Shared care combined with telecare improves glycemic control of diabetic patients in a rural underserved community

Telemed J E Health. 2014 Feb;20(2):175-8. doi: 10.1089/tmj.2013.0037. Epub 2013 Dec 9.


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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Glycated Hemoglobin A / analysis
  • Health Services Accessibility
  • Humans
  • Male
  • Medically Underserved Area
  • Middle Aged
  • Patient Care Team*
  • Rural Population
  • Taiwan
  • Telemedicine / methods*


  • Blood Glucose
  • Glycated Hemoglobin A