第二型糖尿病病患，接受遠距照護服務之成效

Effectiveness of Telecare Services for Type2 Diabetes Glycemic Control

"隨著人口老齡化，民眾罹患慢性疾病盛行率大增，2017年糖尿病為國人死因第五位，第二型糖尿病的西醫門診醫療支出高居第二位，造成醫療保健系統沉重負荷（衛生福利部統計處，2021a；衛生福利部統計處，2021b）。糖尿病患者的照護重點在於減少併發症的風險，同時盡量減少與治療相關的危害，從而延長壽命和提升健康相關的生活品質（Steventon et al., 2014）。糖尿病病患控制不良，容易併發諸多急慢性合併症，且與其他十大死亡原因中之腦血管疾病、心臟血管疾病、腎臟疾病及高血壓等息息相關，因此糖尿病照護及併發症的預防是非常重要的健康照護議題。"

"To explore the effectiveness of glycemic control before and after diabetic patients who received ""diabetic telecare"" and ""usual care"". From October 2016 to December 2018, using a quasi-experimental research design, using conceptual sampling and fixed sampling methods, the experimental group enrolled 38 people with type 2 diabetes who received diabetes telecare, and enrolled 190 people with usual care in the control group, and glycated hemoglobin (HbA1c) was followed up 3 times. Statistical methods include descriptive statistics, paired t-tests, filling in missing data using Last Observation Carrying Forward(LOCF), and generalized estimation equation analysis(GEE). The HbA1c of the two groups decreased in the two post-tests. The HbA1c of the experimental group decreased by 2.37±2.28 in the first post-test and 3.01±2.38 in the second post-test compared with the pre-test. The decrease was significant(P<.001). Using the estimated marginal average to compare the difference between the pre- and post-tests, the experimental group's HbA1c decreased by -2.18 at the second time and -2.47 at the third time. The HbA1c decreased significantly in the two post-tests. Repeated measurements using the generalized estimation model showed that the HbA1c of the experimental group at the second time point was 2.11 lower than that of the control group; the HbA1c at the third time point was 2.27 lower than that of the control group, both reaching a significant level. The results of this study support that patients with type 2 diabetes who receive ""distant diabetic care"" can effectively reduce glycated hemoglobin, and the effect of blood sugar control after intervention is significant. Recommendations for intervention in telecare include: immediate feedback from nurses, assistance in analyzing abnormal blood glucose problems and guiding adjustments to blood glucose control plans, prompting the case to improve self-management, and assisting in communicating with doctors regarding the adjustment of diabetes treatment plans."