The objective of this study was to evaluate the health-related quality of life (HRQoL) of elderly diabetic patients. A cross-sectional, questionnaire survey of diabetic subjects aged 65-84 years (n=177 respondents) from three community health centers in Stockholm County. The HRQoL was assessed by the Swedish Health-Related Quality of Life Survey (SWED-QUAL), a generic HRQoL questionnaire adapted from the Medical Outcomes Study (MOS) and consisting of 67 items covering broad aspects of the HRQoL. Diabetic subjects were compared with age- and gender-matched controls from a random standard population sample (SPS) of the Swedish population. Medical data on the diabetic subjects were extracted from medical records. The HRQoL, as regarded 7 of the 13 scales, was poorer in diabetic subjects than in the SPS controls. These scales were "general health perceptions," "physical functioning," "satisfaction with physical health," "role limitations due to physical health," "pain," "sleep problems," and "role limitations due to emotional health." Atheromatous complications and nonvascular disease were significant predictors of a poor HRQoL. "Cognitive functioning" was the only HRQoL scale on which diabetic subjects with high levels of HbA(1c) (HbA(1c)>7.0%) scored worse than those with acceptable levels (HbA(1c)<7.0%). In our study, elderly diabetic subjects had a poorer HRQoL than the general population, especially regarding physical health. Poor metabolic control was associated with reduced cognitive function.