This year’s Type 2 Virtual Summit featured an informative community Q&A session with Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES. The session focused on addressing the most pressing questions from our community about life with type 2 diabetes (T2D) in 2025.

Dr. Isaacs works at the Cleveland Clinic, a non-profit academic medical center that provides clinical and hospital care. Cleveland Clinic is a leader in medical research, education and health insights. Dr. Isaacs is also a co-host of the Diabetes Dialogue Podcast, where she shares insights on the latest in diabetes therapeutics, technology and real-world perspectives.

If you live with T2D and are looking for answers to questions like:

When does using a continuous glucose monitor (CGM) make sense for me?
Will my insurance cover a CGM?
If I can’t get insurance to cover a CGM, what should I do?
If my T2D treatment isn’t working, should I get screened for T1D?
Is using insulin bad if I have T2D?

Then this session recap is for you!

CGM insurance coverage + type 2 diabetes

During our chat with Dr. Isaacs, we dove into CGM use first—specifically, a community member asked: “When does insurance cover CGMs, and how can they be accessed at a reasonable cost if insurance does not cover them?”

“Most of the time, when someone is taking insulin—whether it’s once-a-day insulin or you’re taking more than that—usually, it’s covered,” Dr. Isaacs answered. “Medicare covers it and many other plans also will.”

About one in four people with T2D take insulin. A small fraction of people with T2D use CGMs—about 12-13% of people living with T2D in 2023 used them. 

Over-the-counter (OTC) CGM availability may help improve access, awareness of the benefits and diabetes support options when insurance doesn’t cover them at the pharmacy. Sometimes, discounts are available when you use OTC options.

“A Libre device has a $75 coupon where you can get a month’s worth of sensors for that amount,” Dr. Isaacs shared. “Many people choose to do that.”

Not all CGM options are created equal. Figuring out CGM insurance coverage can be a bit of a headache when you live with T2D but is still important to pursue first, especially if you take insulin! OTC CGM options are not intended for use in people who take insulin.

“Different insurance plans cover different things, and, with Medicaid, it’s very specific,” Dr. Isaacs said. “For example, in Ohio, where I’m from, our Medicaid actually covers CGMs for any person with diabetes. It doesn’t matter if you’re taking medications or not. It is covered at the pharmacy, but this can vary based on your plan.”

T2D without insulin: over-the-counter CGM options can help

Dexcom Stelo and Abbott Lingo may offer more options for people with T2D who don’t use insulin and are struggling to get CGMs covered by their insurance.

“You don’t need a prescription,” Dr. Isaacs shared. “Any adult could go online and order these. Cost varies depending on whether you decide to get one month or a few months of sensors.”

You can wear a CGM for a month or two to see how it works for you before committing to a long-term subscription. This can help you feel confident in your choice!

If you purchase Stelo directly from the Dexcom Stelo website, a one-time purchase costs $99. This covers a month’s worth of supplies. A subscription will save you 10%, bringing the cost down to $89. If you purchase Lingo directly from the Hello Lingo website, a 4-week plan costs $89. If you subscribe, you will save 5%, bringing the cost down to $84.

“The over-the-counter options do not have alerts for low blood sugars,” Dr. Isaacs said. “So if you use those, it’s really not meant for people taking insulin or other type 2 drugs that could cause low blood sugars.”

Over-the-counter CGMs have fewer features than those you can get through your insurance, which is another good reason to push for coverage through your plan first. If you take insulin, they’re a better option than nothing, but still not medically advised.

“Have I been misdiagnosed with type 2 diabetes?”

Wearing a CGM can help you understand if your diabetes treatment plan isn’t working for you. You’ll have data to back up how you’re feeling! If you’re aligned with your doctor and following their advisory, but your numbers still don’t make sense, it may point to misdiagnosis.

Unfortunately, misdiagnoses are common.

Misdiagnoses can result from biases in healthcare that may stem from someone’s race, age or weight. Type 1 diabetes (T1D) used to be called “juvenile diabetes,” but that doesn’t make sense today. Over 50% of all new cases of T1D occur in adults, regardless of family history. T1D doesn’t exclude!

“One of the ways we know this is when someone isn’t responding to medication,” Dr. Isaacs said. “Maybe you’re on oral medication or non-insulin, and it’s just not responding. We’ll even see some people try to restrict their carbohydrates, adjust their eating and incorporate physical activity and it still isn’t responsive.”

“Other times, we see that someone doesn’t fit the picture of ‘typical’ type 2 diabetes,” Dr. Isaacs shared. “Maybe they don’t have a family history—in some cases, they’re not overweight or obese. Those can be indicators. But the truth is, we should probably do more screening for T1D in general.”

While you can be diagnosed with T1D regardless of family history, having a family history of T1D or other autoimmune conditions does put you at a higher risk.

“My treatment isn’t working! Should I get screened for type 1 diabetes?”

If your T2D treatment isn’t working, there’s no harm in getting screened.

“The way we screen is through a simple lab test to check for autoantibodies,” Dr. Isaacs said. “There are generally four different autoantibodies that we look for.”

Today, you can get screened before the warning signs of T1D even appear! This is a massive advancement over the past decade. 

Depending on the stage of T1D you have when diagnosed, you may qualify for drugs that help delay the onset of T1D, like Tzield, or be able to enroll in groundbreaking clinical trials that offer other T1D treatment solutions. Early detection expands your options!

You can find for T1D screening options through TrialNet, T1D Scout, Sanofi or the ASK Program.

“Is it bad to take insulin if I have type 2 diabetes?”

“The natural progression of T2D is that they might need insulin,” Dr. Isaacs confirmed. “Insulin’s a very effective therapy to reach the goals. Insulin pumps and automated insulin delivery (AID) systems can also be a great option for people with type 2 as well.”

Dr. Isaacs explained that the reason most doctors start people with T2D on non-insulin therapies is the cardiovascular benefits. Many people with T2D start with GLP-1s, SGLT-2 inhibitors or Metformin to manage their diabetes. 

TL;DR

You’re busy—we get it! Here’s the low down on the answers to some of your most frequently asked questions (FAQs) for life with T2D in 2025:

Using a CGM helps anyone managing any type of diabetes make informed treatment decisions.
Insurance coverage varies for CGMs: If you use insulin, your odds of insurance covering it are better but you should still pursue insurance coverage first regardless!
If you can’t get insurance to cover a CGM, see if you need a prior authorization: If that doesn’t work, OTC CGM options are helpful if you don’t use insulin. If you do, they’re better than nothing.
If your T2D treatment plan isn’t working, it’s time to chat with your doctor: Screening for T1D isn’t a bad idea, but sometimes you might need a new medication like insulin—and no, it’s not bad or a failure if you’re on it!

You never have to manage T2D all by yourself. We’re here to help! To get support and make sure you don’t miss future events with experts like Dr. Isaacs, download the Beyond Type 2 community app now.