190. In this case, the record shows that Mrs. Chinchilla’s diabetes and related ailments were known to the prison authorities and to the doctors who treated her free of charge, both at the COF clinic and in the public hospitals. This situation was also reported by the doctors who assessed her and was brought to the attention of the enforcement court. 191. As for the treatment required by Mrs. Chinchilla, particularly after her ailments worsened or became complicated, the doctors referred to this between January 2003 and April 2004, in the context of the incidental motions for early release. They indicated that the treatment involved the following: i) regular monitoring of sugar levels, ophthalmological evolution, kidney disease monitoring, control of irrigation of lower left limb and cardiovascular checkups; ii) verification of the times she took her medicines, help in moving her, access to medical equipment at the COF for laboratory tests in the event of complications; iii) intramuscular insulin injections; iv) special equipment for ketoacidosis in the event of diabetic coma; and v) examination by an endocrinologist.292 For her part, one of the COF nurses noted that Mrs. Chinchilla needed someone “very special to accompany her 24 hours a day and attend to her personally, which they could not do because they had to see to the rest of the prison population.” Another medical report from 2006, provided to the Commission by the petitioners and not challenged by the State, also refers to the treatment that Mrs. Chinchilla should have received.293 192. In the first place, there are contradictory versions regarding the provision of necessary medications and an adequate diet for Mrs. Chinchilla Sandoval. On the one hand, the representatives argued that Mrs. Chinchilla’s family paid for her insulin and provided food appropriate for her health condition, based mainly on the testimony of Mrs. Chinchilla’s daughter, who mentioned the expenses incurred in purchasing her mother’s insulin and the need to buy her a small refrigerator for her cell, claiming that the insulin would get lost in the COF’s medical center.294 For its part, the State insisted that the prison’s medical center on all the circumstances of the case, such as the duration of the treatment, its physical and mental effects and, in some cases, the sex, age, and state of health of the victim […]. Although the purpose of such treatment is a factor to be taken into account, in particular whether it was intended to humiliate or debase the victim, the absence of any such purpose does not inevitably lead to a finding that there has been no violation of Article 3 [.] ECHR, Case of Sarban v. Moldova, No. 3456/05, Judgment of October 4, 2005. Final, January 4, 2006, paras. 75 and 76. Thus, the European Court has taken into account factors such as the lack of emergency and appropriate specialized medical assistance, excessive deterioration of the physical and mental health of the person deprived of liberty and exposure to severe or prolonged pain as a result of a lack of prompt and diligent medical care, the excessive security conditions to which the person has been submitted in spite of their evident grave state of health and without the existence of grounds or evidence to make them necessary, among others, in order to assess if the person deprived of liberty has been subjected to inhuman or degrading treatment. ECHR, Paladi v. Moldova, No. 39806/05, Judgment of March 10, 2009. 292 See the statements of the doctors given at the hearings of August 29, 2003 and April 21, 2004. According to this report, […] a person suffering from diabetes must be assessed clinically, with regular lab tests (pre and postprandial glycaemia i.e. before and after eating), preferably fortnightly or monthly, as well as laboratory tests on urine, blood chemistry, renal, pancreatic, hepatic function, etc., since diabetes is a disease that progresses rapidly and has effects on various systems of the human body […] hypertension […] should be monitored constantly given the problem of terminal occlusive arteriosclerosis that she suffered in her lower limbs, since this increases the risk of venous thrombosis that could cause cardiac or pulmonary thrombosis. Monthly electrocardiograms and taking her pressure every 48 hours is the preventive treatment indicated […] Report of Dr. Edna Karina Vaquerano Martínez, physician and surgeon, and specialist in Psychiatry (evidence file, folios 15201532). 293 The representatives stated that Mrs. Chinchilla’s relatives were the ones who provided her food and medications. In fact, her daughter Marta María Gantenbein Chinchilla de Aguilar stated at the hearing that she was responsible for taking the medicines to the COF, so that the medical department could hand them over to her, but that sometimes “the medicine would be lost.” For this reason, they allowed her to have “a small refrigerator to keep the insulin” inside her cell, a privilege that generated expenses that “one had to pay to have it inside, and she had a television, and also had to pay for the electricity and for the right to keep it there.” For its part, the Commission 294 60