Giving Thanks For Dr. Lois Jovanovic (1947-2018)
Editor’s Note: Dr. Lois Jovanovic passed away on Sept. 18, 2018 at age 71. She was a pioneer in the Type 1 world, particularly through her contributions to pregnancy with diabetes. The impact she had on the diabetes community is immeasurable, and her legacy will live on through her work and the millions of lives she affected.
Dr. Lois Jovanovic changed the world for people with diabetes – especially women. She was first to show that through normalizing blood glucose, we can have healthy pregnancies and babies. An avid researcher, Dr. Jovanovic published more than 500 articles, many on diabetes in pregnancy. Guided by her passionate leadership, Sansum Diabetes Research Institute became an internationally recognized center with combined missions in research, clinical care and community support for people with diabetes. Dr. Jovanovic personally expanded education and specialized programming for women with diabetes, including local Latina populations in California. She never stopped seeking a cure for Type 1 diabetes and was a leader in early artificial pancreas trials.
I had the great fortune of knowing Dr. Jovanovic for more than 30 years. Back in the mid 1980s, my parents excitedly announced that a new endocrinologist had moved to Santa Barbara from New York and they wanted me to meet her. A tween at the time, I had more interest in my appearance than my diabetes. I would tune out doctors who seemed to focus on my parents, but the minute Dr. Jovanovic introduced herself, I knew this would be different. She was a tiny woman, poised as a ballerina, wearing dramatic black and bright flowers with the reddest lipstick. She had beautiful long black hair pulled tightly back, emphasizing her intense eyes. To me, Dr. Jovanovic looked like a woman from a far away land. She spoke directly to me, and I listened intently.
Learning from the best
Dr. Jovanovic’s office was near the lab, where I soon learned she was experimenting with mice and beta cells. She had an A1c machine and an “under seven club” which, even as a kid, I was excited to be a member of. I was determined to please my intently caring woman doctor. Soon her intent rubbed off on me, and I started wanting to take care of myself, for myself – a gift I am thankful for every day.
Through my teenage years, pregnancy was far from my mind, but curing Type 1 started to seem cool. I volunteered in Dr. Jovanovic’s lab, helping her team of scientists inject beta cells into mice. In between patients, she would pop in, bringing her bright enthusiasm with her. Like Dr. Jovanovic, everyone at Sansum was inspired to cure T1D. Walking into the building felt like walking into a place of hope – I loved it!
By the time I was 21, I wanted to start using a pump. I brought the unopened box to Sansum and Dr. Jovanovic herself showed me all the parts and how they worked. That was the day I discovered that Dr. Jovanovic knew what it was like to have a pump, because she wore one herself! I later learned that she helped many of us with type 1 start our pump journeys. She even encouraged prominent endocrinologists to “wear” the pump so they could relate to their patients.
When I had my pump self-consciously tucked in my clothes that day, Dr. Jovanovic hugged me saying, “Your pump is going to change your life.” For a week, she called me daily to check in and help me adjust basal rates. When I saw her in person, she showed me tricks to keep it waterproof in the shower and how to cut a tiny hole in the pocket of my skirt to feed the tubing through and keep the pump in my pocket. I started to wear flowy skirts with pockets like she did.
When I moved to NYC to become a nurse midwife, I kept Dr. Jovanovic’s wisdom with me but we didn’t see one another for many years. After I met my husband David, he wanted to meet the woman I credited with my good health, so we visited Sansum. I was amused that she and David were overjoyed to meet one another. Dr. Jovanovic was absolutely gleeful that day, showing us an early artificial pancreas model and saying, “We WILL solve this, but until then, you know what to do.” It brought me back to my days in her lab.
Soon, David and I were thinking about pregnancy. Scouring the literature on diabetes in pregnancy, Dr. Jovanovic’s name appeared over and over. I followed her advice on keeping my numbers in an incredibly narrow range. On the day we saw a positive pregnancy test, before meeting with anyone in New York or telling even my family, I wrote her an email announcing our “blastula” to her. She wrote back immediately, “I would love to help your blastula become a beautiful bouncing baby!” and she did through many emails of encouragement. I also became one of her research subjects. At that time, she was evaluating c-peptide levels to see if the immunosuppression that naturally occurs in pregnancy could allow for some insulin production, which could potentially lead to a cure for T1D. Miriam was born and became one of “Lois’ Babies!” I was so proud, and she told me often, so was she. She even made a page for our baby book, referring to two miracles: the discovery of insulin and the birth of our daughter.
Contributing to the cause
I ruminated on the good fortune of having Dr. Jovanovic’s care during my pregnancy and wondered how other women got through it. I decided to weave diabetes education into my midwifery practice, and Dr. Jovanovic took on a new role as my mentor. I consulted with her as I put together guidelines for the public hospital system of NYC. She encouraged my involvement in a perinatal diabetes nonprofit she founded in California called SSEP. We just had our first NYC conference, something Dr. Jovanovic and I had excitedly discussed! I also have the honor of working with Dr. Castorino, whom I first met during the pregnancy study I participated in at Sansum. Now we’re studying continuous glucose monitoring and pregnancy outcomes in women with Type 1.
Dr. Jovanovic, I miss your encouraging email messages, passionate talks and new manuscripts. Still, I carry your teachings with me every day and will continue this work in your honor. I am thankful for you in this season and always.