Background: Costa Rica, like other developing countries, is experiencing an increasing burden of
chronic conditions such as diabetes mellitus (DM), especially among its elderly population. This
article has two goals: (I) to assess the level of metabolic control among the diabetic population age
60 years old in Costa Rica, and (2) to test whether diabetic elderly patients of community health
centers differ from patients in other health care settings in terms of the level of metabolic control.
Methods: Data come from the project CRELES, a nationally representative study of people aged
60 and over in Costa Rica. This article analyzes a subsample of 542 participants in CRELES with selfreported
diagnosis of diabetes mellitus. Odds ratios of poor levels of metabolic control at different
health care settings are computed using logistic regressions.
Results: Lack of metabolic control among elderly diabetic population in Costa Rica is described as
follows: 37% have glycated hemoglobin 7%; 78% have systolic blood pressure > 130 mmHg 66%
have diastolic blood pressure 80 mmHg; 48% have triglycerides 150 mg/d1; 78% have LDL 100
mg/di; 70% have HDL 40 mgldl. Elevated levels of triglycerides and LDL were higher in patients
of community health centers than in patients of other clinical settings. There were no statistical
differences in the other metabolic control indicators across health care settings.
Conclusion: Levels of metabolic control among elderly population with DM in Costa Rica are not
that different from those observed in industrialized countries. Elevated levels of triglycerides and
LDL at community health centers may indicate problems of dyslipidemia treatment among diabetic
patients; these problems are not observed in other health care settings. The Costa Rican health
care system should address this problem, given that community health centers constitute a means
of democratizing access to primary health care to underserved and poor areas.