HealthDay News — Unmet material needs are associated with poor diabetes control and increased health-care resource use for adult patients with diabetes mellitus, a study published in JAMA Internal Medicine suggests.

“How specific material need insecurities relate to clinical outcomes and the use of health-care resources in a setting of near-universal access to health care is unclear,” wrote Seth A. Berkowitz, M., MPH, of Massachusetts General Hospital in Boston, and colleagues.

To examine the correlation between material need insecurities and diabetes mellitus control and use of health-care resources, the investigators collected cross-sectional data from 441 patients diagnosed with diabetes mellitus.

Of the participants, 39.1% had at least one material need insecurity, and 46% had poor diabetes control. Food insecurity correlated with greater odds of poor diabetes control and increased outpatient visits, but not with increased emergency department/inpatient visits. Cost-related medication under-use correlated with poor diabetes control and increased emergency department/inpatient visits, but not with increased outpatient visits.

Increased outpatient visits were seen with house instability and energy insecurity. Increases were seen in the odds of poor diabetes control (odds ratio for each additional need, 1.39) and health care resource use (adjusted incidence rate ratio for outpatient visits, 1.09 and for emergency department/inpatient visits, 1.22) with an increasing number of insecurities.

“Material need insecurities may be important targets for improving care of diabetes mellitus,” concluded the authors.


  1. Berkowitz SA et al. JAMA Intern Med. 2014; doi: 10.1001/jamainternmed.2014.6888