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Dr. Lois Jovanovic helped diabetic women have babies

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NEW YORK TIMES

An undated photo provided by the Sansum Diabetes Research Institute shows Dr. Lois Jovanovic in 2006 at the institute in Santa Barbara, Calif., where she was chief executive for 17 years. Jovanovic, who pioneered a medical procedure that enabled more women with diabetes to deliver healthy babies, died Sept. 18 at her home in Santa Barbara. She was 71.

Dr. Lois Jovanovic, who redeemed a childhood pledge when she pioneered a medical procedure that enabled more women with diabetes to deliver healthy babies, died Sept. 18 at her home in Santa Barbara, California. She was 71 and had herself been treated for diabetes since giving birth decades ago.

Her death was announced by the Sansum Diabetes Research Institute in Santa Barbara, where she had been the chief executive and chief scientific officer for 17 years. Katie Haq, a spokeswoman, said that the cause had not yet been determined but that it was not believed to be related to Jovanovic’s Type 1 diabetes.

“There were several absolutes in the field when I started,” Jovanovic (pronounced jo-VAN-oh-vitch) told the medical journal The Lancet in 2005. “Type 1 women were told not to get pregnant, to get their tubes tied or to consider having a therapeutic abortion.”

But in her first research study, during a fellowship at New York Hospital-Cornell University Medical College, she demonstrated as early as 1980 that women with Type 1 diabetes could produce healthy babies if their blood sugar levels were monitored during pregnancy and maintained at a normal level.

Her research also led to the development of precision insulin infusion devices and prototypes for an artificial pancreas.

“It’s thanks to Jovanovic’s pioneering work,” The Lancet wrote, “that a diabetic woman’s chances of having a healthy baby are now on a par with a healthy, nondiabetic woman; before that, such women had less than a 20 percent chance of having a healthy baby.”

Type 1 diabetes is a chronic condition in which the body is unable to metabolize sugar correctly because the pancreas is producing little or no insulin, a hormone necessary for sugar, or glucose, to enter cells to produce energy. The condition, which usually appears in childhood or adolescence but not always, has no cure but can be treated through management of blood sugar levels. (Type 2 diabetes is a more common and usually milder form of the condition.)

Diabetes ran in Jovanovic’s family.

In December 1922 her paternal grandmother, then 8 years old, wrote a thank-you letter to Dr. Frederick Banting, a 31-year-old newly minted physician who had been treating the girl for diabetes. Just a few months earlier, he had for the first time successfully treated a diabetic boy with insulin. The year before, he and a colleague had discovered insulin. (Banting went on to share the 1923 Nobel Prize in Medicine or Physiology for the discovery.)

The girl proudly told Banting that she was sugar free, having given herself daily shots of insulin. She went on to survive with diabetes for more than a decade, long enough to give birth to Lois Jovanovic’s father, who also developed Type 1 of the disease.

As a 12-year-old, Lois and her two siblings helped care for her invalid father until he died of diabetes at 51. She vowed then to become a doctor and to find a cure.

“I saw death and dying as a child,” she once recalled.

Years later, Jovanovic, after 29 weeks of pregnancy, gave birth to a child, her second, with severe cerebral palsy. (The infant spent three months on a respirator.) Within 24 hours of the delivery, doctors discovered that Jovanovic, too, had Type 1 diabetes.

She survived to become a tenacious research endocrinologist. And if she did not find a cure for diabetes as she had pledged to do as a child, she redeemed that vow in part with her success in helping diabetic women have children.

Lois Gretchen Blaustone was born on May 2, 1947, in Minneapolis. Her father, Arnold, was a neuropsychiatrist; her mother, Alice (Dechter) Blaustone, was a homemaker.

Jovanovic earned a bachelor’s degree in biology from Columbia University and a master’s in Hebrew literature from the Jewish Theological Seminary in New York. She earned her medical degree from the Albert Einstein College of Medicine in the Bronx and completed her residency and fellowship in internal medicine, endocrinology and metabolism at New York Hospital-Cornell, in Manhattan.

There she was a principal investigator for studies that found that by strictly regulating their glucose level, women could radically reduce the risks of complications during pregnancy and birth.

Jovanovic is survived by her two children, Dr. Larisa Taylor and Dr. Kevin Jovanovic, both specialists in obstetrics and gynecology; and four grandchildren. Her marriage to Dr. Radoslav Jovanovic, an obstetrician and gynecologist who works with his son in Manhattan, ended in divorce.

Jovanovic joined the Sansum Institute in 1986 and was its chief executive from 1996 until her retirement at the end of 2013. Among her accolades was the Outstanding Physician Award from the American Diabetes Association.

While she grew up watching her father’s health deteriorate and believing that a diabetes diagnosis would always be fatal, she became more hopeful as she progressed in her research and lived longer herself.

“Diabetes is a wake-up call,” Jovanovic was quoted as saying in The Lancet. “Without careful attention to details and the balance that life demands, yes, diabetes can rear its ugly head and still be a death sentence. However, meticulous attention to optimal glucose control is a reprieve from this sentence.”

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