New festival guide supports hybrid closed-loop insulin pump users amidst unpredictable routines

A newly published crib sheet developed by Lesley Mills offers crucial guidance for healthcare professionals assisting people with type 1 diabetes using hybrid closed-loop insulin systems at festivals and large events, addressing unique challenges posed by active environments.

A new crib sheet has been published to help healthcare professionals support people with type 1 diabetes who use hybrid closed-loop insulin pumps at festivals and other large events. The guide was developed by Lesley Mills, a consultant nurse at the Diabetes Centre at North Cheshire and Mersey NHS Foundation Trust, drawing on her experience as both a diabetes specialist and a volunteer festival nurse.

Hybrid closed-loop systems combine an insulin pump with a continuous glucose monitor to adjust insulin delivery automatically, although users still need to manage meals, exercise and some settings themselves, according to Diabetes UK and DigiBete. Those systems are designed to reduce day-to-day burden and improve glucose control, but they still require careful support when routines are disrupted.

That is the problem the new festival guide is aiming to address. Festivals often involve long walks, hours of dancing, standing for extended periods, irregular meals and alcohol, all of which can lower insulin needs. The crib sheet warns that increased insulin sensitivity can last for up to 24 hours, raising the risk of delayed and overnight hypoglycaemia.

The guide sets out key questions for clinicians to ask users of hybrid closed-loop pumps and includes practical advice on hypoglycaemia, hyperglycaemia and blood ketones. It is also intended to help volunteers and other healthcare professionals understand exercise functions on the devices and recognise pump-related problems quickly, as event medicine teams increasingly encounter people relying on diabetes technology in crowded, high-activity settings.