{"id":238640,"date":"2025-12-18T04:15:15","date_gmt":"2025-12-18T04:15:15","guid":{"rendered":"https:\/\/www.europesays.com\/ie\/238640\/"},"modified":"2025-12-18T04:15:15","modified_gmt":"2025-12-18T04:15:15","slug":"dr-isaacs-answers-your-insulin-cgm-misdiagnosis-questions","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/ie\/238640\/","title":{"rendered":"Dr. Isaacs Answers Your Insulin, CGM + Misdiagnosis Questions"},"content":{"rendered":"<p>This year\u2019s Type 2 Virtual Summit featured an informative community Q&amp;A session with <a href=\"https:\/\/www.linkedin.com\/in\/diana-isaacs-pharmd-bcps-bcacp-bc-adm-cdces-45803426\/\" rel=\"nofollow noopener\" target=\"_blank\">Diana Isaacs<\/a>, 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.<\/p>\n<p>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 <a href=\"https:\/\/www.hcplive.com\/view\/diabetes-dialogue-2026-american-diabetes-association-standards-of-care\" rel=\"nofollow noopener\" target=\"_blank\">Diabetes Dialogue Podcast<\/a>, where she shares insights on the latest in diabetes therapeutics, technology and real-world perspectives.<\/p>\n<p><b>If you live with T2D and are looking for answers to questions like:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\">When does using a continuous glucose monitor (CGM) make sense for me?<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">Will my insurance cover a CGM?<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">If I can\u2019t get insurance to cover a CGM, what should I do?<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">If my T2D treatment isn\u2019t working, should I get screened for T1D?<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">Is using insulin bad if I have T2D?<\/li>\n<\/ul>\n<p>Then this session recap is for you!<\/p>\n<p>CGM insurance coverage + type 2 diabetes<\/p>\n<p>During our chat with Dr. Isaacs, we dove into CGM use first\u2014specifically, a community member asked: \u201cWhen does insurance cover CGMs, and how can they be accessed at a reasonable cost if insurance does not cover them?\u201d<\/p>\n<p>\u201cMost of the time, when someone is taking insulin\u2014whether it\u2019s once-a-day insulin or you\u2019re taking more than that\u2014usually, it\u2019s covered,\u201d Dr. Isaacs answered. \u201c<a href=\"https:\/\/beyondtype1.org\/does-medicare-cover-cgms\/\" rel=\"nofollow noopener\" target=\"_blank\">Medicare<\/a> covers it and many other plans also will.\u201d<\/p>\n<p>About <a href=\"https:\/\/www.diabetes.org.uk\/about-diabetes\/looking-after-diabetes\/treatments\/insulin\/type-2-diabetes\" rel=\"nofollow noopener\" target=\"_blank\">one in four people<\/a> with T2D take insulin. A small fraction of people with T2D use CGMs\u2014about <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12007415\/#:~:text=Although%20recent%20reports%20indicate%20that,care%20and%20patient%20outcomes%20globally.\" rel=\"nofollow noopener\" target=\"_blank\">12-13%<\/a> of people living with T2D in 2023 used them.\u00a0<\/p>\n<p>Over-the-counter (OTC) CGM availability may help improve access, awareness of the benefits and diabetes support options when insurance doesn\u2019t cover them at the pharmacy. Sometimes, discounts are available when you use OTC options.<\/p>\n<p>\u201c<a href=\"https:\/\/beyondtype1.org\/abbott-gets-fda-clearance-for-two-over-the-counter-cgms\/\" rel=\"nofollow noopener\" target=\"_blank\">A Libre device<\/a> has a $75 coupon where you can get a month\u2019s worth of sensors for that amount,\u201d Dr. Isaacs shared. \u201cMany people choose to do that.\u201d<\/p>\n<p>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.<\/p>\n<p>\u201cDifferent insurance plans cover different things, and, with <a href=\"https:\/\/beyondtype1.org\/public-health-emergency-medicaid\/\" rel=\"nofollow noopener\" target=\"_blank\">Medicaid<\/a>, it\u2019s very specific,\u201d Dr. Isaacs said. \u201cFor example, in Ohio, where I\u2019m from, our Medicaid actually covers CGMs for any person with diabetes. It doesn\u2019t matter if you\u2019re taking medications or not. It is covered at the pharmacy, but this can vary based on your plan.\u201d<\/p>\n<p>T2D without insulin: over-the-counter CGM options can help<\/p>\n<p><a href=\"https:\/\/beyondtype1.org\/stelo-becomes-the-first-over-the-counter-glucose-biosensor-in-the-u-s\/\" rel=\"nofollow noopener\" target=\"_blank\">Dexcom Stelo<\/a> and Abbott Lingo may offer more options for people with T2D who don\u2019t use insulin and are struggling to get CGMs covered by their insurance.<\/p>\n<p>\u201cYou don\u2019t need a prescription,\u201d Dr. Isaacs shared. \u201cAny adult could go online and order these. Cost varies depending on whether you decide to get one month or a few months of sensors.\u201d<\/p>\n<p>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!<\/p>\n<p>If you purchase <a href=\"https:\/\/www.stelo.com\/en-us\" rel=\"nofollow noopener\" target=\"_blank\">Stelo<\/a> directly from the Dexcom Stelo website, a one-time purchase costs $99. This covers a month\u2019s worth of supplies. A subscription will save you 10%, bringing the cost down to $89. If you purchase <a href=\"https:\/\/www.hellolingo.com\/\" rel=\"nofollow noopener\" target=\"_blank\">Lingo<\/a> 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.<\/p>\n<p>\u201cThe over-the-counter options do not have alerts for low blood sugars,\u201d Dr. Isaacs said. \u201cSo if you use those, it\u2019s really not meant for people taking insulin or other type 2 drugs that could cause low blood sugars.\u201d<\/p>\n<p>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\u2019re a better option than nothing, but still not medically advised.<\/p>\n<p>\u201cHave I been misdiagnosed with type 2 diabetes?\u201d<\/p>\n<p>Wearing a CGM can help you understand if your diabetes treatment plan isn\u2019t working for you. You\u2019ll have data to back up how you\u2019re feeling! If you\u2019re aligned with your doctor and following their advisory, but your numbers still don\u2019t make sense, it may point to misdiagnosis.<\/p>\n<p>Unfortunately, <a href=\"https:\/\/www.verywellhealth.com\/diabetes-misdiagnosis-6745378\" rel=\"nofollow noopener\" target=\"_blank\">misdiagnoses are common<\/a>.<\/p>\n<p>Misdiagnoses can result from biases in healthcare that may stem from someone\u2019s race, age or weight. Type 1 diabetes (T1D) used to be called \u201cjuvenile diabetes,\u201d but that doesn\u2019t make sense today. <a href=\"https:\/\/www.thelancet.com\/journals\/landia\/article\/PIIS2213-8587(17)30362-5\/fulltext#:~:text=58%25%20(749\/1286),were%20aged%2031%E2%80%9360%20years.&amp;text=decades%20of%20life-,Cases%20of%20type%201%20diabetes%20were%20distributed%20across%20all%20ages,p%3C0%C2%B70001).\" rel=\"nofollow noopener\" target=\"_blank\">Over 50% of all new cases of T1D occur in adults<\/a>, regardless of family history. T1D doesn\u2019t exclude!<\/p>\n<p>\u201cOne of the ways we know this is when someone isn\u2019t responding to medication,\u201d Dr. Isaacs said. \u201cMaybe you\u2019re on <a href=\"https:\/\/beyondtype1.org\/history-medications-t2d\/\" rel=\"nofollow noopener\" target=\"_blank\">oral medication<\/a> or non-insulin, and it\u2019s just not responding. We\u2019ll even see some people try to restrict their carbohydrates, adjust their eating and incorporate physical activity and it still isn\u2019t responsive.\u201d<\/p>\n<p>\u201cOther times, we see that someone doesn\u2019t fit the picture of \u2018typical\u2019 type 2 diabetes,\u201d Dr. Isaacs shared. \u201cMaybe they don\u2019t have a family history\u2014in some cases, they\u2019re not overweight or obese. Those can be indicators. But the truth is, we should probably do more screening for T1D in general.\u201d<\/p>\n<p>While you can be diagnosed with T1D regardless of family history, having a family history of T1D or other autoimmune conditions <a href=\"https:\/\/pro.campus.sanofi\/t1d\/articles\/etiology-and-risk-factors-for-autoimmune-type-1-diabetes\" rel=\"nofollow noopener\" target=\"_blank\">does put you at a higher risk<\/a>.<\/p>\n<p>\u201cMy treatment isn\u2019t working! Should I get screened for type 1 diabetes?\u201d<\/p>\n<p>If your T2D treatment isn\u2019t working, there\u2019s no harm in <a href=\"https:\/\/beyondtype1.org\/how-to-talk-to-your-doctor-about-screening-for-type-1-diabetes\/\" rel=\"nofollow noopener\" target=\"_blank\">getting screened<\/a>.<\/p>\n<p>\u201cThe way we screen is through a simple lab test to check for autoantibodies,\u201d Dr. Isaacs said. \u201cThere are generally four different autoantibodies that we look for.\u201d<\/p>\n<p>Today, you can get screened before the <a href=\"https:\/\/beyondtype1.org\/seethesigns\/\" rel=\"nofollow noopener\" target=\"_blank\">warning signs of T1D<\/a> even appear! This is a massive advancement over the past decade.\u00a0<\/p>\n<p>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!<\/p>\n<p>You can find for <a href=\"https:\/\/beyondtype1.org\/inclusive-t1d-screening-underserved-communities\/\" rel=\"nofollow noopener\" target=\"_blank\">T1D screening options<\/a> through TrialNet, T1D Scout, Sanofi or the ASK Program.<\/p>\n<p>\u201cIs it bad to take insulin if I have type 2 diabetes?\u201d<\/p>\n<p>\u201cThe natural progression of T2D is that they might need insulin,\u201d Dr. Isaacs confirmed. \u201c<a href=\"https:\/\/beyondtype1.org\/insulin-type-2-diabetes\/\" rel=\"nofollow noopener\" target=\"_blank\">Insulin\u2019s a very effective therapy<\/a> 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.\u201d<\/p>\n<p>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.\u00a0<\/p>\n<p>TL;DR<\/p>\n<p>You\u2019re busy\u2014we get it! Here\u2019s the low down on the answers to some of your most frequently asked questions (FAQs) for life with T2D in 2025:<\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Using a CGM helps anyone managing any type of diabetes<\/b> make informed treatment decisions.<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Insurance coverage varies for CGMs: <\/b>If you use insulin, your odds of insurance covering it are better but you should still pursue insurance coverage first regardless!<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>If you can\u2019t get insurance to cover a CGM, see if you need a prior authorization: <\/b>If that doesn\u2019t work, OTC CGM options are helpful if you don\u2019t use insulin. If you do, they\u2019re better than nothing.<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>If your T2D treatment plan isn\u2019t working, it\u2019s time to chat with your doctor:<\/b> Screening for T1D isn\u2019t a bad idea, but sometimes you might need a new medication like insulin\u2014and no, it\u2019s not bad or a failure if you\u2019re on it!<\/li>\n<\/ul>\n<p>You never have to manage T2D all by yourself. We\u2019re here to help! To get support and make sure you don\u2019t miss future events with experts like Dr. Isaacs,<a href=\"https:\/\/beyondtype1.org\/community-app\/\" rel=\"nofollow noopener\" target=\"_blank\"> download the Beyond Type 2 community app<\/a> now.<\/p>\n","protected":false},"excerpt":{"rendered":"This year\u2019s Type 2 Virtual Summit featured an informative community Q&amp;A session with Diana Isaacs, PharmD, BCPS, BCACP,&hellip;\n","protected":false},"author":2,"featured_media":238641,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[78],"tags":[126075,30550,2597,18,135,19,126076,17,126077,126078,126074],"class_list":{"0":"post-238640","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-cgm-type-2-diabetes","9":"tag-diabetes-management","10":"tag-education","11":"tag-eire","12":"tag-health","13":"tag-ie","14":"tag-insulin-type-2-diabetes","15":"tag-ireland","16":"tag-misdiagnosed-diabetes","17":"tag-misdiagnosis-type-2-diabetes","18":"tag-type-2"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@ie\/115738635434049521","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/238640","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/comments?post=238640"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/posts\/238640\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media\/238641"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/media?parent=238640"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/categories?post=238640"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/ie\/wp-json\/wp\/v2\/tags?post=238640"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}