Doctor Says No to Diabetes Tech? Here’s How to Advocate for Access

Continuous glucose monitors (CGMs), insulin pumps and automated insulin delivery systems have changed what’s possible in diabetes management. Research consistently shows they improve blood sugar control, reduce hypoglycemia and lower diabetes distress. The American Diabetes Association recommends diabetes technology for all people with diabetes based on shared decision-making and individual preference.

So why are some people still being told they don’t need it?

Studies have found that healthcare providers often act as gatekeepers to diabetes technology, and that gatekeeping isn’t distributed evenly. Research from the Gatekeeper Study found that healthcare provider bias in recommending technology based on insurance was common and increased with years in practice. 

A qualitative study of Black and Hispanic young adults with type 1 diabetes found that many had never been offered technology despite having lived with diabetes for years. When they were, healthcare providers often made the decision for them rather than engaging in shared decision-making.

If you’ve asked about diabetes technology and gotten pushback, you’re not imagining it. Here are some of the most common things healthcare providers say—and what you can say back.

“Your A1C needs to be better before we can consider a pump or CGM.”

This is one of the most common gatekeeping lines, and it gets the logic backward. CGMs and pumps are tools to help improve blood sugars, not rewards for already having it. Research has shown that starting technology earlier leads to better outcomes, not worse. The ADA Standards of Care recommend CGM use from the outset of a diabetes diagnosis that requires insulin management, non-insulin treatment that may cause hypoglycemia or on any diabetes treatment where a CGM would be helpful. 

If your numbers aren’t where you want them, that’s an argument for technology, not against it.

What you can say: “I’d like to use a CGM to help me get my numbers where we both want them. Can we talk about how to make that happen?”

“This device is too complicated for you.”

Research has documented that healthcare providers are more likely to describe technology as “too complex” for people of color and people on public insurance—even when the person has specifically asked about it. A Diabetes Care study found that healthcare providers “discouraged and blocked” the use of technology, citing complexity, despite the person’s own request. This isn’t a clinical assessment. 

It’s a bias-driven assumption about who can handle what.

What you can say: “I’m asking because I want to learn. Can you walk me through how it works so I can decide for myself?”

“Your insurance probably won’t cover it.”

This one sounds practical, but it often shuts the conversation down before it starts. The Gatekeeper Study found that healthcare providers who had been practicing longer were more biased against recommending technology for people on public insurance—possibly because they remembered a time when coverage was harder to get. But coverage has expanded significantly. Medicare covers CGMs for people on insulin therapy, and many state Medicaid plans cover both CGMs and insulin pumps. 

Your healthcare provider may be operating on outdated assumptions.

What you can say: “Can we check my specific plan before we rule it out? I’d like to at least try.”

“Let’s focus on the basics first.”

This framing positions technology as an advanced extra rather than a standard part of diabetes care. The ADA disagrees. Their Standards of Care state that CGM should be considered for anyone newly diagnosed or living with diabetes who are on insulin therapy, non-insulin treatment that may cause hypoglycemia or on any diabetes treatment where a CGM would be helpful. “The basics” and technology aren’t competing, for many people, technology is what makes the basics manageable.

A CGM doesn’t replace carb counting or dose adjustments. It gives you the information to do them better.

What you can say: “I think a CGM could actually help me with the basics. Can we talk about it as part of my plan, not something separate?”

“You’ve never mentioned wanting this before.”

Research shows that many Black and Latinx people with type 1 diabetes reported never being offered technology by any healthcare provider across years of care. If your healthcare provider never brought it up, that’s not a reason to delay now that you’re asking. 

The fact that you’re bringing it up is the conversation your healthcare provider should have started.

What you can say: “I’m bringing it up now. Can we talk about whether this could be a good fit for me?”

What to do if your healthcare provider still says no when you ask for diabetes tech

You have options. 

• Ask your healthcare provider to document their refusal and reasoning in your chart. Request a referral to an endocrinologist or a certified diabetes care and education specialist who has more experience with technology. You are allowed to switch healthcare providers.
• Contact your insurance company directly to ask about coverage and eligibility. 

Diabetes technology isn’t a luxury. It’s a tool, and the research says it should be available to everyone who could benefit from it, not just the people a healthcare provider assumes are ready. 

Join the conversation on our community app to share your story and get tips from other people living with type 1 diabetes who know what it’s like to advocate for access to diabetes technology.