Introduction: Diabetes mellitus is a major health problem in Costa Rica. Its prevalence is rapidly increasing achieving 12.8% and represents a burden for the health system. Changes in mortality due to diabetes have not being fully evaluated.

Objective: To describe specific diabetes mortality and life expectancy in diabetics from 2007 to 2017.

Material and Methods: Death certificates (classification CIE-10) were obtained from the Instituto Nacional de Estadistica y Censos from 2007 to 2017. Total mortality, standardized diabetes mortality rates per 100.000 habitants (SDMR) and deaths due to diabetic nephropathy were assessed. The years of life lost (YLL) due to diabetes was determined using data of life expectancy at birth per 1000 habitants. Gini coefficient, Lorenz curve, Index of Human Development and the Public Morbidity Report were employed to explain changes in diabetes mortality.

Results: Total mortality in Costa Rica remained invariable through the study period. From 2006 to 2014 the SDMR was constant (14.5 to 15.2) However, SDMR steadily peak from 15.2 to 26.3 during the last three years. Compared to males, SDMR was higher in females, the excess of mortality due to diabetes in females ranged from 1.7 to 4.8 deaths per 100.000 habitants. Up to 2013 the YLL ranged from 30 and 20 deaths per 1000 habitants in females and males, respectively. Nonetheless, YLL increased in females and males to 48.9 and to 34.3 at the end of the study. Deaths associated to diabetic renal disease increased. Index of Human Development did not explain the increase in diabetes mortality. Public Health Care Coverage in diabetics reached 40%. HbA1c, LDL and blood pressure control goals were achieved in 41%, 35% and 52%, respectively and 11% of diabetics accomplished the triple goal. Low Public Health Care Coverage in diabetics was seen in two provinces with the higher SDMR.

Conclusions: In Costa Rica deficient coverage and poor diabetes management may explain the changes in SDMR.


J.G. Jimenez-Montero: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at