People facing difficulty paying for food and medicines find it harder to manage their diabetes than those who are affluent, a study says.
Poor diabetes control leads to higher blood sugar, cholesterol and blood pressure than normal.
The findings suggest that mere access to health insurance may not lead to better diabetes care unless people can meet even their basic material needs.
"Health care systems are increasingly accountable for health outcomes that have roots outside of clinical care," said lead author Seth Berkowitz from Massachusetts General Hospital, Boston.
"Strategies that increase access to health care resources might reasonably be coupled with those that address social determinants of health, including material need insecurities," Berkowitz said.
The study of 411 patients included data from June 2012 to October 2013 in Massachusetts.
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The researchers found that food insecurity and medication under-use were associated with greater odds of poor diabetes control.
Greater number of economic insecurities increases the likelihood of poor diabetes control and increased health care use, the findings showed.
"Food insecurity and cost-related medication under-use may be promising targets for real-world management of diabetes mellitus," the researchers said.
The study appeared online in the journal JAMA Internal Medicine.