Both Type 1 and Type 2 diabetes are insurable — but the rating you receive depends heavily on how well the condition is controlled, how long ago it was diagnosed, and whether complications have developed. Carrier selection matters enormously here: the spread between the best and worst offer for the same diabetic applicant can be several table ratings or more.
What Underwriters Evaluate for Diabetes
Life insurance underwriters reviewing a diabetes history will request and analyze the following factors. Each one directly affects your rate class:
Type 1 vs. Type 2 — Type 1 (insulin-dependent from childhood or adolescence) is viewed as higher risk due to longer duration and greater complexity of management. Type 2 (typically adult-onset) varies widely depending on control and treatment regimen. Both are insurable; Type 2 with diet/exercise control only often qualifies for the best offers.
HbA1c (A1C) Level — The single most important lab value underwriters review. A1C below 7.0 is ideal and may qualify for standard or better rates at select carriers. A1C of 7.0–8.0 is manageable — typically Table 2–4. A1C above 8.5–9.0 results in higher table ratings or declines at many carriers. Trend over time matters as much as the most recent reading.
Age at Diagnosis & Duration — Earlier onset generally signals longer disease duration and greater cumulative risk. A 45-year-old diagnosed at 40 is viewed far more favorably than one diagnosed at 20. Longer duration with no complications is a positive signal; longer duration with complications is significantly penalized.
Complications — Neuropathy, nephropathy (kidney damage), retinopathy (eye damage), or cardiovascular complications each add meaningful rating. Multiple complications, or complications combined with other risk factors, can push a case to decline. No complications is a key positive underwriting factor.
Treatment Regimen — Diet and exercise only is the most favorable. Oral medications (metformin, etc.) are viewed positively. Insulin use — especially multiple daily injections — increases the rating. GLP-1 agonists (Ozempic, Mounjaro, Trulicity) are increasingly common and most carriers treat them similarly to other oral/injectable medications when A1C is well-controlled.
Comorbidities — Obesity, hypertension, high cholesterol, or cardiovascular disease alongside diabetes compounds risk significantly. Well-controlled blood pressure and cholesterol offset some of the diabetes-related rating. BMI is evaluated independently and can add additional table ratings.
Understanding Table Ratings for Diabetics
Most diabetic applicants receive a substandard (table-rated) offer rather than a standard one. Table ratings use numbers 1–10 or letters A–J. Each full table step adds approximately 25% above the standard rate:
| Table Rating | Premium vs. Standard | Typical Diabetic Profile |
|---|---|---|
| Standard | Base rate | Type 2, diet/exercise only, A1C under 6.5, diagnosed after 40, no complications, no other risk factors — select carriers only |
| Table 2 (B) | +50% | Type 2, oral medications, A1C 7.0–7.5, well-controlled, no complications, diagnosed after 35 |
| Table 4 (D) | +100% | Type 2 on insulin or A1C 7.5–8.5; or Type 1 with excellent control, no complications, shorter duration |
| Table 6 (F) | +150% | Type 1 or Type 2 with A1C above 8.5, early-stage complications, or insulin use with additional risk factors |
| Table 8–10 (H–J) | +200–250% | Significant complications (nephropathy, neuropathy), poorly controlled A1C, or multiple comorbidities |
| Decline | — | Active kidney failure, recent cardiovascular event plus diabetes, A1C consistently above 10–11 with complications |
Carrier Guidelines: Diabetes Underwriting Comparison
Below are current general guidelines for how major carriers we represent approach diabetes. Always verify current guidelines with us before applying — these represent typical scenarios and individual cases vary.
| Carrier | Type 2 Best Case | Type 1 Best Case | Table Shaving | Notes |
|---|---|---|---|---|
| Protective Life | Standard possible; A1C <7.0, diet/exercise, no complications | Table 4–6 minimum; excellent control required | Available on select permanent products | One of the most competitive carriers for well-controlled Type 2; strong overall pricing |
| Banner Life / Legal & General | Standard to Table 2; A1C <7.0, oral meds or less, no complications | Table 4+ depending on duration and control | Available on qualifying permanent products | Competitive term pricing; favorable for recent-onset well-controlled Type 2 |
| Prudential | Standard possible for exceptional Type 2 profiles; otherwise Table 2–4 | Table 4–8; highly dependent on A1C trend and duration | Available on PruLife permanent products | Strong for complex Type 1 cases; medical director review available for borderline cases |
| Pacific Life | Standard to Table 2 for well-controlled Type 2 without complications | Table 4–6; favorable for young-onset with consistent good control | Available on permanent products | Good option for applicants with strong lab trends; values improving A1C history |
| Transamerica | Table 2–4 typical; standard rare | Table 6–8; more conservative on Type 1 | Available on select products | Competitive on pricing at table ratings; less favorable for recently diagnosed or higher A1C |
| North American Company | Standard to Table 2 for well-controlled Type 2; no complications required | Table 4–6 minimum | Available on permanent products | Solid option for Type 2; straightforward underwriting process |
| Lincoln Financial | Table 2–4 typical for Type 2 on oral medications | Table 6+ depending on control and duration | Available on qualifying permanent products | Competitive pricing at table ratings; complete medical records required |
| Mutual of Omaha | Table 2–4 for well-controlled Type 2 | Table 6–8; conservative on Type 1 | Available on permanent products | Strong final expense and simplified issue options for cases that don’t qualify for fully underwritten coverage |
Guidelines current as of 2025–2026. Carrier underwriting guidelines are subject to change. Verify with us before applying.
Table Shaving: Getting a Better Rate Than Your Health Suggests
What is table shaving? Several carriers offer a program where a substandard table rating on a permanent life insurance policy can be “shaved” to standard after the policy is in force, or issued at a better rate than the standard underwriting process would produce. This is available on select whole life and universal life products — not term. When it applies, a permanent policy that would otherwise be rated Table 4 may be issued closer to standard, making it cost-competitive with a rated term policy.
Who qualifies? Table shaving is typically available for applicants rated Table 2–6 on certain permanent products. It requires the applicant to otherwise meet full underwriting criteria — it is not a substitute for poor control or active complications. Carriers and products offering this program change over time; we identify the best current option for each client.
What You Can Do to Improve Your Outcome
Get your A1C as low as possible before applying. Even a modest improvement in A1C — from 8.0 to 7.2, for example — can shift your table rating by 2–4 steps. If your A1C has been trending down over the last two years, make sure that history is documented and available for underwriting review.
See your endocrinologist or PCP regularly. Active, documented follow-up care signals to underwriters that your diabetes is being managed proactively. Gaps in care are a red flag regardless of your lab values.
Control comorbidities. Keeping blood pressure, cholesterol, and weight well-managed removes additional rating factors that would otherwise stack on top of the diabetes rating.
Work with a specialist broker. Do not apply direct or through a non-specialist. Different carriers use completely different underwriting grids for diabetes — a case that is Table 6 at one carrier may be Table 2 at another for the same applicant. Carrier selection is the single biggest lever available to you.
Diabetic? Let’s Find Your Best Rate.
We specialize in high-risk life insurance cases and have placed coverage for many diabetic clients at the lowest available rates. Tell us your profile — A1C, type, duration, medications — and we’ll identify the most competitive carrier for your specific situation.