OBJECTIVES: To evaluate existing diabetes-specific patient reported outcome (PRO) measures and the Patient Reported Outcomes Measurement Information System (PROMIS) item banks in relation to their their ability to capture health-related quality of life (HRQoL) domains that are relevant to multi-ethnic English speaking Asians with Type 2 diabetes mellitus (T2DM).  METHODS: Eligible patients were recruited from a diabetes clinic in a Singapore tertiary care hospital to participate in focus group discussions about how diabetes affect their HRQoL. Thematic analysis was performed to distil domains and sub-domains of HRQoL through open coding by two independent coders followed by axial coding for category refinement. These domains and sub-domains were then compared with items from Diabetes Quality of Life Measure, Audit of Diabetes Dependent Quality of Life, Diabetes Health Profile, Diabetes-39, the Comprehensive International Classification of Functioning, Disability and Health Core Set for Diabetes and PROMIS Version 1.0 item banks (all developed in the West).  RESULTS: Of 79 T2DM patients approached, 18 participated in 6 focus groups (9 men; 10 Chinese, 2 Malays, 5 Indians and 1 Eurasian; mean (SD) age: 46.8 (10.45) years). HRQoL issues in T2DM were organized into 26 domains and 58 sub-domains. Existing DM-specific PRO measures did not capture cognitive functioning and restricted participation in religious activities (domains) and modified participation in social activities and engagement of others (sub-domains). 13 of 26 domains and 19 of 58 sub-domains were addressed by the PROMIS Version 1.0 item banks (physical functioning, anxiety, depression, anger, fatigue interference/ experience, social role performance / satisfaction, pain interference / quality / behavior).  CONCLUSIONS: There is a significant degree of overlap in HRQoL domains and sub-domains between Western and Asian populations but gaps exist. When using generic PROMIS item banks to assess HRQoL among multi-ethnic Asian populations with T2DM, additional item banks are needed to fill these gaps and increase content validity.