Quality of life is an important health outcome in its own right, representi
ng the ultimate goal of all health interventions. This paper reviews the pu
blished, English-language literature on self-perceived quality of life amon
g adults with diabetes. Quality of life is measured as physical and social
functioning, and perceived physical and mental well-being. People with diab
etes have a worse quality of life than people with no chronic illness, but
a better quality of life than people with most other serious chronic diseas
es. Duration and type of diabetes are not consistently associated with qual
ity of life. Intensive treatment does not impair quality of life, and havin
g better glycemic control is associated with better quality of life. Compli
cations of diabetes are the most important disease-specific determinant of
quality of life. Numerous demographic and psychosocial factors influence qu
ality of life and should be controlled when comparing subgroups. Studies of
clinical and educational interventions suggest that improving patients' he
alth status and perceived ability to control their disease results in impro
ved quality of life. Methodologically, it is important to use multidimensio
nal assessments of quality of Life, and to include both generic and disease
-specific measures. Quality of life measures should be used to guide and ev
aluate treatment interventions. Copyright (C) 1999 John Wiley & Sons, Ltd.