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A worksheet for organizing the diabetes records an underwriter will ask for
A fill-in worksheet for diagnosis dates, treatment changes, A1C results, complication screenings and visits, with why underwriters weigh each item.
Two people can both answer "yes" to the diabetes question on a life insurance application and receive very different offers. The difference rarely comes from the word "diabetes." It comes from a handful of facts that sit in your medical records: when the condition was diagnosed, how treatment has changed, what your long-term blood sugar results look like, and whether anything has been found in the eyes, kidneys, nerves or heart. An underwriter reads those facts together. This worksheet helps you assemble them first, in one place, so the application is accurate and the conversation with the insurer is short.
The people and numbers below are hypothetical illustrations chosen for easy arithmetic. They are not benchmarks, and nothing here says what any insurer will offer. For the broader picture of how diabetes is rated, read the guide on life insurance with type 1 or type 2 diabetes.
Why a worksheet helps
An application usually asks a few direct questions: type of diabetes, date of diagnosis, current medications, most recent A1C, and whether you have had complications. A phone interview or a records request may go deeper. If you answer from memory, small errors creep in, such as a diagnosis date that is a year off or a medication that was changed twice and is described as "the same for years."
A worksheet also lets you see your own file the way an underwriter does. Instead of one big label, the underwriter sees five questions:
- How long has the condition been present, and at what age did it start?
- How stable is treatment, and what does the treatment tell us about severity?
- How well controlled has blood sugar been over time, not just at one visit?
- Have routine checks found any damage?
- Does the file show regular follow-up?
Each part of the worksheet below answers one of these. Keep your copy next to the application and use it for every company, so your answers stay consistent.
Part A: The diagnosis timeline
What to record: type of diabetes (type 1, type 2, or another type your doctor named), the month and year of diagnosis, your age then, and how it was found (routine screening, symptoms, a hospital visit).
Why underwriters care: Length of time with the condition matters because complications tend to appear over years rather than months, so a longer history means more years in which a complication could have developed. Age at diagnosis matters because earlier onset means a longer exposure. The circumstances matter too: a condition found on a routine screening with no symptoms looks different from one found during an emergency.
The calculation (repeat this with your own dates):
- Today's date: ______
- Date of diagnosis: ______
- Years and months with the condition = today's date minus diagnosis date: ______
- Age at diagnosis, as written in your records: ______
Worked example (hypothetical). Dana was diagnosed with type 2 diabetes in March 2019, at age 49, found on a routine screening. Today is November 2026.
- From March 2019 to March 2026 is 7 years; March 2026 to November 2026 is another 8 months.
- Time with the condition: 7 years, 8 months.
- Age at diagnosis: 49, as written in the chart.
If you were diagnosed as a child or teenager with type 1 diabetes, the same arithmetic gives a long span. That is normal and is one reason underwriters read the other parts of the file closely, since the rest of the record shows how the years have gone.
Part B: The treatment log
What to record: every diabetes medication you have taken, with start and stop dates, doses if you know them, and the reason for any change. Include insulin (type and whether by injection or pump), oral medications, injectable non-insulin medications, and any diet or exercise-only period. Also note any hospital or emergency visit for very low or very high blood sugar.
Why underwriters care: Treatment is a proxy for severity. A condition managed by lifestyle alone or a single oral medication generally signals something different from a regimen that has had to be intensified repeatedly. Frequent changes can suggest difficulty achieving control. Long stretches on a stable regimen with good results usually read as steadier. Underwriters also look at adherence: a prescription history showing regular refills supports the record, and gaps raise questions. The prescription database check glossary entry explains how those histories are used, and the post on reading your medication list the way an underwriter does shows how a medication list is read.
How to fill it in: use your pharmacy's printed history and your portal's medication list. If a drug was stopped, write why: "side effects," "doctor switched," "no longer needed." Reasons matter more than people expect.
| Medication or therapy | Start (month/year) | Stop (month/year) | Reason for change |
|---|---|---|---|
| ______ | ______ | ______ | ______ |
| ______ | ______ | ______ | ______ |
| ______ | ______ | ______ | ______ |
Worked example (hypothetical). Dana's log shows:
| Medication or therapy | Start | Stop | Reason |
|---|---|---|---|
| Diet and exercise plan | Mar 2019 | Sep 2019 | Result not low enough |
| Metformin | Sep 2019 | Ongoing | Added by primary care |
| Second oral medication | Feb 2023 | Ongoing | Added after A1C rose |
Dana can say: "Two medications added over about seven and a half years, no insulin, and nothing changed since February 2023." That is a precise, checkable statement, and it is better than "I take pills." Count it yourself: the log has three lines, one for the lifestyle-only period and two for medications, and the most recent line began in February 2023, which is about three years and nine months before November 2026.
Medication names and practice patterns change over time, so if a drug you take is unfamiliar to the application, write the name exactly as it appears on the label and let the underwriter classify it.
Part C: The long-term glucose results
What to record: every A1C result you can find from the past three years, with dates. A1C is a blood test that reflects average blood sugar over roughly the previous two to three months. It is the most common long-term control measure in a diabetes record, so it gets close attention. If you test glucose at home or wear a continuous monitor, your doctor's summary of that data may also appear in the chart, but the A1C is usually the number the application asks for.
Why underwriters care: A single reading can be a good day or a bad one. A series shows direction and stability. Underwriters generally consider the most recent results and the trend: improving, steady, drifting up, or swinging widely. The reference values and how each company reads them are company-specific, so do not look for a threshold here. Your job is to give the true series.
The calculation:
- List the readings: ______, ______, ______, ______
- Add them up: ______
- Divide by how many readings you have to get the average: ______
- Subtract the oldest reading from the newest to see the change: ______ (negative means it fell)
- Note the highest and lowest values and the spread (highest minus lowest): ______
Worked example (hypothetical). Dana's four A1C results over about 30 months are 7.2, 6.9, 6.8 and 6.6 (percent), oldest to newest.
- Sum: 7.2 + 6.9 + 6.8 + 6.6 = 27.5
- Average: 27.5 divided by 4 = 6.875, which rounds to 6.9
- Change from oldest to newest: 6.6 minus 7.2 = negative 0.6
- Highest 7.2, lowest 6.6, spread 0.6
Dana reads the result in plain words: "Four readings over thirty months, drifting downward, narrow spread." That is a summary of a stable-to-improving pattern. If the readings had been 6.6, 8.1, 6.9 and 8.4, the average (30.0 divided by 4 = 7.5) would hide a spread of 1.8, and an underwriter would notice the swings rather than the average. The same average can come from very different histories, which is why you list the series and not just the mean.
If you cannot find old results, do not estimate. Ask your doctor's office for the lab history, or use the portal's lab view. If you have only the most recent value, say that.
Part D: The complications screening log
What to record: the date and result of each routine screening that checks for damage associated with diabetes. The common ones are:
- Eye exam (usually a dilated exam by an eye specialist): date, and whether it found changes to the retina.
- Kidney checks: a blood test for kidney function and a urine test for protein or albumin. The guide on what a life insurance blood and urine test looks for explains what insurers' own labs look for, and life insurance with kidney disease covers how kidney findings are rated.
- Foot exam and nerve checks: date, and whether numbness or reduced sensation was noted.
- Cardiovascular assessment: blood pressure readings, cholesterol panel, and any ECG, stress test or heart procedure.
- Dental or other checks your clinic includes in its diabetes care plan.
Why underwriters care: Complications are a major driver of risk in diabetes. A file that shows regular screenings with clean results suggests that the condition has not caused damage so far. A file with no screenings leaves the question unanswered, and an unanswered question tends to be priced cautiously. A file that shows a finding is not necessarily disqualifying, but it does change the analysis, and the underwriter will want the detail: stage, treatment and trend.
How to fill it in:
| Screening | Most recent date | Result as written in the record | Next due |
|---|---|---|---|
| Eye exam | ______ | ______ | ______ |
| Kidney blood test | ______ | ______ | ______ |
| Urine protein or albumin | ______ | ______ | ______ |
| Foot and nerve exam | ______ | ______ | ______ |
| Cholesterol panel | ______ | ______ | ______ |
| Blood pressure (typical) | ______ | ______ | ______ |
Worked example (hypothetical). Dana's eye exam was in August 2026 with "no retinopathy" noted. Kidney blood test and urine albumin were done in June 2026, both listed as normal. A foot exam happened at the annual physical in April 2026 with "sensation intact." A cholesterol panel was done in the same month. Dana can state: "All four routine checks were done in 2026 with no findings."
If you do not have a screening in the log, the right move is to schedule it with your doctor for your own health. If you have a gap in screenings, you can say so honestly on the application. Do not rush a test purely to improve the paperwork; let the doctor decide what is clinically appropriate.
Part E: The visit and follow-up record
What to record: your visits for diabetes care over the past three years, with date, provider, and the reason (routine, medication change, urgent). Include visits to an endocrinologist, primary care, diabetes educator, dietitian, eye doctor and any urgent care or emergency room visit linked to blood sugar.
Why underwriters care: Regular follow-up is a sign the condition is being monitored, and a pattern of missed care can be a concern. Hospital or emergency visits for diabetes problems, including severe low blood sugar episodes or diabetic ketoacidosis, are among the items underwriters ask about directly. If you have had any, record the date, what happened, and what changed afterwards.
How to count: list the dates and then count visits per year. For Dana, the log shows about four visits a year: a check-in roughly every quarter, with the annual physical and the eye exam counted among them. That is a record of ongoing care.
Putting it together: the one-page summary
When Part A through E are filled in, write a one-paragraph summary you can read aloud on a phone interview and paste into a notes field:
"Type 2 diabetes diagnosed March 2019 at age 49. On two oral medications, no insulin, one addition in February 2023. Last four A1C results 7.2, 6.9, 6.8, 6.6 over thirty months. Eye exam August 2026 normal; kidney and urine albumin June 2026 normal; foot exam April 2026 normal. Regular follow-up every three to four months. No hospitalizations or emergency visits for blood sugar."
Each clause there is something an underwriter can confirm from records. If any clause is not true for you, change it to what is true. If you are not sure of a detail, say that, and offer to provide records. The post on Can't remember your medical history? A checklist for the application covers what to do when the details are fuzzy, and borderline lab results: a worksheet for tracking your own trend extends the numbers approach to other lab results.
How the pieces combine
Underwriters do not usually add up points for each item. They weigh the pieces together, and one strong element can offset a weaker one in some companies' guidelines, while one severe element can dominate. A few general patterns are worth knowing, without any promise about how a given company will treat you.
- Control and complications carry heavy weight. A long history with good control and clean screenings is a very different profile from a short history with poor control.
- Age at diagnosis and duration interact. A long duration is more significant when onset came early, and a recent diagnosis has less history to read.
- Other conditions travel with diabetes. Blood pressure, cholesterol, weight and smoking status are rated alongside diabetes, so the guides on life insurance with high blood pressure and life insurance, weight and build charts matter to the final offer.
- Companies differ. Guidelines vary, which is why an independent broker who handles health-impaired applicants can be useful. The guide on life insurance rate classes: preferred plus to substandard explains the classes, and table ratings and flat extras explained explains the surcharges that sometimes apply.
If an offer comes back rated, ask what drove it. The explanation often points to a specific item in the file, such as one reading or a missing screening, and that is useful information for the next year of care and for a later request to review the rating.
Practical tips for assembling the file
- Pull records in one session, from the portal, the lab, the pharmacy and the specialist offices. Print or save them as PDFs and label them with the date and source.
- Check dates against two sources. The portal and a billing statement should agree. If they do not, ask the office.
- Keep the worksheet updated. After each appointment, add the new A1C and the next screening date. The same sheet is handy for future applications and for annual policy review.
- Do not alter or omit anything. If a reading is high, it goes on the list. The insurer will see the lab history through records anyway, and an application that matches the records is the best foundation for a policy that will pay a claim.
- Tell your doctor you are applying for insurance if you plan to request a physician's statement. Offices answer insurers faster when they know a request is coming. The attending physician statement entry explains what such a request involves.
For personal medical questions, such as whether a test is due or whether a medication should change, ask your doctor. For the details of how a specific company rates diabetes, ask an independent agent or broker, and for complaints about how an application was handled, your state insurance department is the right place.
Key takeaways
- Underwriters read diabetes through five lenses: duration and age at diagnosis, treatment stability, long-term glucose results, complication screenings and follow-up, so organize your records the same way.
- List the whole A1C series with dates rather than a single number; the average, change and spread tell a story that one reading cannot.
- Record the reason for every medication change and every gap in screenings; explanations carry weight.
- Use a one-paragraph summary built from the worksheet for every application, keeping your answers consistent across companies.
- Report what the records say, including unfavorable readings; accuracy protects both the application and any future claim.