Shared Care Combined with Telecare Improves Glycemic Control of Diabetic Patients in a Rural Underserved Community

Objective:To investigate the effectiveness of shared care combined with telecare in type 2 diabetic patients in an underserved community in Asia.Research Design and Methods:In total, 95 patients with type 2 diabetes who had a glycosylated hemoglobin (HbA1c) level of >7% were recruited from six community health centers in remote areas in Changhua County, Taiwan. All patients were randomly divided into intervention (shared care combined with telecare) and usual-care groups and followed up for 6 months.Results:The decrease in HbA1c level was significantly greater in the intervention group than in the usual-care group (0.7 +/- 1.3% versus 0.1 +/- 1.0%, p=0.03). There were no significant differences in lipid profiles and blood pressure changes between the two groups.Conclusions:Shared care combined with telecare could significantly reduce HbA1c levels in type 2 diabetic patients with poor glycemic control in underserved rural communities. Further studies should be conducted to clarify the target users and to develop cost-effective interventions.