What is HARPdoc?

HARPdoc (Hypoglycaemia Awareness Restoration Programme for People With Type 1 Diabetes and Problematic Hypoglycaemia Persisting Despite Optimised care) is a randomised control trial research study, with four centres across the UK and one in Boston, USA. The study opened for participant recruitment in March 2017 and will run until 2020 (although recruitment of new participants will cease in 2018). The doctor in charge of this study is Professor Stephanie Amiel, diabetes consultant at King’s. The study is funded by the JDRF (Juvenile Diabetes Research Foundation) and is being jointly sponsored by King’s College London and King’s College Hospital NHS Foundation Trust.


The aim of the study is to find an effective way to help people with type 1 diabetes reduce their risk of hypoglycaemia (low blood sugar episodes), particularly those who continue to have problems with hypoglycaemia despite their best efforts at insulin self-management.


Specifically, we want to help people who can’t always tell when their blood sugar is dropping to regain awareness of hypoglycaemia and most importantly reduce the number of times they have hypoglycaemia so severe that it has to be treated by someone else. In the study, we will compare two interventions, both new to the NHS and both short courses, run over six weeks.One course, called Blood Glucose Awareness Training or BGAT for short) teaches new ways for people with diabetes to predict and feel what their blood sugar levels will be. This course has been successful in reducing severe hypoglycaemia in America, where it was designed and in some European countries.


The other course, HARPdoc, is a completely new approach. As well as revising learning about hypoglycaemia and how to avoid it, HARPdoc explores thoughts and beliefs around hypoglycaemia that we have identified as possible barriers to regaining awareness of hypoglycaemia and reducing risk of severe episodes. It uses “talking therapies” to find new ways of thinking and worked very well in an early small test.

The study will try to find out how important such thoughts and beliefs really are in increasing risk of severe hypoglycaemia and whether addressing them helps people lower their risk and stop having hypoglycaemia that affects their quality of life.