Who Gets Diabetes Tech and Who Doesn’t

Access is often framed as a positive—the more people have it, the better. But when it comes to diabetes tech, that idea has become more nuanced. Devices like CGMs are increasingly being used by people without diabetes, often for reasons that aren’t life-sustaining. At the same time, many people living with diabetes are still being denied access to the very tools they need to survive. So who gets it, and who doesn’t? The reality of diabetes tech access is more complicated than it appears.

Technically speaking

Chances are you already know how essential diabetes tech can be, but in case you’re new here—here’s a quick primer. The most common tools include continuous glucose monitors (CGMs), insulin pumps and automated insulin delivery (AID) systems. Alongside these, there are apps (and even games) designed to support day-to-day management.

Diabetes tech has come a long way, having become a standard of care, not a luxury. Still, not everyone gets access to the information they need to make informed decisions about which tools are right for them.

Access denied?

People from lower-income backgrounds, those with public or no insurance and individuals in certain geographic regions are significantly less likely to be prescribed or use devices like CGMs and insulin pumps. Disparities persist across race and ethnicity as well. In healthcare settings, both conscious and unconscious bias can shape who is seen as a “good candidate” for diabetes tech, often through assumptions about adherence, cost or someone’s ability to manage devices.

Conscious bias involves beliefs a provider is aware of, while unconscious bias works more subtly—guiding decisions without realization often rooted in stereotypes or past experiences. In diabetes care, this can affect who gets offered tools, education or advanced tech. Providers might assume a patient won’t be “adherent,” can’t afford devices, or won’t be able to manage something like a CGM or insulin pump—especially for those from marginalized communities. Even when unintentional, these assumptions can gatekeep access to life-changing care and reinforce existing disparities.

Barriers to better care

On top of that, barriers like insurance restrictions and minimal provider education play a part in access limitations. The result: many people aren’t getting the tools that could help them most. One example is Kalex Willzy, a UK-based content creator living with type 1 diabetes. He wasn’t aware he could use or even request a CGM until recently, despite being diagnosed a decade ago. “I thought if I really needed something, doctors would tell me,” he explained. “Then someone online was like, ‘Why haven’t you got one? You’re entitled to it.’ At my next appointment I asked, and the nurse literally left the room and came back with one. No discussion.”

The gap is loud

A recent survey on digital technology use, conducted with adults with type 1 and type 2 diabetes at the diabetes clinic of Grady Memorial Hospital in Atlanta, Georgia, highlights a major gap in access. Among those who had never used a CGM (44%), the most common reason wasn’t cost or preference—it was simply that they’d never been offered one (64%). Other respondents pointed to cost as a barrier (12%).

The ADA (American Diabetes Association) also underscores how systemic these gaps are:

• If you’re on Medicaid, you’re much less likely to get a CGM—especially if you’re a person of color. 
• CGM access is lowest in the Southeast, where poverty rates are higher and diabetes mortality exceeds 20%. 
• Older adults with diabetes are less likely to be prescribed CGMs than younger people.

What needs to change

When diabetes tech isn’t equally available, the impact shows up fast; not just in the data, but in real life. Missed access can mean more complications, more ER visits and higher long-term costs. It can also add a mental load, leading to burnout and a feeling of being left behind.

The good news? Momentum is building—and the push for more equitable care is getting louder. But what can you do right now? Start with self-advocacy. Learn what to say when a provider tells you “no” and how to speak up at the pharmacy if you’re hitting barriers with insulin or supplies. Small moments of advocacy can lead to real change.

Want to dig deeper into health equity in diabetes care? Explore Beyond Type 1’s Beyond Barriers program and check out the resource directory to find organizations supporting underserved communities.