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Background: Hypoglycemia is a common and often serious implication in patients with type I diabetes. The risk of low blood sugar while on insulin therapy can be detrimental, especially since most type I diabetics are diagnosed in childhood. Objective: The purpose of this research is to examine the reliability of specially trained dogs to alert type I diabetic patients who are experiencing a hypoglycemic episode. Study design: The study design employed was a systematic literature review, utilizing studies that address the research question “Are service dogs reliable in detecting hypoglycemic events in patients with type I diabetes?” Methods: Several databases were searched, including PubMed, Google Scholar, and EBSCO host. Search terms included were “Diabetic alert dogs”, “Diabetic service dogs”, and “Detecting hypoglycemia”. Articles were searched for and reviewed independently by three researchers against inclusion of “Type I diabetes” and exclusion criteria of “comorbidities” and “pharmacological management” to narrow down the search. All articles were assessed for quality and then qualitatively analyzed. Results: Six studies were included in the review and each revealed different responses to dog breeds, level of dog training and experience, comparison methods such as continuous glucose monitoring and symptom diaries and the psychosocial effect the diabetic alert dogs (DADs) had on the patients. The majority of the results from the six studies showed the data was inconclusive, needing more research to ultimately decide whether alert dogs can be used to accurately detect hypoglycemic episodes. Conclusion: Given the clinical implications for patients with T1DM, more research is needed to fully understand DADs ability to monitor blood glucose levels. In a real-world scenario, relying DIABETIC ALERT DOGS TO DETECT HYPOGLYCEMIA v on DADs is far more complex than the studies have shown. From this research, the recommendation is that DADs are beneficial as an adjunct therapy in addition to current glucose monitoring for Type 1 diabetic patients.