Diabetes Care at Valley Health Inspires Patient to Become Health Coach

When Strasburg resident Clark Speaker, 58, went into the Winchester Medical Center Emergency Room in February 2023, he had a blister on his toe and a red leg.

Doctors quickly diagnosed him with a blood infection and a diabetic foot ulcer.

Speaker, who has diabetes, learned his A1C— a blood test that measures your average blood sugar levels over three months—was dangerously high at 13.5%. For people without diabetes, the normal A1C range is 4-5.6%. Per the American Diabetes Association, the A1C goal for individuals with diabetes is 7% or less.

“There was a shock phase,” he says. “I’d been going to the gym, I was on a diet, and I didn’t eat processed foods. I thought, ‘How is that possible?’’

The Diabetes Stewardship Program

Providers determined that Speaker’s diabetes was not well controlled, so he began receiving treatment through the inpatient WMC Diabetes Stewardship Program. The goal of the Stewardship Program is to manage glycemic control, educate patients about their diabetes, develop a post-discharge plan, and prescribe the necessary medications and supplies for home use.

Nurse practitioner Susan Zontine collaborated with Speaker to identify the best strategy and medicine for optimal diabetes control once he left the hospital. It was decided that Speaker should be prescribedinsulin. If not, there was a chance he could end up losing his leg or foot and potentially develop long-term complications related to high blood sugar, such as kidney, heart, eye and nerve disease.

Cathy Philpot, CDCES, certified diabetes care and education specialist, educated Speaker about insulin, how to self-administer it, and how to check his blood sugar and understand blood glucose targets. She also provided courtesy post-discharge follow-up texts and calls.

“It’s not helpful to hand a patient literature, ask them to read it, and expect that to have a meaningful impact,” Speaker says. “My diabetes educator met me where I was and spent time explaining things to me. That made all the difference.”

The inpatient Diabetes Stewardship team encouraged Speaker to obtain a referral to the Valley Health outpatient diabetes program from his primary care provider in order to receive ongoing diabetes education, care and support.

After he was discharged, Speaker went on to see Jane O’Doherty, a clinical dietitian at the Valley Health Outpatient Diabetes Management Program.

“We talked about consuming a balanced diet, incorporating low glycemic carbohydrates, decreasing protein to 90 grams a day for kidney function and elevated uric acid level, and resuming physical activity,” she says. “At the one month follow-up, Clark had incorporated fruits and was receptive to decreasing protein and adding low glycemic carbs.”

Personalized Care Leads to ‘Phenomenal’ Outcome

After three months, Speaker’s A1C decreased from 13.5% to 6.6%, which is a drop of almost 7%.

“Usually after three months, you could lower your A1C by about 1-3%,” Philpot says. “In my nursing career, I’ve never seen anyone in three months lower their A1C by almost 7 %. It’s phenomenal and simply unheard of.”

Speaker is so excited about his improvement and the care he received at Valley Health that he has decided to become a diabetes health coach. He is currently enrolled in the national online Health Coach Institute and will begin his internship in July. Speaker wants to help patients with weight management, diabetes control, diet, and food shopping—all while empowering them to make good choices. “People need help when they leave the hospital,” he says. “They need someone to help guide them.”

Speaker credits the Valley Health Diabetes Management Program for making him feel like more than just a patient and a number. “When you sit with them, you realize these people really care,” Speaker says. “They ask questions. They follow up. Their personalized care and compassion is amazing.”