This study aimed to assess the effect of community participation (CP) on diabetes screening rates and other related factors, compared between the intervention community (IC) and the control community (CC). The CP was conducted over an eighteen-month period. First, primary care workers and local groups identified community needs relating to diabetes screening. Second, educational training and resource mobilizing were performed. Third, community members participated in three negotiation sessions in terms of diabetes screening. Community members aged 36 to 60 years who did not have a diabetes screening during the past three years at baseline were randomly sampled for interviews. There was an improvement in diabetes and benefit coverage knowledge, health attitudes, and screening use in the IC. Diabetes screening rate of total population in the IC increased from 10% to 45% (p < 0.001) and the screening rate of those in the CC rose from 10% to 20% (p = 0.04). A suitable screening service including a frequently mobile screening unit had been devised from the decisions made by the community members. Health attitudes, the suitable screening service, and community support had an influence on the utilization of diabetes screening. This study demonstrates the effectiveness of the CP intervention in promoting diabetes screening utilization in rural communities.