Remembering the Great Dr. Lois Jovanovic
By Kelly Close
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By Peter Rentzepis and Kelly Close
Passing of Dr. Lois Jovanovic, the leading figure in pregnancy and diabetes, brings sorrow to many; friends and colleagues share moving tributes
Dr. Lois Jovanovic was a legend and a leading light, very well known as the leading voice in pregnancy and diabetes. It’s the end of an era, said Dr. Howard Zisser of Alphabet (and formerly of Sansum), who stressed in a conversation with us just after her passing that she changed the world in so many ways. “She was incredibly generous with her time and knowledge. She lives on in the numerous “little Lois’s” around the world that she personally trained. They continue in her quest to care for those in need and to elucidate scientific truths,” said Dr. Zisser.
Said Dr. Francine Kaufman, Medtronic Diabetes’ Chief Medical Officer, of the inspiring legacy Dr. Jovanovic leaves behind: “Through an almost 40-year friendship built on common interests, respect and love, I had the opportunity to see the depth of commitment Lois made to her patients (her “mommies” and their babies), her research, her students, and her family. She leaves an unbelievable legacy – tens of thousands of healthy pregnancies, thousands of lectures and teachings, nearly 500 manuscripts, hundreds of women mentored, and an Institute transformed by her leadership. During her illness and long course of rehabilitation, she wrote a short paper on her phone and planned future lectures. For those of us who had the privilege of knowing her, hearing her lecture or reading her manuscripts, and those of us who were not so privileged, may none of us ever forget the contributions she made and how she helped transform diabetes care, and how she did it with caring and brilliance.
Kelly Close, Editor-in-Chief of diaTribe, was so lucky to know Lois over the last 15+ years and to see her speak so very many times. Kelly says, “Boy was she committed and whip-smart and strong and elegant. She made me feel proud to have diabetes, to just be in community with her, just as someone in the audience seeing someone else like her who herself had diabetes and was making such a difference in the world to SO many patients. People listened to her. She acted and she did, in addition to talking – for a researcher, the number of appointments she had always baffled me (“how can you be seeing this many patients outside research?”), and she made so much happen for so many underserved patients all over.”
Lois would always pick up the phone. It seems only yesterday that she spoke with the diaTribe team on creating this resource page on gestational diabetes and for an interview just two years ago) and how she responded to that request was as if you’d asked her to lead an NIH study of the highest order. (She always said things like “I’d LOVE to talk to your high schoolers! And how is John? And dear Coco, she must be 12 ...”) Lois did everything from being awarded a $4.5 million grant for artificial pancreas research from the NIH to being an author of the AACE/ACE 2016 Outpatient Glucose Monitoring Consensus Statement to counseling thousands personally and professionally. Even recently, when our first associate ever (now on the emergency medicine faculty at Johns Hopkins), asked me who to speak to on pregnancy for those with diabetes, I instantly responded that she must call Lois.
When Kelly asked Howard Zisser what Lois was most known for, he said the following, and we should just breathe this in: “It was not one thing. Of course, she is known for pregnancy but she was on DCCT, early A1c. Early computer integration. AP. Sensors. Implantable. Inhaled etc. She also advised pharma. And they listened for 40+ years.” We all did.
We have received a flood of comments on the incredible impact that Dr. Jovanovic has had on so many of our lives. She was a true inspiration and will be missed greatly.
“So sad about Lois. She was a force of nature, and I learned so much from her. She changed the world of diabetes and pregnancy in so many ways...Lois really catapulted the role of the diabetes educator in the successful management of diabetes and pregnancy, creating an army of believers that self-management matters across the nation. With her direction, we coached patients in how to achieve tight blood glucose targets both pre and post meals via following a well-spaced 3 meal, 3 snack meal plan and regular physical activity. I can still hear her demonstrating how she taught Spanish speaking woman with gestational diabetes in Santa Barbara how to exercise recommending they sit in front of the TV watching the Spanish 5 o'clock news from the beginning until the sports came on (20 minutes) lifting bags of beans or rice over their head in sets of ten counting in Spanish!” – Dr. Jane Seley (Manager of Inpatient Glycemic Control Program, New York-Presbyterian/Weill Cornell Medicine, New York, NY)
“Lois was the guiding influence and speaker for the patients in the DCCT – she helped with the pregnancy issues during that trial but more than that understood the nuances of having T1DM, the angst, the frustration and path forward – she will be sorely missed but will have a long time effect on the practice and management of diabetes.” – Dr. Michael Pfeifer
“I miss Lois already. She and I had the opportunity to collaborate together, lecture together, and most wonderful of all, break bread together. Here is a wonderful piece that she wrote about her grandmother’s near-death experience with type 1 diabetes and how Banting saved her life…and allowed Lois to come into being!” – Dr. Ian Blumer
“I have T1D and I worked with her as a UCLA medical student in ~1998. My two favorite stories: (1) when I was there, her pre-pregnancy planning clinic required women to have an A1c value equal to or lower than their healthy husbands before getting pregnant (the men always hated getting labs drawn!) (2) she had an arm ergometer in her office and every time we met she made us both check our BG before we started the meeting (pre-CGM); if either of us had a BG>150, we both drank a glass of water and the one of us with the higher BG exercised first while we talked. She just couldn’t tolerate sitting in the presence of hyperglycemia and loved to lead by example. I will miss her!” – Dr. Jenna Bollyky (VP of Clinical Research & Analytics, Livongo, Mountain View, CA)
“Dr Jovanovic was a true mentor and friend. I had been awarded the opportunity to do research with her in 2010 in her clinic in Santa Barbara when I was a fellow in endocrinology. I witnessed firsthand her role as an inspiration to all her pregnant women with gestational diabetes and her dynamic and caring demeanor which encouraged her patients to take the best care of themselves. She was passionate and was always available to answer a question and involving me in a future project. We remained in touch since collaborating initially in 2010 and she would always send thoughtful notes and emails. There was always a project she was working on, a lecture she was giving, countless students she was teaching, and patients and colleagues she was inspiring. It is a tremendous loss to not have her guidance and she will be greatly missed and remembered.” – Dr. Rachel Pessah-Pollack (Assistant Professor of Endocrinology, Diabetes & Bone Disease, Mount Sinai, New York City, NY)
“Lois was indeed so very special. She was the force behind and reason my T1D pregnancy was so successful. It was a privilege to know her and to have her lovingly care for me and my baby. For many years after Ava was born, we would meet up with Dr. Lois to show her how healthy and happy little Ava is. She would call her “one of her babies.” (I will forward a photo when I find it.) Dr. Lois inspired me to do so many things...in fact it was because of hearing her speak in 2004 I decided to try pregnancy. Since 1993, I had wholeheartedly believed that my body would not allow me to have a healthy baby. (I was told this by hcp’s.) Dr. Lois showed me and helped me believe in possibility. She gave me hope and inspired me. She was the first person I told I was pregnant in 2005. She then invited me to do one of the most remarkable things in my life, participate in research. I was in her study related to the regeneration of insulin producing cells in the bodies of pregnant T1D women. I will never forget the day she called me and exclaimed, “you are making insulin naturally!” What a moment! Dr. Lois also inspired me to research type 1 diabetes and pregnancy for my Master’s thesis…with a newborn in my lap. Throughout her career and in her every breath she gave women with diabetes hope! She will be missed, but remembered for her pioneering spirit, her spunk, her graceful presence, her tender care and her fierce advocacy for people with diabetes and science.” – Dr. Nicole Johnson (National Director, JDRF Mission, New York City, New York)
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“As a woman with diabetes and as a RN, CDE who used to specialize in caring for woman with high risk pregnancies and have experienced a high-risk pregnancy myself, Lois will first and foremost be treasured by me as a guardian angel. I KNEW through her erudition and skills she championed for me, my son Max, my patients, and their babies. She was a fountain of knowledge. I will mourn a friend.” – Ms. Gloria Yee (RN and CDE, UCSF, San Francisco, CA)
“Dr. Jovanovic was a legend in her own right and was always ready to share her expertise. I admired her passion for pre, intra, and post-natal care. She was a great example, a pioneer, for women in diabetes care. Thanks for sharing this information. Prayer and love to her family.” – Dr. Cris Anunciado (Clinical Science Liaison, AstraZeneca, San Diego, CA)
“It was a privilege to have worked with Lois. As a member of the AACE Board of Directors, she contributed her vast knowledge, commitment and enthusiasm to AACE's efforts on behalf of people with diabetes. Although Lois was diminutive in stature, she was a giant among our colleagues. Not only was her productivity legendary, but her superb didactic skills, commitment to excellence in research and clinical care, and nurturing approach to all of her patients (and their offspring) set an example for the hundreds of physicians, CDEs and others that she taught and mentored. Her vivacity and personal warmth made every room glow when she was in it. Her work will live on in all of her proteges as well as the thousands of people whose health is better because she was here. Her memory is a blessing.” – Dr. Rhoda Cobin (Former AACE/ACE President and Clinical Professor of Medicine, Mount Sinai, New York City, New York)
“I have known Lois since 1980 when we presented research at ADA in the same session. She has been a dear colleague and friend over the years… I am so very sad – she revolutionized the care of the pregnant diabetic…something she and I both dedicated our lives and careers to!” – Dr. Edith Miller (Medical Director, Carolinas Diabetes Center, Charlotte, NC)
“It was a privilege to have worked with Lois. As a member of the AACE Board of Directors, she contributed her vast knowledge, commitment and enthusiasm to AACE's efforts on behalf of people with diabetes. Although Lois was diminutive in stature, she was a giant among our colleagues. Not only was her productivity legendary, but her superb didactic skills, commitment to excellence in research and clinical care, and nurturing approach to all of her patients (and their offspring) set an example for the hundreds of physicians, CDEs and others that she taught and mentored. Her vivacity and personal warmth made every room glow when she was in it. Her work will live on in all of her proteges as well as the thousands of people whose health is better because she was here. Her memory is a blessing.” – Dr. Rhoda Cobin (Former AACE/ACE President and Clinical Professor of Medicine, Mount Sinai, New York City, New York)
“I have known Lois since 1980 when we presented research at ADA in the same session. She has been a dear colleague and friend over the years… I am so very sad – she revolutionized the care of the pregnant diabetic…something she and I both dedicated our lives and careers to!” – Dr. Edith Miller (Medical Director, Carolinas Diabetes Center, Charlotte, NC)
“I had the privilege to meet Lois 12 year ago and to work with her and Howard almost on a daily basis. She was an amazing teacher and mentor and was always happy to educate the engineering team on diabetes and physiology and the needs of the patients. Lois encouraged us to work on the design and development of medically inspired control engineering for the artificial pancreas. I am honored that I can continue the research path that was established by Lois - integration of the science of medicine and advanced control and system engineering to improve care of people with diabetes.” – Dr. Eyal Dassau (Director of the Biomedical Systems Engineering Research Group, Harvard, Cambridge, MA)
“I had the wonderful fortune to have her as a mentor in my grad school days at UC Santa Barbara, studying AP algorithms. I learned so much from her, and really enjoyed spending time with her. I would always look for her at conferences – and despite her tiny frame, she was always easy to spot with those colorful outfits! She’ll be missed in a big way.” – Dr. Dan Finan (Director of Research, JDRF, New York City, New York)
“What little I recall from 2014's conference is that she provided confidence for women with type 1 to pursue their goals of motherhood at a time when many care providers were arguing against it. Lois proved that women with type 1 could have a successful pregnancy and healthy baby, and with her guidance many women with type 1 became parents. Through Lois's efforts and the successes of the women she counseled, today women with type 1 diabetes can embrace the goal of motherhood with the knowledge that the science is behind them. This is a major achievement for parents -- and grandparents -- everywhere.” – Jeff Hitchcock (President, Children with Diabetes, West Chester, OH)
“Lois was an inspiration to me from the first day we met. I loved not only that she shared her T1D story with wit and humor, but she was an amazing researcher, clinician, mother, colleague, friend and overall human being. I have always been in awe of her. Such a loss, but so wonderful to have known her and learned from her. She lived much longer with T1D than did her grandmother and father. But it is never long enough when losing someone so special. She will be missed by all.” – Dr. Anne Peters (Director, USC Clinical Diabetes Program, Los Angeles, CA)
Dr. Peters also brought to our attention this tribute to Dr. Jovanovic, which details that her grandmother was one of the first children to be given insulin.
"This is sad news indeed, for we have lost a beloved colleague, advocate, pioneer, researcher, scholar, and friend to so many of us who have worked for years in the diabetes space to reduce the number of instances and stories like this one over which we grieve today. Lois provided help and hope for so many, and her legacy will continue to inspire us and many generations to come, to keep working for improved outcomes and for increased reduction of impact of diabetes on the lives of those affected by it. We will remember her and honor her by relentless pursuit of these goals, both by ourselves and hopefully by all those whom we teach, serve, and seek to inspire. Comfort and peace to her family and loved ones. Our hearts are heavy, but our memories of our times with Lois and her impact on our lives will continue to drive and inspire hope, commitment, and unyielding determination to defeat diabetes.” – Dr. James Gavin III (Professor of Medicine, Emory University, Atlanta, GA)
“I remember fondly connecting with Lois as I was forming dLife. right from the get-go and in subsequent interactions she was so effusively warm and personally encouraging. She did not need to make the time, but she did because she cared about patients. It meant so much to me and was so motivating to hear the authenticity and sincerity in her validation. I will always hold that memory close and mourn her passing.” – Howard Steinberg (Former founder and CEO of dLife, Westport, CT)
“I too was sad to read about Lois’ death. One thing that I always admired about Lois is that she really believed in people with diabetes… she believed they could do the work, put in the extra effort to triumph over the adversity of the disease. This was obviously the case for all the mothers who she coached through successful pregnancies. It was also the case for her pioneering work on self-monitoring of blood glucose. After her patients had successfully given birth, to everyone’s surprise except Lois', they wanted to keep the toaster-size SMBG units so they could continue to test themselves because it helped them do better even with the crazy lancets, huge blood samples and the complicated operation of the devices.” – Dr. Tom Peyser (SVP, Biolinq, Menlo Park, CA)
