Harold E. Lebovitz, MD: Legendary Diabetologist

Harold (Hal) Lebovitz turned 85 years old in October 2016. You wouldn’t know it from his travel schedule. He seems to go to India, or somewhere equally far, at least once a month. Despite long travels, he always shows up looking very perky and full of energy. In Harold’s case, some people will drive as much as 500 miles to attend his presentations, and as one physician commented, “Oh, yes, Harold Lebovitz is the greatest. I would go any distance to hear him speak.” And, in speaking, he has always adjusted his presentation to fit exactly to the time allocated without apparently looking at his watch. His array of topics spans all of diabetes and is always quite up to date.

Harold Emil Lebovitz was born in Pittsburgh, PA, on 13 October 1931 to David (Dave) and Frieda Pachman Lebovitz. Harold’s father, Dave, had wanted to be a physician, but his parents told Dave he could never support a family as a physician, so he became a pharmacist. Dave opened Lawrenceville Drugs in Pittsburgh. The family lived above the store and Harold and his older brother, Al, as teenagers and while in college, worked there as soda jerks and helped fill prescriptions. All three of the brothers became physicians: Al, now deceased, was a psychiatrist; Harold is an endocrinologist; and Philip, the youngest, is a cardiologist. Dave continued to work actively as a pharmacist, even after selling his store and moving to Florida, only retiring at age 86.

Harold received his undergraduate and medical degrees, in 1952 and 1956, respectively, from the University of Pittsburgh. During his senior year of medical school, he was a Lederle Research Student Fellow in Pathology. He also served as president of Alpha Omega Alpha Honor Medical Society and received the Brinton Prize for highest overall average in medical school. After completing an internship at Mount Sinai Hospital in New York City, he returned to the University of Pittsburgh Medical Center for his residency in internal medicine, serving as chief resident under the legendary chairman of medicine, the tyrannical Jack D. Meyers. Known as “Black Jack,” Meyers was rumored to not let anyone finish his training program unless they demonstrated superior clinical skills. Harold then headed south to Duke University Medical Center for a 3-year fellowship in endocrinology and metabolism, completing it in 1962. Following that, he joined the Duke faculty as an associate in medicine. A year later, in 1963, he was promoted to assistant professor, and he was awarded a prestigious 10-year Research Career Development Award from the National Institute of Arthritis and Metabolic Diseases.

That same year in early July, tragedy struck. Frank Engel, who was Harold’s mentor and friend and was chief of the Division of Endocrinology and Metabolism, suffered a myocardial infarction while in teaching rounds and died the same day, at age 49. At the time, Harold was a junior faculty member but had planned on taking a year “in-house sabbatical” to work with Robert Hill in biochemistry. However, with Frank Engel’s death, the fellows in the division—including Larry Frohman, Saul Genuth, Ed Horton, Bruce Squires, and Peter Kohler—“were left rudderless and uncertain about what this meant for their developing careers,” stated Larry Frohman. Harold, the only other faculty member in the endocrine research lab, became its head (1–3). Harold also suddenly became chief of the Endocrine Division of the Department of Medicine, all told a huge responsibility thrust upon a junior faculty person who was just beginning his own bench research career. Harold is well known as a generous, supportive, and conscientious mentor, who has always taken his responsibility for mentorship very seriously. Harold was appointed the division chief although there were several older, distinguished members of the division. His overall intelligence and energy impressed many. Colleagues found it remarkable that Harold managed to do all that he did.

That was a remarkable beginning of a career that provided mentorship to an incredible number of future “stars” of endocrinology, diabetes, and metabolism. These included such luminaries as Aubrey E. (Chris) Boyd, Kenneth Quickel, Jerome Feldman, Thomas Huff, Francis Neelon, Glenn Cunningham, Robert Downs, Marc Drezner, Warner Burch, Mark Feinglos, James Plonk, Peter Wilson, Charles Stuart, Mary Ann Banerji, JoAnne Palmisano, Rochelle Chaiken, Michelle Baron, Dana Andersen, and Samy McFarlane. I was a fellow in Harold’s lab the same time as George Eisenbarth, Steve Beuttel, Harry Delcher, and Dave Wellman. It was a very collegial group, all working on different aspects of hormonal regulation of cartilage. Harry Delcher noted, “Fellows were impressed that all of us had to have a unique project—we were not working on something of which his laboratory was a published expert.” Yet, Harold was quite flexible, delving into polyendocrine autoimmunity with George Eisenbarth (4), empty sella syndrome with Frank Neelon (5), defining the mechanism of pseudohypoparathyroidism type II with Marc Drezner (6), defining the effects of biogenic amines on insulin secretion with Jerry Feldman (7), identifying a role of pancreatic polypeptide in glucose homeostasis with Dana Andersen (8), determining the mechanism of postgastrectomy hypoglycemia with Kirk Schultz (9), probing the utility of L-DOPA as a stimulus for growth hormone secretion with Chris Boyd (10), studies of carcinoid syndrome with Jerry Feldman (11), endocrine aspects of sarcoidosis with Charles Stuart (12), discovering abnormal insulin secretion in myotonic dystrophy with Tom Huff (13), effects of sulfonylureas first with Jerry Feldman (14) and later with Mark Feinglos (15), and defining the syndrome of Flatbush diabetes (16) and of clinical remission of diabetes in black individuals with Mary Ann Banerji, Rochelle Chaiken, and Samy McFarlane (17). This diversity of topics for studies was made possible by having an National Institutes of Health (NIH)–supported Clinical Research Center both at Duke and The State University of New York Health Science Center at Brooklyn (SUNY Downstate) and by three important NIH grants: Harold’s Research Career Development Award (mentioned above), a training grant for endocrinology fellows, and Harold’s long-standing R01 grant titled “Hormones and Intermediary Metabolism,” a title that allowed near-total flexibility in research directions.

Harold’s lab was an exciting place to be, even for his children. His son Dan recalls, “The lab as a kid was always a place of fun and activity. My first ‘job’ was cleaning the hamster and mouse cages. I think I grew up calling him Chief instead of Dad having heard it so many times. I have always been amazed at his ability to navigate so many different areas of endocrinology successfully and to cross into other disciplines seamlessly.” His daughter, Sharon, adds, “He was so dedicated to his work that he often returned to his lab after we had dinner as a family to monitor or work on studies that needed to be progressed overnight. I'll never forget the smell of the rat chow (mouse chow?) that they fed the hamsters ... the metal cages they were in, the feeling of being in a very special place when in his lab.” Son Mike says, “I remember when his unit moved from the old Bell Building to the new area. In the new office, he got a new LED calculator about the size of a brick when they first came out.” A colleague also remembered that when Harold suffered a significant back injury he arranged to have a cot brought into the lab in order to supervise the work, even while lying down! Most people would not have done that, and yet there he was.

Harold is proud of his children. His eldest, daughter Sharon (“Princess”), graduated from Duke and from Stanford School of Business, after which she stayed in Palo Alto where she works as a management consultant and author. Older son Daniel graduated from Washington University in St. Louis and Duke Medical School and did his postgraduate work at Case Western Reserve and the University of Virginia. He now is a pediatric intensivist in Cleveland. Younger son Michael earned an engineering degree at Georgia Tech and is now a senior executive in industrial insurance, living in Rhode Island. Harold has seven grandchildren, ranging in age from 14 to over 30 years. His voice fills with happiness and enthusiasm whenever he mentions them.

Harold rapidly rose through the ranks at Duke, becoming an associate professor in 1965 and full professor in 1971. He also had an appointment as assistant professor of physiology beginning in 1969 and became an associate professor of physiology in 1978. He was chief of the Division of Endocrinology and Metabolism from 1965 to 1982. He had a sabbatical as a visiting professor of cell biology at Baylor College of Medicine in Houston, TX, during 1975–1976.

In 1982, Harold moved to SUNY Downstate as professor of medicine, a position he still holds. He was chief of the Division of Endocrinology and Metabolism/Diabetes from 1982 to 1999 and was director of the NIH-sponsored Clinical Research Center at SUNY Downstate from 1982 to 1996. From 1996 to 1999, he was director of the Diabetic Treatment Center.

Harold has been (and still is) an absolute stalwart of diabetes research, diabetes care, and diabetes education. He has made seminal contributions to each of these areas, which is testament to his versatility as well as durability. The versatility is a hallmark of his capability as a clinical scientist as well as a clinician; the durability we could ascribe to active longevity. At age 85 he is much the same as he was when endocrine section chief at Duke in the mid-1970s. As a “complete endocrinologist” he gets excited about metabolic mechanisms and new science, likes to interact with investigators of all ages, and is as scientifically rigorous as ever. He is actively engaged with several research projects and focuses on mechanistic research concerning a variety of metabolic topics.

Harold is known as a mentor, advisor, iconoclast, collaborator, and friend to many of his trainees, and for some he became a part of their extended family. I feel the same way—Harold has attended so many of my family events that he is part of my family. He came to hear our colleague George Eisenbarth deliver the first Jay Skyler Visiting Lectureship at the University of Miami—proud of two of his disciples.

In 1994, Harold received the Albert Renold Award from the American Diabetes Association (ADA), an award for distinguished service in mentorship and training of diabetes research scientists. At a reception in his honor, many of his trainees commented on how important Harold has been to their careers. Some similar comments are offered with this article. It is said Harold can be described with three words: “Harold is fun.” Professionally there are few peers that can match Harold. His infectious manner of linking research to the passion of his trainees to help patients is the secret of his legacy. His joy at tackling a difficult problem and asking clearly answerable questions that lead to discovery is his modus operandi. His openness to new ideas, new technologies, and new theories has established his legacy as a master educator and scientist. When asked about Harold, Mark Feinglos replied, “I have never seen anyone who can match his boundless energy and enthusiasm, nor the speed with which he can develop new ideas and insights.”

Harold’s educational commitment also is legendary. He has served on the scientific sessions planning committee for the ADA, including 2 years as chairman. He also cochaired an ADA postgraduate course, chaired the diabetes section for an Endocrine Society Postgraduate Course, and for several years chaired the Diabetes for Internists Program of the American College of Physicians. He was editor of the first five editions of the ADA book Therapy of Diabetes Mellitus and Related Disorders. Harold is known as the quintessential teacher, sharing his love of science and knowledge of clinical care by directly engaging learners in one-on-one Socratic discussions.

That noting of enthusiasm is a common theme. Colleagues say Harold is clearly one of the brightest and most energetic clinician scientists they have met. He is critical and thoughtful and seems to have great insight.

Richard Kahn notes, “My first and continuing impression of Harold is that of an ever-energetic, devoted, and committed seeker of knowledge. He is a person that never seems to give up or even slow down. His curiosity and so obviously passionate love for all things diabetes are truly remarkable. Couple this professional zeal with his unqualified integrity and goodwill to all places him as one of the few people in my life who has been an unforgettable and significant mentor.”

Harold’s energy and commitment have led to several honors and awards, including the Charles H. Best Award from the ADA in 2001 and American College of Endocrinology Distinction in Endocrinology Award in 2003. He has served his profession in many capacities, often serving as a reviewer for NIH and the Veterans Administration and serving on the board of directors of the ADA and of the American Association of Clinical Endocrinologists. He was on the ADA Expert Committee on Diagnosis and Classification of Diabetes Mellitus in 1997 and 2003. He has served on multiple journal editorial boards.

Harold has also been a frequent advisor to industry, helping develop products that help people with diabetes and/or obesity and sometimes advising that their efforts are likely to be fruitless. Currently, he serves on the scientific advisory boards of Biocon Pharma (Bangliore, India), Intarcia Therapeutics (Boston, MA), MetaCure (Orangeburg, NY), and Poxel Pharma (Lyon, France). Since joining MetaCure in 2003, first as an adviser and subsequently as a member of its board, Harold has been leading the scientific and medical research of MetaCure using his immense knowledge and global contact base. MetaCure has developed an implantable device for the treatment of obesity and type 2 diabetes with a combination of improved glycemic control and weight loss. This is typical of the contributions he has made to multiple companies over the past several decades.

Harold Lebovitz is a legendary figure in the field of diabetes. Yet, despite his legendary status, he is humble, kind, fun, and always stimulating to be with. I love and respect him and was honored to be asked to write this Profiles in Progress about him. I thank the many colleagues who contributed their thoughts—too numerous to use all of them, but I have tried to include many.

Ralph DeFronzo summed it up very well saying, “We all should remain as young, enthusiastic, and inquisitive as Harold. He is a role model for a diabetes educator and has devoted countless hours to the training of aspiring clinical investigators. We should aspire to follow his footsteps.”