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This typically means your provider submits: Your BMI and weight history A1C and fasting glucose levels showing prediabetes Documentation of failed lifestyle interventions (prior diet programs, exercise plans) Any additional metabolic risk factors (family history of diabetes, elevated triglycerides, hypertension) A letter of medical necessity explaining why pharmacological intervention is warranted before full diabetes develops Some insurers respond to the preventive argument, especially when the cost of treating type 2 diabetes (which runs $10,000 to $15,000 annually on average) is weighed against the cost of preventing it