Beyond education: A Hypoglycaemia Awareness Restoration Programme for people with type 1 diabetes and problematic hypoglycaemia persisting despite optimised care

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What is HARPdoc?

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HARPdoc is intended to help people with type 1 diabetes reduce their risk of severe hypoglycaemia particularly when those problems persist despite otherwise optimised insulin self-management. HARPdoc is an adjunct to conventional strategies that are known to minimise hypoglycaemia risk and works alongside, not instead of, structured education in flexible insulin self-management and diabetes technologies. Specifically, HARPdoc may help people who can’t always tell when their blood sugar is dropping to regain awareness of hypoglycaemia and who need to reduce the number of times they have hypoglycaemia so severe that it has to be treated by someone else where such problems have persisted despite otherwise optimised diabetes self-care. 

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What does HARPdoc do that is different?

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HARPdoc is a facilitated course that uniquely addresses how people think about their hypoglycaemia and its avoidance. In a recent trial, HARPdoc helped people recover a degree of hypoglycaemia awareness and reduce their experience of severe episodes. It also helped improve mental health, with reduced diabetes distress, anxiety and depression - all of which are higher in people with treatment-resistant hypoglycaemia. 

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How does HARPdoc work?

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HARPdoc uses psychological theory to address unhelpful health beliefs that act as barriers to hypoglycaemia avoidance and recovery of awareness. It is delivered by specially-trained diabetes educators to small groups, on-line or face-to-face, over six weeks, with re-enforcement at 3 and 6 months. The educators are supported by the HARPdoc psychology team. People participating in HARPdoc remain under the care of their usual diabetes care provider.    

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