Table 2

HARPdoc: the curriculum

Week 1: how low can you go?
Full-day group programmeIntroduction to the course and goal setting
Education topicsWhat is a hypo?
Consequences of severe hypos.
Model of hypo unawareness.
Novel hypo awareness signsTeaching the body scan.*
Complete individual severe hypo risk assessment.
Modify goal setting based on education.
HomeworkEstimating bg levels; doing a body scan and noting any novel hypo signs.
Week 2: the balancing act
Full-day group programmeEducation topicsHow to anticipate peaks/nadirs of insulin action.
CHO counting and matching.
Modifications for exercise/physical activity.
Behavioural plan
HomeworkEstimating bg levels (as above) and noting insulin/diet/activity (biological factors) and making insulin/food adjustments.
Week 3: thinking traps
Full-day group programme
Patients review answers to A2A questionnaire.
Education topics.Concept of thinking traps.
Pros/cons of each one.
How thinking traps interact with hypo management.
Group discussion about more helpful thoughts.
Strategies to support patients in their social context.
Thinking traps plan.
HomeworkEstimating bg levels (as above) and noting thoughts in response to bg level (psychological factors).
Weeks 4 and 5
One hour each week individual appointments for face-to-face, telephone or internet-based contact with educator.Reviewing patient progress/plans and provide troubleshooting support.
Week 6: keeping on track
Full-day group sessionRevise core education topics with group.
Invitation to bring significant other and Q&A session.
Group discussion on progress made.
Group discussion on future challenges/relapse prevention.
Opportunity for final trouble shooting.
Individual relapse prevention plans.
  • *Teaching patients to scan their body for any subtle cues that may indicate being low.

  • A2A,¬†Attitudes to Awareness (of hypoglycaemia); bg, blood glucose; CHO, carbohydrate; HARPdoc, Hypoglycaemia Awareness Restoration Programme for People with Type 1 Diabetes and Problematic Hypoglycaemia Persisting Despite Optimised Self-care.