Diabetes care in Virginia

Diabetes is a disease in which your body's ability to produce or use insulin, a hormone that regulates the amount of glucose in the blood, is hindered. Diabetes has the potential to lead to other disabling medical conditions, so it is vital to receive the best care possible and follow your treatment plan accordingly. At HCA Virginia's hospitals, our diabetes doctors (endocrinologists) and other diabetes specialists provide you with quality education and treatment options to help you maintain a healthy lifestyle despite diabetes.

For more information about our diabetes services or for help finding an endocrinologist, call our free, 24/7 Consult-A-Nurse® line.

What causes diabetes

Our bodies make insulin, a hormone that helps move sugar (glucose) out of the blood and into the cells, where the sugar is converted to energy. When someone has diabetes (diabetes mellitus), their body can't make enough insulin or can't use insulin correctly. This causes the blood sugar level to rise, resulting in high blood sugar (hyperglycemia).

When this happens, the glucose remains in the body, potentially causing damage to the organs. It can also lead to significant health problems, including heart disease, high blood pressure, kidney damage, chronic wounds and cerebrovascular accident (stroke).

Types of diabetes

Our specialists and doctors treat all forms of diabetes, including:


This type of diabetes exists when blood glucose levels are above normal but not high enough to be diagnosed as Type 2. Prediabetes has a high likelihood of developing into Type 2 diabetes over time, but lifestyle changes and medications can help.

Type 1 diabetes

This type of diabetes was previously referred to as "juvenile diabetes," as it is often diagnosed in children or young adults. It occurs when the insulin-making cells in the pancreas produce little or no insulin. Treatment usually requires regular insulin injections to regulate their blood glucose levels.

Type 2 diabetes

This occurs when the body can produce insulin, but is unable to process it properly (insulin resistance). This allows sugar to buildup in the blood. Type 2 is the most common and rapidly growing form of diabetes because of the increase in obesity and sedentary lifestyles, which contribute to the disease.

Free Type 2 Diabetes Risk Assessment

Gestational diabetes

This type of diabetes occurs in pregnant women, usually in the third trimester, when the hormones produced by the placenta block insulin. This contributes to a high-risk pregnancy. Medication and lifestyle changes are the preferred treatment options, but insulin injections may be needed in some cases.

Type 3 diabetes

Some research has suggested diabetes and Alzheimer's disease are related, referring to this connection as "Type 3 diabetes." Although there is still much to be determined about this relationship, our specialists are here to help you with all your diabetic care needs.

Risk of developing diabetes

Although the causes of diabetes remain uncertain, there are several known risk factors. Some of these factors, such as age and ethnicity, cannot be changed. However, other factors, such as weight and blood pressure, can often be addressed with lifestyle modifications.

Ask your doctor about diabetes if you:

  • Are overweight or obese
  • Currently have or previously had gestational diabetes
  • Experience ongoing or continuous stress
  • Have a family history of diabetes, heart disease or stroke
  • Have an inactive or sedentary lifestyle
  • Have high blood pressure (typically 140/90 or higher)
  • Have high cholesterol
  • Recently or previously gave birth to a baby weighing more than nine pounds

Symptoms of diabetes

You should also ask your doctor about diabetes if you have any of these common symptoms of diabetes:

  • Excessive or increased hunger or thirst
  • Extreme fatigue or weakness
  • Increased or frequent urination, especially at night
  • Irritability
  • Slow- or non-healing sores or wounds
  • Unexplained weight loss
  • Vision trouble, such as blurred vision

Diabetes screening and diagnosis

Per the American Diabetes Association, individuals should get screened for diabetes every three years, beginning at 45 years old, or sooner if you have diabetes risk factors. This screening is important even if you are not experiencing symptoms, since early detection gives you a better chance of preventing or delaying progress of the disease.

Depending on the results of screening, or if your doctor deems it is necessary for another reason, further testing may be requested.

Diabetes treatment

To help manage diabetes symptoms, our endocrinologists and support teams prioritize education. As part of that, our diabetes educators provide inpatient education for individuals with new-onset diabetes. No matter which type of diabetes you have, the goal of diabetes treatment is to properly maintain the glucose level in your blood.

Type 1 diabetes treatments

Those who have Type 1 diabetes will need to monitor their blood-sugar levels and give their body insulin throughout the day. This is usually performed through injections or an insulin pump that provides continuous doses.

The type of insulin used depends on when and how long the insulin needs to perform. The most commonly used types of insulin are:

  • Rapid-acting (begins to act within five to 15 minutes with an overall duration of three to four hours)
  • Short-acting (begins to act within 15 minutes with an overall duration of three to five hours)
  • Intermediate-acting (begins to act within one to two hours with a duration 18 to 24 hours)
  • Long-acting (begins to act within one to one and a half hours with a duration of up to 24 hours)

Type 2 diabetes treatments

Those who have Type 2 diabetes may not have to take insulin to regulate their blood sugar, but they usually do require some form of medication. Maintaining a healthy weight, making healthy food choices and getting physical exercise are key factors in helping a person with Type 2 diabetes manage their disease.

Emergency diabetes care

If insulin levels spike or plummet, you may experience a diabetic medical emergency, such as insulin shock or a diabetic coma. At this point, home treatments, such as your normal insulin injection, are unlikely to help—you need to seek emergency medical care. Advanced treatment is required to help prevent long-term damage. Our hospitals provide extensive emergency care services and endocrinologists who are ready to intervene 24/7 with the care you need.

Long-term diabetes care

Diabetes can have a range of long-term medical complications. The longer the amount of time that your blood sugar levels are unstable, the higher the risk of developing medical complications from the disease. Complications may include:

  • Circulatory problems
  • Damage to the kidneys, which may require a kidney transplant in severe cases
  • Decline in oral health and hygiene
  • Diabetic foot ulcers and other conditions, which can lead to the need for amputation
  • Heart disease, potentially leading to heart attack or stroke
  • Neuropathy (nerve damage)
  • Non-healing wounds resulting from poor blood circulation
  • Vision complications, such as glaucoma, eye disease, cataracts and blindness

Diabetic Limb Salvage Program at Chippenham Hospital

The Diabetic Limb Salvage Program at Chippenham Hospital is designed to provide high-quality, compassionate care to patients with diabetic-related limb issues. The program is dedicated to promoting overall health and optimizing lower extremity leg function through a streamlined, state-of-the-art multispecialty network.

About the program

Referring physicians maintain direct coordination of their patient's care while having access to our outstanding team of specialists. This team includes cardiologists, interventional radiologists, vascular surgeons and others from a wide range of medical fields.

Program features

Our limb salvage program features:

  • A comprehensive evaluation to develop an individualized care plan based on established protocols and your unique needs
  • A nurse navigator (available to you by phone and during your appointments) to help with communication and care coordination among your care team
  • A team of specialists to work with you and your current healthcare providers
  • Appointment times within 24-48 hours of referral
  • Education, including nutrition and diabetes management skills for home use
  • Long term follow-up care
  • Prevention, including off-loading, pressure relief and routine foot care

Contact the program

To learn more about the diabetic limb salvage program at Chippenham Hospital, please call (804) 823-4208.

Diabetes education centers

The key to managing diabetes is education. Our teams of certified diabetes educators are the core of our programs. They counsel, teach and care for people with all forms of diabetes. They also follow the most current and advanced protocols and teaching methods recommended by the American Diabetes Association.

Although you will find expert diabetes care at all our hospitals, we offer three diabetes education centers with advanced diabetes education programs:

Center for Diabetes and Medical Nutrition Therapy at LewisGale Medical Center

Diabetes specialists at the Center for Diabetes and Medical Nutrition Therapy at LewisGale Medical Center near Roanoke offer nutrition classes and one-on-one counseling services to help you manage your diabetes and live a healthier life. You will need a referral from your practitioner.

Diabetes self-management services

Our advanced self-management training includes education on:

  • Exercise
  • Medication
  • Monitoring your blood pressure
  • Nutrition
  • Preventing disease complications

In addition, we offer individual counseling sessions and small classes on a wide variety of diabetes topics, including medical-based and practical lifestyle guidance. We also host free diabetes support groups that meet monthly at LewisGale Hospital Pulaski and LewisGale Hospital Montgomery. Our support groups are open to anyone impacted by diabetes and their loved ones. Registration is not required.

Schedule an appointment

To schedule an appointment at the Center for Diabetes and Medical Nutrition Therapy, please call (540) 776-4567.

Diabetes Education Center at Reston Hospital Center

The Diabetes Education Center at Reston Hospital Center was founded in 1992 and is accredited by the American Diabetes Association for the quality of its educational services. We follow the National Standards for Diabetes Education. Our goal is to provide you with the knowledge and tools necessary for diabetes prevention or management.

Support persons 18 years old and older are invited to learn along with you.

Diabetes management services

Our services include:

  • Diabetes education classes for Type 2 and gestational diabetes
  • Glucose monitoring (if needed)
  • Individual counseling for all types of diabetes
  • Insulin training
  • Medical nutrition therapy
  • Pattern management
  • Support groups
  • Other support services
    • Physical therapy and fitness programs
    • Surgical weight loss programs
    • Medical (nonsurgical) weight loss programs

Schedule an appointment

To schedule an appointment at the Diabetes Education Center at Reston Hospital Center, please call (703) 689-9164.

Insurance coverage

Under Virginia law, most employed people in the state are covered at some level for outpatient diabetes education and blood sugar testing supplies. Check with your insurance company for details regarding your plan's benefits. If an authorization is required, contact your doctor's office for an order from your doctor that includes a diabetes diagnosis and the doctor's signature.

Diabetes education is also partially covered by Medicare and Medicaid with a doctor's order.