Dear Editor,I read the article by Chaturvedi et al. (2018) with considerable interest.[1] Measures for improving the quality of life (QOL) should be treated as an essential part of diabetic care. The findings of the authors show that improving QOL correlates with improvement in metabolic outcomes such as glycemic control. However, I have two concerns regarding the methodology and conclusion advanced by the author which need clarification.The authors wanted to answer the research question that whether antidiabetic drug treatment improves the QOL and other biochemical parameters in diabetes mellitus (DM) patients. However, the mean duration of diabetes in the patients was over 10 years, so most patients were likely to be on treatment before enrollment in the Chaturvedi (2018) study. In this regard, for the study to have answered the desired research question, it should have preferably included only newly diagnosed DMpatients who were previously not on standard antidiabetic treatment consisting of either oral hypoglycemic agents (OHAs) or insulin. This is because QOL and metabolic outcomes in DMpatients are not constant but are likely to show variation with time depending on patient factors such as level of stress, extent of medical adherence, change in drug therapy, or onset of any diabetes-related complications.[2] Among the previously diagnosed patients on antidiabetic treatment, therapeutic outcomes such as glycemic control are likely to improve on increasing adherence to medication, self-care practices, reducing stress, and intensification of drug therapy using newer OHAs or insulin.[3] The Chaturvedi (2018) study should report the change in the determinants of the above study outcomes during the 6-month period of observation.The authors concluded that using fewer medicines offers better treatment satisfaction and QOL in the patient. Nevertheless, the authors finding could be due to confounding since patients with recent onset of DM need fewer medicines to manage their diabetes and are less likely to suffer diabetes-related complications compared to DMpatients with long duration of diabetes.[4] Moreover, the failure to sufficiently intensify the antidiabetic treatment in patients with poor glycemic control poses the risk of therapeutic inertia and likelihood of adverse health outcomes.[5]