I am on a pump (Medtronic 670G, using Auto Mode pretty much all the time).
With the use of the GLP-1RAs, I have had to somewhat “game” the algorithm a bit sometimes to keep from bottoming out after meals by giving an initial partial bolus followed by the remainder later on (I really wish Medtronic would make it possible to deliver extended and/or mixed mode boluses in Auto Mode to make this easier, but it is what it is), if I’m eating something that takes especially long to be absorbed. This would be much more difficult to do without a CGM, so that’s something to keep in mind…
As for insurance, I’ve been pretty lucky… A Prior Auth from my endocrinologist is all I’ve needed thus far. I am in the process of changing my insurance again as we speak (moving to my wife’s plan out of necessity) so I’ve got my fingers crossed that’s all I’ll need again - but I won’t know for another few weeks.