We read with great interest the article by Wang et al. 1 We would like to draw your attention to the results of our study which evaluated the impact of Marmara earthquakes (Turkey) on 17 August and 12 November 1999, on the quality of life (QoL) of our type 1 diabetic patients using the WHO Well Being Questionnaire (W-BQ).The study included a group of patients (n = 77; males 47%; age 24.2 ± 8.5 years) who had participated in a previous QoL study in October 1998 and they were affected by at least one of the quakes. For the new study, data were collected in the third month following the second quake and compared to results of the previous ones. In addition, metabolic control (HbA1c), body mass index and daily insulin requirement were assessed before and after earthquakes. In the meanwhile, the type of effect by the earthquake, socioeconomically and/or physically, was investigated via a questionnaire which was completed by the patients.According to our results, W-BQ scores were affected inversely by the quake. Mean total W-BQ score was decreased from 69 ± 13 to 44 ± 14 (P < 0.001). However, depression and anxiety scores increased significantly (prior and after the quake; 34 ± 14 vs 54 ± 13; P < 0.001 and 41 ± 18 vs 70 ± 19; P < 0.001, respectively). Our results also revealed the scores for positive well-being and energy decreased from 64 ± 21 to 36 ± 20 (P < 0.001) and from 73 ± 18 to 62 ± 20 (P = 0.008), respectively. When the data were compared before and after the quakes there was no difference for body mass index (23 ± 1.4 vs 23 ± 2.8 kg/m 2 ). However, HbA1c (7.4 ± 1.5 vs 8.8 ± 2.5%; P < 0.001) and daily insulin requirement (0.58 ± 0.3 vs 0.75 ± 0.3 IU/kg per day; P < 0.001) were increased. Moreover, physical and/or socioeconomic impacts of the quake obtained from the questionnaire were not found to be changed in parallel to the psychological impact (DW-BQ scores) of the quake. Finally, we did not find any meaningful difference in W-BQ scores of the subgroups of those who were affected seriously or those who were affected minimally by the earthquake in terms of physical and socioeconomical levels. The fact may be explained by the limited number of injured people in the study cohort. Those who were not seriously affected still have a strong fear of a new quake. REFERENCE1. Wang X, Gao L, Zhang H et al. Post-earthquake quality of life and psychological well-being: Longitudinal evaluation in rural community sample in northern China.