, owing to other health complications that arose from the disease.
“I was in hospital four or five times a week – I didn't know the meaning of 'home'.”
As Chris's health declined, so too did his options. Finally realising that he may never work again, Chris decided to research the idea of a medical assistance dog, which he thought were only available to people suffering with similar conditions in the United States.
“My wife and I sat down to look into the idea of an assistance dog in the UK and the first charity that came up was Medical Detection Dogs.”
The pioneering charity based in the Great Horwood, Milton Keynes, trains dogs to detect changes in a person's hormone output when they are experiencing - or due to experience - an attack associated with a particular disease.
For people like Chris, the implications behind this research are enormous. A few months after applying to receive an assistance dog, his life took a huge turn for the better.
In March 2015, a sandy-haired Labrador Retriever named Jade arrived in Chris's family home, and instantly started making a huge difference to his daily routine.
After a decade of near-constant hospital care, Jade instantly set to work alerting him to changes in his blood sugar levels that could spark an attack, twenty minutes before any incident is likely to occur.
“Jade's not just helped me, she's given me all my confidence back,” he said. “I've got a five year old son, Jayden, and my wife and I could never really plan anything – all that's changed now.”
Despite this significant step forward for Chris and people like him who have been fortunate enough to be accepted onto the scheme, the science behind Medical Detection Dogs still meets scepticism from experts and public alike.
The charity's CEO, Claire Guest, has been at the forefront of research into disease detection using dogs for over twenty years and in 2003 was the training director of the first programme in the world to train dogs to identify cancer by odour.
She said: “When that first article came out in 2004, it was hugely interesting, but there were a huge amount of stages following that. It is only in the past year that people have taken it seriously as a concept.
“It's really due to the constant message that we have given that the dog does not become the doctor, they just assist the doctor. The message of how this is going to work will take a long time for people to understand.”
For Chris, though, adjusting to life with Jade has only brought one problem: allowing enough time to travel from one place to another.
He said: “You have to put at least two to three hours on your journey when you go out because people stop and ask what Jade does.
“Jayden absolutely loves Jade and it's him who answers proudly: 'This is my daddy's diabetes detection dog!”
Chris is not the only person who has benefited from a remarkable improvement to their daily lives as a result of the charity's assistance dogs programme.
In June 2006 15-year-old Alice Halstead from Embsay, North Yorkshire, awoke one morning feeling dizzy. Despite a trip to the doctor's, she still expected to go to school – until it emerged that she was severely ill with type one diabetes.
Alice said: “At the time of diagnosis, I felt overwhelmed! It was just like being on a roller coaster, emotionally going up and down as I came to terms with all the information that I had to digest and the changes it meant to my everyday life.”
A normal blood sugar might fluctuate between four and seven millimoles, where Alice's varied between 0.5 and 39, leading to frequent loss of consciousness and seizures.
After months in Leeds General Infirmary, Alice was facing the prospect of not only suffering from type one diabetes, but a unique illness that made managing her blood sugar independently nearly impossible.
After taking the decision to undergo a course of unlicensed and highly risky drug therapy, Alice finally caught a break when the treatment proved to be successful as a means to settle some of the more violent attacks – but it was still necessary to monitor her blood sugar every hour throughout the day.
As such, her independence was restricted and the quest for a more normal life led her to the pioneering work of Medical Detection Dogs. After filling in the company's application form and spending a few months on the waiting list, a curly coated Labrador Retriever named Holly arrived to take up the challenge.
Alice said: “When I applied for a Medical Alert Assistance Dog, I always had at the back of my mind whether a dog could actually cope with the fluctuation in my blood sugar levels and the prolonged high and low blood sugars I can have.
“From the very first day Holly arrived, she experienced what life was going to entail living with the girl who had been diagnosed with a one in seven billion condition.”
Now five years into their partnership, Holly has carried out over 4,500 alerts, and can warn Alice of a dangerous blood sugar level up to 40 minutes before it occurs.
Alice said: “I think for us it was just, like – wow! I needed to get used to having her around and she needed to get used to me and my condition, but now I'm completely besotted with her.
Like Chris, Alice often experiences lots of questions about Holly from members of the public. Despite admitting that she can can stubborn from time to time, Alice often hears passers-by commenting on how well trained she is.
“I'm very fortunate to know that I could take her anywhere and she will behave. Never are two days the same with her: she's stubborn and determined, but she's very loving and she always wants to be close to me.”
This is a behavioural trait that Claire Guest knows only too well. She said: “Our dogs are the sorts of dogs that always want to be with their owners. They are required to be very well behaved.
“We have about a two or three year waiting list, but the more funding we have for training, the more we can help.”
After over a decade of world-leading work, the charity is finally gaining ground with its public awareness campaign, and even once-sceptical medical staff are paying attention.
Alice's GP is now used to visits with Holly. Alice said: “He's seen the effect Holly has had. He says I'm a completely different person – he understands the positive impact now, when I come to my check-ups.
“He sits there, talking to me, with one hand stroking Holly. He considers her to be part of my medical team - and she is.”