There is a quiet assumption that circulates through the diabetes community, passed between friends, shared in online forums, and reinforced by the well-meaning but misinformed. The assumption is this: if you have diabetes, you cannot get life insurance. Or if you can, it will be so expensive that it is not worth pursuing.
This assumption is wrong. It is not slightly wrong. It is substantially and consequentially wrong, and it costs families tens of thousands of dollars in missed protection every year.
The truth is that people with diabetes obtain life insurance every single day. They obtain term policies. They obtain permanent policies. They obtain coverage at rates that, while higher than the rates offered to people in perfect health, are far more affordable than the rumor mill suggests. The key is understanding what insurers actually care about, how they evaluate diabetic applicants, and which companies are most lenient.
This guide provides that understanding. Whether you have Type 1 or Type 2 diabetes, whether you were diagnosed last month or thirty years ago, and whether your A1C is 6.0 or 9.0, this is what the life insurance industry actually looks at, how they price the risk, and how to get the best possible rate.
Part I: The Underwriting Philosophy – Why Diabetes Matters to Insurers
Life insurance underwriting is the process by which an insurance company evaluates the risk that you will die during the policy term. Every piece of information you provide—age, gender, medical history, lifestyle, occupation—is an input into a mortality risk calculation. The output is your rate class: Preferred Plus, Preferred, Standard Plus, Standard, or a substandard table rating.
Diabetes matters to underwriters because it is a condition that, over time, increases the risk of cardiovascular disease, kidney disease, neuropathy, vision loss, and other complications that can lead to premature death. The insurance company is not punishing you for having diabetes. They are pricing the statistical risk that your diabetes introduces.
But here is the critical distinction that most people with diabetes do not understand: the insurance industry does not treat all diabetes the same way. A 55-year-old with well-controlled Type 2 diabetes, an A1C of 6.5 on metformin alone, a normal weight, and no complications is an entirely different risk than a 30-year-old with Type 1 diabetes diagnosed in childhood, an A1C of 9.0, and a history of diabetic ketoacidosis. The first applicant may qualify for Standard or even Standard Plus rates. The second may be declined or offered a highly substandard rate.
The difference is control, compliance, and complications. Those are the three variables that matter most. Understand them, and you understand what the underwriter is looking for.
Part II: Type 1 vs. Type 2 – How Insurers Distinguish
The first major underwriting distinction is between Type 1 and Type 2 diabetes. The two conditions share a name and a central feature—elevated blood glucose—but they are fundamentally different diseases with different risk profiles, and insurers evaluate them differently.
Type 1 Diabetes
Type 1 diabetes is an autoimmune condition in which the body attacks the insulin-producing beta cells of the pancreas. It typically manifests in childhood or young adulthood. People with Type 1 diabetes require exogenous insulin for survival. There is no oral medication alternative. There is no remission.
From an underwriting perspective, Type 1 diabetes introduces several concerns:
- Duration of disease: A person diagnosed with Type 1 at age 10 has lived with the disease for decades by the time they apply for life insurance in their 30s or 40s. The cumulative exposure to glycemic variability increases the long-term complication risk.
- Insulin dependence: Insulin use introduces the risk of hypoglycemia—dangerously low blood sugar—which can lead to loss of consciousness, accidents, and in severe cases, death.
- Complication risk: The longer a person has Type 1 diabetes, the higher the statistical probability of microvascular and macrovascular complications.
Historically, Type 1 diabetes was an automatic decline with many carriers. That is no longer the case. Several major insurers now offer coverage to Type 1 diabetics, and some offer competitive rates to those with excellent control and no complications. However, the underwriting is more intensive, and the number of available carriers is more limited than for Type 2.
Type 2 Diabetes
Type 2 diabetes is a metabolic condition characterized by insulin resistance and progressive beta-cell dysfunction. It typically manifests in adulthood and is strongly associated with obesity, sedentary lifestyle, and genetic predisposition. It is far more common than Type 1, accounting for approximately 90% to 95% of all diabetes cases.
From an underwriting perspective, Type 2 diabetes is generally viewed more favorably than Type 1, for several reasons:
- Later onset: The disease typically develops later in life, meaning the cumulative exposure to hyperglycemia is shorter.
- Treatment flexibility: Many people with Type 2 diabetes manage their condition with oral medications, lifestyle modification, or non-insulin injectables. Insulin use in Type 2 diabetes is a marker of more advanced disease and will affect the rate class, but it is not the automatic declination signal that some applicants fear.
- Reversibility: Some people with Type 2 diabetes achieve normal or near-normal blood glucose levels through significant weight loss, dietary changes, and exercise. While insurers will still rate the applicant as diabetic, evidence of sustained control through lifestyle modification can improve the rate class.
Part III: The A1C Scale – The Number That Drives the Decision
If there is one number that dominates the life insurance underwriting process for diabetics, it is the hemoglobin A1C. This blood test measures your average blood glucose over the previous two to three months. It is the single most important metric the underwriter will evaluate.
How A1C Is Used
Insurers use A1C as a proxy for diabetes control. A low A1C indicates that blood glucose is well-managed, which correlates with a lower risk of complications. A high A1C indicates poor control, which correlates with a higher risk of complications and premature mortality.
The A1C scale typically ranges from below 5.7% (normal) to above 9.0% (poorly controlled). Here is how most carriers map A1C levels to rate classes for diabetic applicants:
| A1C Level | Typical Underwriting Outcome |
|---|---|
| Below 6.0% | Best possible diabetic rate; some carriers may offer Standard Plus |
| 6.0% – 6.5% | Standard to Standard Plus; very competitive rates available |
| 6.6% – 7.0% | Standard; most carriers will offer coverage |
| 7.1% – 7.5% | Standard to Table 1-2 (mild substandard) |
| 7.6% – 8.0% | Table 2-4 (moderate substandard) |
| 8.1% – 8.5% | Table 4-6 (significant substandard); some carriers decline |
| Above 8.5% | Many carriers decline; limited options at highly substandard rates |
| Above 9.0% | Most carriers decline; guaranteed issue may be the only option |
The A1C the Insurer Uses
The insurer will order a blood test as part of the paramedical exam. They will use the A1C from that blood draw, not the A1C from your last endocrinologist visit. If your A1C has been trending down and your exam A1C is lower than your historical levels, the exam A1C works in your favor. If your A1C has crept up since your last doctor visit, the exam A1C will reflect that.
This is why timing matters. If you are actively working to lower your A1C through medication adjustment, diet, or exercise, it may be worth waiting until your A1C has stabilized at the lower level before applying. A difference of half a percentage point—from 7.8 to 7.3, for example—can move you from a Table 3 rating to a Standard rating, reducing your premium by 30% or more.
Stability Matters
A single excellent A1C is good. A history of stable, excellent A1Cs is better. The underwriter will review your medical records and will see your A1C history over time. An A1C that has been 6.2 for three consecutive readings is stronger evidence of good control than a 6.2 that dropped from 9.0 six months ago. The underwriter wants to see sustained control, not a single good test.
Part IV: Beyond A1C – The Full Underwriting Picture
A1C is the most important metric, but it is not the only metric. The underwriter evaluates the complete picture of your diabetes and your overall health.
Age at Diagnosis
For Type 2 diabetes, diagnosis after age 50 is viewed more favorably than diagnosis at age 30. Later onset suggests a slower disease progression and less cumulative exposure. For Type 1 diabetes, diagnosis in childhood means a long disease duration, which will be factored into the risk assessment.
Treatment Regimen
The complexity of your treatment regimen is a proxy for disease severity. Insurers typically categorize diabetic applicants into tiers:
- Diet and exercise only: The most favorable tier. The applicant has controlled their blood glucose through lifestyle modification alone.
- Oral medications only (metformin, sulfonylureas, etc.): Still favorable. The disease is controlled with first-line medications.
- Non-insulin injectables (GLP-1 agonists like Ozempic, Trulicity, Mounjaro): Increasingly common. Insurers are still developing their underwriting frameworks for these medications, but they are generally viewed as a middle tier between oral medications and insulin.
- Insulin: The highest tier. Insulin use signals more advanced disease. For Type 2 diabetics, insulin use will typically result in a substandard rating. For Type 1 diabetics, insulin is universal and expected, but the dose and the frequency of hypoglycemic episodes will be scrutinized.
The specific medications matter, too. Metformin alone is the best-case scenario. Multiple oral medications suggest more resistant disease. The underwriter will review your medication list and your prescription fill history to verify compliance.
Comorbidities and Complications
The presence of diabetes-related complications is the single largest factor that can move an application from “approvable at a reasonable rate” to “declined.” The underwriter will look for:
- Cardiovascular disease: Coronary artery disease, history of heart attack, stroke, peripheral artery disease.
- Kidney disease: Elevated creatinine, reduced glomerular filtration rate (GFR), proteinuria, microalbuminuria.
- Neuropathy: Numbness, tingling, pain in the extremities.
- Retinopathy: Damage to the blood vessels of the retina.
- History of diabetic ketoacidosis or hyperosmolar hyperglycemic state.
- Amputations or non-healing wounds.
If you have no complications, your application is in the most favorable category possible for a diabetic applicant. If you have one or more complications, your insurability depends on the severity, the stability, and the carrier’s specific underwriting guidelines.
Other Health Metrics
The underwriter will evaluate your overall health profile, including:
- Blood pressure: Hypertension is common in people with diabetes, and controlled hypertension is manageable. Uncontrolled hypertension compounds the cardiovascular risk.
- Cholesterol and lipids: Elevated LDL, low HDL, and high triglycerides are common in Type 2 diabetes and increase the cardiovascular risk profile.
- Body mass index: Obesity is a risk factor for Type 2 diabetes and compounds mortality risk. Weight loss and a BMI in the normal or overweight range improve the rate class.
- Smoking status: Smoking with diabetes is a significant compounding risk factor. Diabetic smokers pay substantially more than diabetic non-smokers.
- Kidney function: Creatinine, GFR, and the presence of protein in the urine are closely scrutinized.
Compliance and Follow-Up
The underwriter will review your medical records for evidence of regular physician visits, medication adherence, and recommended screenings—eye exams, foot exams, microalbuminuria testing. A pattern of missed appointments and unfilled prescriptions suggests poor disease management and will negatively impact the underwriting decision.
Part V: The Best Life Insurance Companies for Diabetics in 2026
Not all carriers evaluate diabetic risk equally. Some have carved out competitive advantages by developing sophisticated underwriting frameworks that reward well-controlled diabetes. Here are the carriers most frequently recommended for diabetic applicants.
Prudential
Prudential is widely regarded as one of the most diabetic-friendly carriers in the industry. Their underwriting is nuanced, and they evaluate the full picture of the applicant’s health rather than applying rigid cutoffs. For Type 2 diabetics with excellent control—A1C below 7.0, no complications, normal weight, controlled blood pressure—Prudential may offer Standard Plus or even Preferred rates in some cases. They are also one of the better carriers for Type 1 diabetics, though rates will be higher than for Type 2.
Banner Life / William Penn
Banner is competitive for well-controlled Type 2 diabetes. Their underwriting guidelines allow for Standard rates for diabetics with A1C below 7.0, no insulin use, and no complications. They are less competitive for Type 1 diabetes and for insulin-dependent Type 2 diabetes, where other carriers may offer better terms.
Pacific Life
Pacific Life has a strong diabetic underwriting program that rewards compliance and control. They are particularly competitive for Type 2 diabetics on oral medications with A1C below 7.5. Their guaranteed universal life products are worth considering for diabetic applicants seeking permanent coverage.
Lincoln Financial
Lincoln Financial has become increasingly diabetic-friendly in recent years. They evaluate diabetic applicants holistically and may offer Standard rates to well-controlled Type 2 diabetics. They are also worth considering for applicants with a history of gestational diabetes who have since returned to normal blood glucose levels.
Mutual of Omaha
Mutual of Omaha is a strong option for diabetic applicants who may not qualify for the best rates with the carriers above. Their underwriting is more lenient for applicants with A1C in the 7.5 to 8.5 range, and they offer simplified issue products that may be appropriate for diabetics who have been declined by fully underwritten carriers.
AIG (Corebridge Financial)
AIG has a long history of impaired risk underwriting and is often a good choice for diabetics with complications or multiple comorbidities. Their rates may not be the lowest for well-controlled diabetics, but they will consider applicants that other carriers decline.
Part VI: The Application Process for Diabetics
The application process for a diabetic applicant is essentially the same as for any other applicant, with a few additional layers of scrutiny.
The Paramedical Exam
You will complete a paramedical exam, typically at your home or workplace. The examiner will measure your height, weight, blood pressure, and pulse. They will draw blood and collect a urine sample. The blood work will include A1C, fasting glucose, lipid panel, kidney function, and liver function. The urine sample will be tested for protein, glucose, and other markers.
The Attending Physician Statement
For diabetic applicants, the carrier will almost always request an attending physician statement—a detailed report from your primary care physician or endocrinologist. The APS will include your diagnosis date, your treatment history, your A1C history, your medication list, any complications, and your compliance record.
The APS is where the stability of your control becomes evident. A series of A1C readings between 6.0 and 6.4 tells a very different story than a series of readings between 8.0 and 10.0. The APS also documents the presence or absence of complications, which is why regular screenings are important.
The Telephone Interview
Some carriers conduct a telephone interview as part of the application process. The interviewer will ask about your medical history, your diabetes management, your medications, and your lifestyle. Answer honestly and thoroughly.
Preparing for the Application
Before applying, gather the following:
- Your most recent A1C results and your A1C history if available.
- Your complete medication list, including dosages.
- The name and contact information for your endocrinologist or primary care physician.
- Records of your most recent eye exam, foot exam, and kidney function tests.
If your A1C is higher than you would like, consider delaying the application for three to six months while you work with your physician to improve your control. A lower A1C at the time of the exam can save you thousands of dollars over the life of the policy.
Part VII: What If You Are Declined?
A decline is not the end of the road. It is a signal that the carrier you applied to was not the right fit for your risk profile. A different carrier may view the same profile differently.
Work with an Independent Broker
An independent broker who specializes in impaired risk underwriting can shop your profile to multiple carriers, including carriers that are known to be lenient on diabetes. They can conduct anonymous prescreens—submitting your health profile to underwriters without revealing your identity—to gauge which carriers are likely to offer coverage and at what rate. This avoids a formal decline on your MIB record.
Consider Simplified Issue or Guaranteed Issue
If fully underwritten coverage is unavailable due to complications or poor control, simplified issue and guaranteed issue policies provide an alternative. Simplified issue policies ask a limited number of health questions but do not require a medical exam. Guaranteed issue policies require no health questions and no exam. Both options provide smaller death benefits—typically $25,000 to $50,000—at higher premium rates per dollar of coverage.
These are not ideal solutions, but they are far better than having no coverage at all. A $25,000 guaranteed issue policy can cover final expenses and prevent your family from facing a financial burden on top of their grief.
Reapply After Improvement
If your diabetes control improves—your A1C drops, you lose weight, your blood pressure normalizes—you may become insurable at better rates. A decline today does not mean a decline forever. Work with your physician, focus on control, and reapply when your metrics have stabilized at a better level.
Part VIII: The Cost Reality
Diabetic life insurance rates are higher than non-diabetic rates. That is the reality. But the difference is often smaller than people fear, especially for well-controlled Type 2 diabetes.
Sample Premiums: 20-Year Term, $500,000, Age 50 Male
| Health Profile | Rate Class | Approximate Monthly Premium |
|---|---|---|
| No health conditions | Preferred Plus | $105 |
| Type 2, A1C 6.2, metformin only, no complications | Standard Plus | $145 |
| Type 2, A1C 6.8, metformin + sulfonylurea, no complications | Standard | $170 |
| Type 2, A1C 7.5, insulin, no complications | Table 2 | $245 |
| Type 1, A1C 7.0, insulin pump, no complications | Table 3-4 | $300 – $380 |
The spread between Preferred Plus and Standard—the rate class achievable by many well-controlled Type 2 diabetics—is meaningful but not prohibitive. The $40 to $65 monthly difference is real money, but it is not the 6-to-10-times multiplier that smokers face. Well-controlled diabetes is an insurable condition at reasonable rates.
Conclusion: You Are Not Uninsurable
The most damaging consequence of the myth that diabetics cannot get life insurance is that it prevents people from applying. They assume the answer is no, so they never ask the question. They leave their families unprotected not because coverage was unavailable, but because they believed it was.
If you have diabetes, you owe it to yourself and your family to find out what is actually available. Work with an independent broker who understands diabetic underwriting. Get prescreened with multiple carriers. See the real quotes based on your actual health profile, not the horror stories from a diabetes forum.
The answer may be better than you expect. And even if it is not—even if the only coverage available is a modest guaranteed issue policy—something is infinitely better than nothing. The worst-case scenario is not paying a higher premium. The worst-case scenario is leaving your family with nothing.
You are not uninsurable. You are a risk that some carriers will price and others will decline. Your job is to find the ones that will price it, and to accept the coverage that protects the people you love.
