Profile of type 2 diabetic patients aged 55 and over, from a peripheral clinic of the Costa Rican Social Security Fund

Abstract

Diabetes mellitus is a chronic disease whose prevalence Will increase with the ageing ofthe Costa Rican population. The predictive and the quality of life of these patients rely on their chronic complications that usually begin around the sixth decade. Therefore, it is necessary to know the profile ofthese patient in order to determine the best way to offer them health services thatrespond to their necessities. In 1986 a Program of Chronic Diseases was created in the outdoor-patient Clinic Dr. Marcial Fallas de Desamparados. Besides the specialized medical consultation, there is a preconsult given by a nurse, a Diabetic Foot clinic and a Diabetic Club. The sociodemographic, pathologic and metabolic control profile of the diabetic patient type 2 of 55 years and over that attends this program is described in this paper.

In 1995, there was a total of 603 patient registered in the program, ofwhich 432 (71.6%) were DM type2 patients with 55 years ormore. This population was characterized by being more than two thirds women (71%), of Iow education, of low economical level (28% in wealth care state policy). There was a high prevalence of chronic pathologies Iike hypertension (61.92%), obesity (78.5%, including overweight) and

dyslipidemia (41.5%). The secondary complications were important: retinopathy in approximately 25% and nefropathy 8%. The risk of suffering dangerous pathology (ulcers or amputation) in the lower limbs was almost 45% (yellow Foot in PATONA). Their metabolic profile was dissapointing: 72% of the patients had an annual average of glycemias over 140 mg%, 75% had their colesterol > 200 mg% and 67.3% had LDL-colesterol> 130 mg%.

Looking at this panorama, we should search for new strategies of attention in health care since this must go further than the common medical attention given up to now in our Clinic. We must put emphassis in health promotion and prevention.