Nancy is a 66-year-old female who works full time as a human resources manager in a shoe factory. She has a medical history of non–insulin dependent diabetes, obesity, and osteoarthritis. She is able to control her diabetes with diet and oral antidiabetic agents. She has recently lost 70 pounds, which has also helped improve her blood sugar control. Along with her recent weight loss, she has joined a walking club and has gradually increased her exercise routine to power walking 3 miles per day on most days of the week. Nancy relates that she has a difficult time “getting going” in the mornings because her arthritis is in her knees and has had this difficulty for years.
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