INTRODUCTION: There is a lack of information on health-related quality of life (HRQOL) for Aboriginal diabetic people.OBJECTIVE: To investigate HRQOL among aboriginal diabetics living in an isolated, rural Canadian community.METHODS:DESIGN: Mixed methods: (1) A mailed health-related survey; and (2) a population based retrospective chart review.STUDY POPULATION: People aged 17 years and older living in the Bella Coola Valley, British Columbia, Canada, and having a chart at the Bella Coola Medical Clinic as of September 2001 were asked to complete a detailed HRQOL survey during the period August to December 2001.MAIN OUTCOME MEASURES: Demographics (age, sex, ethnicity). Health-related quality of life was measured using the MOS 36-item Short Form Health Survey (SF-36), and the US Centers for Disease Control healthy day's items.RESULTS: Relatively greater percentages of diabetic people (n = 72 [57%]) completed the survey than did non-diabetics (n = 675 [37%]). Mean scores for Aboriginal people were lower/poorer than mean scores for non-Aboriginal people in all the quality of life questions. Mean scores for diabetic people were lower than mean scores for non-diabetics in all the quality of life questions. Aboriginal diabetics reported the worst scores on almost all of our quality of life questions.CONCLUSION: Rural diabetics experience significant impairment in their health-related quality of life. Among rural diabetics, Aboriginals report the worst HRQOL scores. Compared with other people, Aboriginals fare worse in HRQOL, which may explain the difference.