Updated: Nov 8
Author: Ryan Osal, MS, OTR/L, CEAS, CHC
I have been an Occupational Therapist (OT) for 10 years and I am currently working in a subacute adult and geriatric setting in the US. Most of my clients have a co-morbid condition of diabetes mellitus (DM). When I started working as an OT in the adult population, I focused on interventions for the sensory and motor deficits as complications from uncontrolled DM. Most of the clients were able to achieve their optimal functional skills at home and in the community, but they were still re-admitted to the hospital and rehabilitation centers, due to poor self-management of their chronic medical conditions. The cycle of admission and discharge to and from home and healthcare facility goes on and on.
I started to pursue training in health and wellness coaching because of my interest in food and nutrition. That opened up my idea of the preventive part of OT and our important role in diabetes and lifestyle modification.
According to the World Health Organization (WHO), the number of people diagnosed with DM has risen to 422 million in 2014, from 108 million in 1980. Diabetes is a major cause of lower limb amputation, blindness, stroke, kidney failure and heart attacks. The WHO recommended lifestyle measures to prevent or delay the onset of diabetes (Diabetes, 2019).
Diabetes self-management (DSM) is an important part of this medical condition and the expertise of OT practitioners in health-promoting activities is a promising resource.
Unfortunately, DSM in OT literature is not widely published (Pyatak, 2011). Self-help tasks, such as healthy eating, taking prescribed medications, exercises, coping strategies, risk reduction and problem-solving are components of lifestyle management, for individuals with DM to better their health and improve quality of life (Chen, et al, 2011).
There are training programs for OT clinicians geared toward the management of diabetes and related medical conditions. One is the Lifestyle Redesign course from the University of Southern California. Another one is the list of approved programs from the National Board for Health and Wellness Coaching. The International Board of Lifestyle Medicine has affiliate organizations to be certified in lifestyle medicine.
Inter-professional collaboration in diabetes care is critical to yield better patient health outcomes. It is recommended to clarify roles, have frequent communication and negotiate space and place to practice among healthcare professionals. This way of integrating health services in diabetes management is vital to the success of the program (Gucciardi, et al, 2016).
Author Ryan Osal is currently a graduate student in the Post-Professional Doctor in Occupational Therapy, Boston University, College of Health & Rehabilitation Sciences: Sargent College; Boston, MA, USA.
Chen, Mei‐Yen, Huang, Wei‐Chao, Peng, Yun‐Shing, Guo, Jing‐Song, Chen, Chia‐Pei, Jong, Ming‐Chung, & Lin, Hui‐Chuan. (2011). Effectiveness of a health promotion programme for farmers and fishermen with type‐2 diabetes in Taiwan. Journal of Advanced Nursing, 67(9), 2060-2067.
Diabetes (2019). Retrieved from: https://www.who.int/news-room/fact-sheets/detail/diabetes.
Gucciardi, E., Espin, S., Morganti, A., & Dorado, L. (2016). Exploring interprofessional collaboration during the integration of diabetes teams into primary care. BMC Family Practice, 17(11), 12.
Pyatak, E. (2011). The role of occupational therapy in diabetes self-management interventions. OTJR : Occupation, Participation and Health., 31(2), 89-96.