糖尿病的盛行率逐年上升，而血糖的自我管理與心理負擔是糖尿病人所需面對的主要問題。越來越多研究使用網路或是行動上網裝置來傳送衛教訊息、服藥提醒來幫助糖尿病人的自我管理。中老年人對於科技使用有較大的阻礙，也較少研究將科技介入運用在慢性病的中老年人身上。因此，本研究藉由行動通訊軟體”LINE”的介入，發送糖尿病衛教及相關的提醒訊息，協助目前已罹患糖尿病之中老年人提升血糖管理及降低負向情緒。本研究採類實驗設計，實驗組為2014年11月-2015年2月於家醫科及內分泌科符合收案條件之門診病人共49位，而2012年9月-11月於家醫科收案之門診病人，分成電話追蹤(N=91)與一般門診衛教(N=91)兩組為本研究之對照組。研究結果指出，在糖尿病中老年人中，最多人發問的是飲食問題(26.7%)及藥物諮詢(26.7%)；其次，相對於其他兩組，在降低糖化血色素方面，藉由行動通訊軟體介入糖尿病衛教相較於電話追蹤組與一般門診衛教組有較顯著的進步(P=0.02)；而在降低負向情緒方面，行動通訊軟體組的糖尿病困擾分數有顯著降低(P=0.01)，與其他兩組比較，行動通訊軟體組也有較顯著的降低糖尿病困擾(P=0.02)，除此之外，行動通訊軟體的介入在中老年糖尿病人身上有其可行性，也能讓糖尿病中老年人感覺到知識、態度、行為的改變。

Background: Diabetes has an increasing prevalence all over the world, and self-management and diabetes-related distress are the main issues in diabetic patients. Previous studies showed that technology or Internet-based intervention has benefits for diabetes self-management. Few studies focused on improving self-management through technology in middle-aged and older adults.
Objectives: our study aims to compare the mobile-based intervention, telephone-based and usual care interventions in middle-aged and older adults. Methods: Participants (N=49) are recruited in endocrine and family medicine clinics during Nov. 2014-Feb 2015. Those who aged ≥50, diagnosed with diabetes, without cognitive impairment and depression symptoms were included in this study.
The control groups with telephone-based intervention (N=91) and usual care (N=91) were recruited in family medicine clinics from Sep. 2012 to Nov. 2012.
Results: Comparing to the telephone-based and usual care groups, the reduction of HbA1C in the mobile-based group was significant. (P=0.02) Also, diabetes specific distress scores (PAID) have the more significant reduction in the mobile-based group than in the other two groups. (P=0.02).
Conclusion: Though the mobile-based, telephone-based and usual care interventions have the potential to reduce the diabetes specific distress, only the mobile-based intervention could improve glycemic control and reduce diabetes specific distress in a short-term period. The mobile-based communication application might be useful and cost-effective for diabetes health education.

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