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Background Intensive blood glucose control is proven to be associated with the diabetic microvascular and macrovascular complications, which could affect quality of life (QOL). This study was performed to determine the effects of intensive glucose control therapy on QOL of elderly patients with type 2 diabetes in Anhui Province.Methods Ninety-seven elderly patients with type 2 diabetes in Anhui were randomly assigned to standard treatment group and intensive therapy group. All patients were followed up for five years on average. Correlated information has been collected during the regular follow-up.Results Patients with microvascular complications reported significantly lower European Quality of Life-5 Dimensions (EQ-5D) scores and had more problems with usual activities, pain and anxiety than those without complications (P ＜0.05).Patients having experienced hypoglycemic episodes had significantly more problems with anxiety than those without hypoglycemic episodes (P ＜0.05). No significant difference was detected in all dimensions in quality of life, as well as in Visual Analog Scale score between two groups (P ＞0.05). There was no significant difference in quality of life at the fifth year compared with that of the first year in both groups. Women had more feelings of pain and anxiety than men (P ＜0.05)and longer disease course was associated with increased levels of pain and anxiety (P ＜0.05), as well as with lower QOL.In addition, patients with higher body mass index (BMI) had more problems with daily activities than patients with lower BMI (P ＜0.05).Conclusions Anxiety is common in elderly diabetic patients and they experienced frequent hypoglycemic episodes.Diabetic vascular complications significantly affect QOL of the patients. Intensive glucose control has no significant effect on QOL of the diabetic patients. Female, older age, long disease course, less education and high BMI are all factors caused reduced QOL and patients with these factors should be given more psychological support. Frequent mild hypoglycemic episodes do not cause impaired function of the central nervous system.