OBJECTIVES: Individuals with schizophrenia are found to receive poorer medical care, and have a higher prevalence of diabetes than general population. Once a hypoglycemic therapy is needed, proper compliance to the therapy and diabetic care are important for achieving good glycemic control as well as preventing acute complications. Therefore, this study aimed to compare diabetic care and risk of acute complications after the initiation of the therapy for three years, between type II diabetics with schizophrenia versus those without schizophrenia. METHODS: This study used the claims database of the National Health Insurance program. Enrollees who began oral hypoglycemic therapy in 2001, and had been diagnosed with schizophrenia and refilled at least one prescription of antipsychotic(s) in the year prior to the index date were included in the study (the case group). Enrollees without schizophrenia who began oral hypoglycemic therapy in 2001 were selected from a randomly selected sample of the enrollees to match the age and gender of the case group (1:1) (the comparison group). Indicators of diabetic care included good medication compliance (a medication possession ratio≥0.8), blood glucose test, and HbA1c test. Indicators were measured annually. Acute complications were defined as emergency room visits or hospital admissions due to coma, hypoglycemia, hyperglycemia, or diabetic ketoacidosis. Cox proportional hazards model was adopted to assess risk of acute complications. RESULTS: There were 544 subjects in the case group and comparison group, respectively. The percentage of subjects compliant to the therapy in the case group was decreasing. In addition, the case group had poorer blood glucose-related monitoring in the long run, and had a higher risk of acute complications than the comparison group. CONCLUSIONS: Diabetics with schizophrenia, compared with those without such a condition, had worse diabetic care. Better disease management will be necessary for this patient group.