Objective: To examine the relationship between health care access and diabetes management among a geographically diverse sample of American Indians (AIs) aged 50 and older with type 2 diabetes. Method: We examined the relationship between access to care and diabetes management, as measured by HbA_1c, using 1998-1999 data from the Strong Heart Family Study. A series of bivariate and multivariate linear models examined the relationships between nine access-related variables and HbA_1c levels. Results: In bivariate analyses, out-of-pocket costs were associated with higher HbA_1c levels. No other access-related characteristics were significantly associated with diabetes management in bivariate or in multivariate models. Discussion: Access-related barriers were not associated with worse diabetes management in multivariate analyses. The study concludes with implications for clinicians working with AI populations to enhance opportunities for diabetes management.