Getting to the Heart of Diabetes with Dr. David Lieb

More than 40 million Americans live with diabetes, with an additional 115 million diagnosed as having prediabetes, according to the American Diabetes Association. With nearly one in two adults affected, the diabetes epidemic is a challenge David Lieb, MD, FACE, FACP — a person living with diabetes himself — is all too familiar with.

“Living with diabetes is a daily, lifelong struggle,” said Dr. Lieb, the inaugural Aaron Vinik, MD Professor in Endocrinology & Diabetes at Macon & Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion University. “It affects every part of the body; there are frequent doctor’s appointments, the need for frequent medications and glucose-testing, all which impact family, work and everyday life. It’s a complex, ongoing responsibility.”

In addition to his work as the vice chair for education in the Department of Medicine and the program director of the Endocrinology, Diabetes and Metabolism Fellowship, Dr. Lieb serves as a physician in the Strelitz Diabetes Center, supporting patients in their journey with diabetes.

For Diabetes Awareness Month, Dr. Lieb shared symptoms of Type 1 and 2 diabetes, the long-term side effects of the disease, and his approach to diabetes management as a physician.
 

• Diabetes symptoms: Type 1 diabetes tends to be of sudden onset, because it’s an autoimmune disease, though people may feel terrible weeks to months before seeking medical attention. With Type 2 diabetes, its onset may be slower, but both forms of diabetes cause frequent urination, which is the body’s way of getting rid of excess glucose. Other symptoms include extreme thirst, weight loss and severe exhaustion. Sometimes the muscles also ache.
   
• Long-term side effects and complications: There are two classes of complications: those involving small and large blood vessels. If tiny blood vessels are exposed to high blood sugars over time, patients are at risk of developing nerve problems, including numbness or burning in the feet. Uncontrolled diabetes can also affect vision and can lead to blindness if left untreated. Chronic kidney disease can also develop. As for the large blood vessels, long-standing high blood sugars are associated with heart disease, which is the number one killer of people with either type of diabetes. People with diabetes are also at risk of stroke, especially if they are obese or have sleep apnea.
   
• Dr. Lieb’s approach to diabetes care: Generally speaking, doctors must work with their patients to see what they’re able to do. Because Type 1 diabetes is an autoimmune disease that kills the cells that make insulin, those individuals must take insulin — they can’t live without it. For Type 2 diabetes, there’s a lot doctors can recommend as far as lifestyle changes to control diabetes better. Those folks should be referred to a dietician, an educator, physiologist or a life coach. There are also medicines that have been approved for treating prediabetes, such as GLP-1 medications  the GLP drugs. For many people, doctors can prevent the development of diabetes if they help their patients along the way.

Looking to manage diabetes care or support someone with diabetes? Learn more about the Strelitz Diabetes Center and get connected to a diabetes care professional.
 

About David Lieb, MD, FACE, FACP

Dr. Lieb is actively involved with the American Diabetes Association (ADA) in Hampton Roads, serving on its Leadership Board since 2019 and currently as mission chair and medical advisor. He also serves on the ADA's Regional Advocacy Council, supporting efforts to improve access to diabetes care, promote diabetes education and advocate for policies that benefit people living with diabetes. A major focus of Dr. Lieb's clinical and research work has been improving diabetes care in underserved communities, particularly in rural Virginia. He previously directed the EVMS Diabetes Center of Western Tidewater and the endocrine clinic at the Western Tidewater Free Clinic. Through his clinical practice, teaching, research and community partnerships, he is dedicated to improving the lives of people affected by diabetes, particularly those facing barriers to high-quality care.