The purpose of this study was to determine if occupation-based activities improve diabetes self-management and reduce depressive symptoms in an elderly Mexican-American woman with type 2 diabetes mellitus (T2DM). There have been no known studies showing occupational therapy's role in self-care management of T2DM in people with depressive symptoms. The individual in this single-subject research was evaluated using glycosylated haemoglobin blood tests, four self-reported standardized questionnaires, participant reflective logs and clinical observations following an 8-week intervention. The participant improved on all measures, which were sustained 1 month after treatment ended. Clinical implications highlight a new role for occupational therapists providing early intervention in people with diabetes and depression for secondary prevention of complications of uncontrolled diabetes. Research suggestions include multiple single-subject studies showing occupational therapy contributions. Copyright © 2012 John Wiley & Sons, Ltd.