Non-Insulin Dependent Diabetes Mellitus, or more commonly referred to as Type 2 Diabetes Mellitus (T2DM) is a common metabolic disorder that affects more than 35 million Americans according to the CDC. T2DM has dueling factors which in combination cause the characteristic metabolic distress: a maladapted insulin response in insulin-sensitive tissues coupled with an altered or defective secretion of insulin by pancreatic β-cells. Insulin sensitivity and insulin release are essential for blood glucose regulation and overall glucose homeostasis, and thus, the mechanisms involved in insulin detection and release are strictly regulated and complex. Being such a complex disorder, management and treatment are often individualized from patient to patient. In addition, there are a wide variety of pharmacological agents used to treat T2DM including metformin, insulin secretagogues, thiazolidinediones, and alpha-glucosidase inhibitors. Often, pathological causes of T2DM like obesity, diet, and exercise are scrutinized and altered while developing a patient’s management plan. Up until recently, T2DM was viewed as a chronic metabolic condition with no cure. However, recent evidence shows that the use of metabolic surgeries, primarily the Roux-en-Y gastric bypass (RYGP) and vertical sleeve gastrectomy (VSG) have been extremely effective procedures in helping patients achieve “normal” insulin sensitivity and glycemic control. Herein, the available literature detailing the mechanisms of rejuvenated glycemic control following a surgical intervention are reviewed as well as the current prevailing therapeutic modalities to treat T2DM.

Due to the rising rates of obesity present in the United States, occupational therapy practitioners will likely be seeing this population more frequently in a variety of health care settings. A thorough search of the evidence literature identified that occupational therapy practitioners were found to be lacking education on the topics of obesity and bariatric care and how to effectively assist this population. Furthermore, occupational therapy and occupational therapy assistant academic curriculums were found to be lacking education in the areas of safe patient handling with the obese population. Clients who are obese also expressed dissatisfaction with the health care that they have been receiving due to the identified barriers. Through an online educational program, called Bariatrics, obesity, and occupational therapy: How can we help? (BOOTH) the following topics will be integrated through a case study approach for occupational therapy practitioners and occupational therapy students: 1. general knowledge on the topics of obesity, 2. common co-morbidities, 3. bariatric equipment, 4. safe patient handling recommendations, 5. obesity related stigma, and 6. techniques for occupational therapy evaluation and intervention. Through completion of the online obesity and bariatric care education modules, students and practitioners will have heightened knowledge of how to safely assist this population to optimize client independence and reduce work related injuries. In doing so, occupational therapy will be identified as a vital resource for clients who are obese in health care settings, telehealth, and primary care.

Weight gain due to poor diet and lack of exercise is responsible for over 300,000 deaths each year (U.S. Department of Health and Human Services, 2010). Obese adults have an increased risk for serious health conditions including high blood pressure and cholesterol, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and certain cancers (National Cancer Institute, 2012). Participation in exercise can help control weight, strengthen muscles and bones, and reduce the incidence of cardiac events, stroke, hypertension, type 2 diabetes, colon and breast cancers, osteoporotic fractures, gallbladder disease, obesity, depression, anxiety, and delay mortality (ACSM, 2009). The purpose of this study was to determine the effectiveness of exercise participation during weight loss on a high protein-low carbohydrate diet plan during a 12-week span in females aged 15 to 25 years. Specifically, this research study was a comparison of markers of health such as weight, fat mass, percent body fat, and fat-free mass in females who consistently exercised during the diet (Exercisers) from those who did not participate in consistent exercise (Non- Exercisers). The population in this study was selected due to the transition from high school to college being a critical period because it is associated with many identity choices and lifestyle changes that can lead to weight gain (Anderson, Shapiro, & Lundgren, 2003). The data indicate participation in regular exercise, while consuming a high protein-low carbohydrate diet plan, increases the loss of body weight, fat mass, and percent body fat when compared to participating in the diet plan alone. There was no significant difference in fat-free mass reduction between the groups. One implication for practice is recommending moderate to vigorous exercise for a minimum of 30 minutes at a time, totaling a minimum of 150 minutes per week, for females trying to achieve weight loss. Based from the results of this research study, in order to achieve a greater amount of body weight, fat mass, and percent body fat reduction one should consider incorporating exercise participation and high protein-low carbohydrate dieting into their weight loss plan.