OBJECTIVES: Lack of access to healthcare for patients with diabetes has been associated with lower self-reported health-related quality of life (HRQOL), which may lead to significant economic burden. The objective of the study was to determine the impact of healthcare access on HRQOL of patients with diabetes. METHODS: The 2009 Behavioral Risk Factor Surveillance System (BRFSS), a national health telephone survey administered by the Centers for Disease Control and Prevention (CDC), was analyzed. It included questions on patient demographics and health-related perceptions, conditions, and behaviors. HRQOL was defined as the number of unhealthy days, a sum of physical and mental unhealthy days in the past one month. Healthcare access was defined by whether the patient had healthcare coverage, had a healthcare professional or could not see a doctor because of cost. Descriptive analysis included means, standard errors and relevant T-tests. Poisson regression was performed to measure the impact of healthcare access variables, age, race, gender, marital status and median household income on unhealthy days. RESULTS: In 2009, from 5.2 million diabetic patients, 0.7 million (14%) did not have healthcare coverage, 0.48 million (9%) did not have healthcare professional and 1.54 million (30%) could not see a doctor due to cost. The average number of unhealthy days in a month, for diabetic patients with healthcare coverage was lower than those without (22 days versus 23 days, p-value<0.01); for those who could see a doctor due to cost was lower than those who could not (22 days versus 24 days, p<0.01); was the same for those with or without a healthcare professional. Regression results showed, not having healthcare coverage and healthcare professional, each significantly (p-value<0.01) increased an excess unhealthy day in diabetic patients. CONCLUSIONS: Lack of healthcare access negatively impacts HRQOL.  Measures are needed to ensure adequate healthcare access in diabetic patients.