Saturday, June 9, 2012

How Don Orione Coped with a Disease: Diabetes

During his second stay in Argentina, Don Orione began to feel his age, and at 62 years old he experienced some health problems, among them diabetes.
This article aims at being both a historical and medical study of Don Orione’s diabetes.

Diabetes is a disease which produces hyperglycemia, meaning a high level of blood sugar. The normal level of blood sugar ranges between 70 and 110 mg%. Diabetes is usually related to the absence or low level of insulin. Basically there are two kinds of diabetes.
Type 1 diabetes, or juvenile diabetes (IDDM), the origin of which is genetic. It is found in children and young people who will become insulin-dependent. This is usually the more severe diabetes and likely to have complications.
Type 2 diabetes, or adult-onset diabetes (NIDDM), is also determined genetically. The pancreas can produce insulin, but in insufficient quantity. As the years go by, the pancreas produces less and less insulin, so the patient needs to be treated with oral anti-diabetics which improve insulin secretion or reduce the hyperglycemia. It usually has a better prognosis and can sometimes be regulated by an appropriate diet. It was type 2 diabetes which Don Orione suffered from.

The First Symptoms of Diabetes
In many letters written by Don Orione between June and July 1935, he briefly described how the symptoms of diabetes had appeared, his treatment, medical tests and other details.
In a letter to Fr. Sterpi, Don Orione wrote about what made him suspect something was wrong and consult a doctor: a great sense of exhaustion and extreme thirst: “I have been very weak for more than a month; I thought I was exhausted due to hard work – I could not manage to get any useful writing or work done. Then, as I was also extremely thirsty, I began to think that it must be something else, and when they tested my urine, they found it was diabetes”.[1]
The increase of sugar in the blood produces the loss of a lot of water through urine, due to osmosis; the cells become dehydrated and cause extreme thirst. In fact, excessive thirst and the excessive production or passage of urine are the main symptoms of diabetes.
In addition, diabetes also causes an alteration in the metabolism of proteins and fats, as well as chronic inflammation of nerves and blood vessels, which produces a feeling of tiredness and pain, especially in the arms and legs.
The result of his urine test showed that he was suffering from diabetes.
Together with this, stress and tiredness increase a kind of hormone called catecholamine, which produces hyperglycemia. The doctors probably thought that resting would help Don Orione, together with a reduced carbohydrate diet to normalize the level of sugar, which otherwise was not so high.
In another letter to Fr. Sterpi, he explained other details:
“I didn’t want to cause you any worry about my diabetes, but this is what happened: I had a great thirst and I felt unable to work, I didn’t know why. I thought it might be diabetes, and the urine test showed 42 per one thousand of glucose. They have forbidden me to eat potatoes, fruit, eggs, rice, and only very little bread, etc. Today they took a blood sample and repeated the urine test, too. Now I’m better than I was, certainly because I have cut out some kinds of food and have rested more. So you need not worry, and I’ll keep you informed.”[2]
Above 30 decigrams per 1000 of sugar in the urine shows as traces in the tests, and above 40 is positive, which shows us that the doctor found a high level of sugar in Don Orione’s urine (42 decigrams per mil); which is equivalent to 140 mg % - 180 mg % of sugar in the blood.

Calming the confreres down
Trying to calm down his religious in Italy who were concerned about this news, Don Orione begged them to believe that he was well. Then he transcribed the results of his tests:
 “I assure you that I’m fine, and there’s no need for you to worry about my diabetes; it is quite fashionable to have diabetes these days! I don’t think there is anything else wrong with me; you must believe me that I’m fine (…) Regarding my diabetes, I have received the results of both my blood and urine tests, and  I’m sending them to reassure Fr. Sterpi. / Blood test: blood sugar: 1,51 grams per thousand. / Glucose in the blood (Follin-Wu Method) / Urine – Albumin – serine – traces. Globulin idem. Albuminosa – nil. / Mucins – traces / Glucose – 3,034 gr. per one thousand / Laevulose – nil / Acetone – nil”[3]
Looking at these new results, we can see that a minimum detectable level of sugar in the urine and blood was 151 mg %, though the letter shows the old way of measuring in grams per thousand.

Reduced Carbohydrate Diet
There is another indirect mention of Don Orione’s diabetes in a draft, where he described the diet he was following.
“Veal, mainly grilled, or maybe some boiled or grilled chicken: / boiled or raw eggs / Clear soup – milk, tea or coffee – butter / A little brown bread, or better crackers. / Vegetables – boiled chard and spinach with a little oil / celery – cucumber – cabbage- salad with oil and lemon / Fruit: an orange or mandarin – 100 grams of wine with meals - mate tea or coffee / Forbidden: flour – pasta – semolina and noodles / White bread – biscuits – sweets – fruit – sugar – potatoes – sweet potatoes – pumpkin- – carrots – carrots – lentils – beans and chickpeas”.[4]
The diet described by Don Orione is a typical example of a reduced carbohydrate diet, which cuts out sugar, alcohol, honey, carrots, cereals and both white and brown bread.

Sense of humor
In a letter to Bishop Albera, his friend, Don Orione told him what had happened, joking about his confinement to bed, drinking:
“I am quite well; I am slightly diabetic, but it is already much better. They wanted me to stay in bed for at least three days, condemned to drink nothing but plain water. Can you imagine it? And do you remember Gonella? He was one of our students at San Bernardino for his first year, and then he went on to St. Chiara. He is a doctor here now, a medical authority. (…) Do you know what I told him? ‘Listen, Gonnella, if you tell me to stay in bed for three days drinking only wine, such as nebbiolo, barbera or grignolino,[5] then I would be quite willing. I might then sing all day long, and it would be fine. But drinking only water, come on! Show some sense! Is this your gratitude to me for allowing you into our school?’ You can imagine, dear bishop, what a laugh it was!”[6]

In the book “La gioia del bene” (Messagi 19), Fr. Orlandi told many stories about Don Orione’s sense of humor: “If it was money that the bursar had lent him, Don Orione would joke about his forgetfulness: - ‘I don’t remember’ - he would say, smiling – ‘I can’t remember ... don’t you know, I am diabetic!...’- and everything ended on a jolly note…”[7]

From a medical point of view, we can affirm that Don Orione had type 2 diabetes, a mild form, which could be treated by diet alone. We do not have any information about whether he took oral antidiabetics, because his hyperglycemia was probably normalized by the prescribed diet.
We cannot but admire how, even though he was diagnosed with a chronic disease, needing lifelong care, Don Orione bore it with optimism and did not get discouraged, even managing to laugh about it.
We can also see how responsible he was in taking care of his health, following the doctors’ advice, calming the worries of his religious, not thinking about himself, but doing his best to prevent anybody being too worried about him.
The saintly man shows his maturity in every circumstance, even when coping with a disease.

Sr. Maria Rosa Zbicajnik, PHMC
Fr. Facundo Mela, FDP

* Sr. María Rosa is a graduated doctor in the “Universidad de Buenos Aires” (Buenos Aires University), with adult infectious diseases residency in Francisco J. Muñiz Hospital (Buenos Aires City).

[1] Letter to Fr. Sterpi. Buenos Aires, 12th June 1935.
[2] Letter to Fr. Sterpi. Buenos Aires, 14th June 1935.
[3] Letter to Fr. Sciaccaluga. Buenos Aires, 19th June 1935.
[4] This draft has neither date nor place. Scritti 100, 106 and 100, 126.
[5] Three different kinds of Italian wine.
[6] Letter to Bishop Albera. Buenos Aires, 22nd June 1935.
[7] L. Orlandi, “La Gioia del Bene”, Messaggi di Don Orione 19 (1973) 19.

1 comment:

  1. I love reading this blog! :) My mother also has a diabetes.. this is ARBY of San Isidro Labrador Chapel.