This article emphasises the need to assess quality of life (QoL) as a key outcome of diabetes management and introduces the linguistically validated and culturally adapted, Hindi and Punjabi versions of an individualised questionnaire (the ADDQoL) to assess the impact of diabetes on the QoL of Indian people with diabetes. ADDQoL findings in the UK indicated that approaches to diabetes management were needed that allowed for dietary freedom. Use of the ADDQoL in the subsequent DAFNE (Dose Adjustment For Normal Eating) trial showed significant benefits to quality of life from training in insulin dose adjustment to provide for dietary freedom without loss of diabetes control. ADDQoL findings from research in India have helped highlight the negative impact of diabetes on various life domains of Indian people with diabetes, especially their self-confidence, their family life and their freedom to eat as they wish. It is suggested that targets of diabetes management are more likely to be achieved if the importance of protecting and improving QoL is recognised and monitored alongside biomedical outcomes such as blood glucose levels.