There’s an overlap between the complications connected with diabetes and some of the side effects linked to HIV medications. If you’re familiar with the side effects of some HIV medications, you’ll probably recall hearing about “insulin resistance,” high triglycerides, and cardiovascular problems in general.

Diet, exercise, medication, and supplements can be used to control diabetes. A low-sugar, low fat diet and regular aerobic exercise should be a part of anybody’s lifestyle if they’re dealing with or seeking to avoid type 2 diabetes.

WARNING! Consult your doctor before using any of these supplements to manage your diabetes. DO NOT stop or change dosage of any diabetes medications prescribed to you without consulting your doctor. Diabetes can be an extremely fast-changing health condition and needs very careful monitoring at all times!

Many supplements are currently under study for help in controlling diabetes; below is a short list–all of which are stocked by the New York Buyers’ Club Member Store.

Now for some better news: everybody agrees that adequate, sustained levels of calcium and Vitamin D intake are excellent ways to reduce the risk of osteopenia and osteoporosis. Since studies have shown that many HIV+ people of all ages do not get enough calcium and Vitamin D, it would be wise to pay extra attention to these items in your diet. The usual recommendations are 1000-1200mg calcium per day for men, and 1000-1500mg for women. (Recommendations vary by age as well as sex.) For Vitamin D, 800 IU per day is standard. Note that you can get calcium from foods like milk, cheese, broccoli, and tofu, while Vitamin D is obtained through fortified dairy products, egg yolks, saltwater fish—and exposure to sunshine! (Yes, research indicates that osteoporosis may be less frequent in southern, sunnier climes.)

Lark Lands, an expert on nutrition and HIV, suggests using supplements such as ginger root and the omega-3 fatty acids found in fish oil and flaxseed oil, to help lower HIV-related inflammatory response, which has been linked to osteoporosis. Of course, lowering inflammatory response can benefit the body in many ways, beyond decreasing the risk of bone problems. One of Lark’s major points: better health is more likely to come through broad nutritional supplementation, rather than through just a few isolated nutrients added here and there to the diet.

Finally, don’t underestimate the importance of exercise in maintaining long-term bone health. This cannot be stressed enough! You may be surprised to learn that bone is a living tissue–and, like muscle, gets stronger through exercise. So why not walk to the store to pick up that Vitamin D-fortified milk, rather than driving your damn motor vehicle?!

For more information about bone health in people with HIV, see Lark Lands’ tips on countering side effects at larrylands.com. We also recommend aidsmeds.com’s summary of bone issues.

The following is an excerpt from the New York Buyers' Club Self-Care Guide. The author, NYBC's Outreach Director Carola Burroughs, can be found spreading the good word on Friday evenings at GMHC

Some call them “Nature’s Prozac,” but depression is only one of many emotional imbalances that can be improved by the use of Bach flower remedies and other flower essences. These gentle healers are non-toxic, non-habit-forming essences of flowering plants that help to re-balance negative emotional states such as fear, anxiety, depression, or poor self-image. They have no floral scent or taste, and are not related to aromatherapy, which is closer to herbology. Rather, like homeopathy, they are classified as ‘vibrational’ or ‘subtle energy’ medicine.

Developed in the 1930's by noted British bacteriologist and homeopathic physician Edward Bach, Bach flower remedies, and other more recently developed flower essences, seem to still be one of the best kept secrets among natural therapies. Perhaps it’s because the idea just seems too good to be true: ‘take a few drops a day of a harmless, pleasant-tasting liquid, and your feelings of anxiety or depression or other negative emotions will just melt away.’ Yet for many people, including many people with HIV, that appears to be just what happens.

Like many other natural therapies, flower essences act on the level of an individual’s innate healing capacity or healing intelligence. Taking them is rather like “rebooting” one’s inner computer, restoring order to a system that has gone off course. There is as yet no clear scientific explanation for how or why these essences work. Author Mechtild Scheffer, in her book Bach Flower Therapy: Theory and Practice, describes the action of the Bach remedies as “healing by restoring harmony in awareness.”  In one of a very few double-blind, controlled studies done thus far, a 1979 California study found that use of the Bach remedies enhanced creativity, deepened self-understanding and self-acceptance, and increased humor. Los Angeles practitioner Yolanda Lacombe believes that the essences help the immune system by strengthening a person’s sense of protective boundaries, reinforcing the distinction between self and non-self - which is, when you think about it, just what the immune system does.

Flower essences may be used in conjunction with any other therapy, and can be especially useful used along with psychotherapy. Each flower essence deals with a particular emotional state. In the Bach Flower Remedies, the original essences developed in England by Edward Bach, there are 38 different remedies, plus one combination, called “Rescue Remedy,” “Calming Essence,” or “Five Flower Formula,” which is particularly useful for coping with any high-stress or emergency situation, such as accidents, exams, dentist appointments, or temper tantrums. Rescue Remedy also comes in a cream form that is wonderfully soothing for burns, stings, cuts and other skin afflictions. Flower essences can be used equally effectively with adults, children, animals, and plants. In addition to the original essences developed by Dr. Bach, there are now hundreds of other lines of essences made from flowers worldwide.

There are two basic ways to use the essences: for either occasional or long-term use. On an occasional basis, such as for passing stress or anxiety, they may be administered directly under the tongue or added to any beverage, using two drops of each remedy indicated (four in the case of Rescue Remedy). For long-term treatment of more chronic problems, such as fears or trauma, a formula can be made up containing one or more remedies (up to a combination of six) in a one-ounce dropper bottle. The formula is then taken several times a day for a month or more. This method achieves much deeper acting, more long-term results.

Flower essences are classified as over-the-counter substances regulated under the homeopathic pharmacopoeia of the Food and Drug Administration, and are available at most health food stores and many pharmacies, or directly from the manufacturers. The Flower Essence Society (FES), in Nevada City, California, offers training, research, and an extensive list of publications.

NYBC does not presently carry Bach flower remedies, which are available at most health food stores, natural pharmacies, and the Vitamin Shoppe, as well as through FES, but if members want us to, we can. Let us know

Is anybody anxious?
Many people suffer anxiety around HIV/AIDS treatment options. They've been presented with monumental medical choices that scare the #*~@!# out of them. Take drugs or, to put it bluntly, get sick and die. Nobody likes to talk about it in such frank terms because the words aren't very people friendly. People use words like drug therapy and disease progression, but the choice is still pretty much the same, hit it hard and early or risk the possibility of illness and….

I've been dealing with my own diagnosis and have worked in the AIDS community for over a decade. I’ve talked to a lot of PWAs, and it’s so clear to me that most of you/us either have in the past or are now experiencing these and many other concerns. On any given day, I hear about how someone...isn't very happy about going on any of the anti-viral combinations...is very grateful to finally have something to take…is worried that HAART is toxic…balks at the thought of taking something for the rest of her life...hates that the only options he’s presented with are western traditional choices...is terrified of side-effects...isn't sure if or when to start...is afraid she's already waited too long...is afraid of starting too early...is afraid the drugs will give her secret away at work...is afraid the combo he's chosen isn't working anymore...or, worst of all, is afraid that the smart choices made today may be the wrong choices of tomorrow. These issues are real and, right now, there are no clear answers.

When everything is fluid and changing, how do you maintain your equilibrium? Is it enough to just put on a happy face?  I don't think so. Just putting on a happy face doesn't even buy you time. When confronted with a situation for which there are no immediate answers and when everything keeps changing, it’s important to search for the positives and try not to dwell on the negatives. It sounds Pollyannaish, but what other options do we have? I, for one, am not interested in sinking into a black hole of depression. Been there, done that! Why board the barge for a meaningless trip to denial?  Besides, these days water sports can be dangerous. What can you do? What doesn't cost any money and is available 24-7? That’s easy, a positive attitude. That sounds like a simplistic answer, and your right, it’s way more complex than just putting on a happy face. There’s no real proof that thinking positively works, but then consider the mystery of the placebo effect. The placebo effect happens in almost all double blind clinical trials.  Why not put it to work for you? 

What's the placebo effect?
That’s when, unknown to you, you're given "sugar pills" (pills with no medicine in them) and you get better anyway. No one is sure why it happens or who it’s going to happen to, but it does happen. This, of course, means that there’s an unknown mechanism at work, which is triggered by the belief that this pill (sugar pill) is going to give benefit.  Somehow, it’s possible to manifest a positive physical response simply by believing it’s possible to manifest a positive physical response. Now that's positive thinking.  If such good things can happen by accident, then what might happen if a little positive energy is put into it?  The answer is that absolutely nothing might happen, other than you start feeling better about yourself. Don't get it wrong, no one should ever expect to be cured simply because of a positive attitude. But what’s wrong with believing that everything concerning your/our health is enhanced by positive thoughts. 

How do you maintain a positive attitude?
Well, here’s a little trick.  Take a few moments at the end of the day, when you have total privacy and quiet, and review the good things that have happened to you during the day.  Refuse to spend time on the negatives. Devote your energy to compiling a list of all the good things you can remember from your day, those you’ve done to or for others and those that have been done to or for you. Then try to let all of the good feelings wash over you and, at least for the moment, let yourself linger for awhile in all of those good feelings.  This will help you to be more aware of the positive experiences you have on a daily basis, as they’re actually happening. It's hard work. Sometimes I find myself standing on a street corner cursing a cab driver or wanting to stick my foot out an extra six inches to trip the big so-and-so who just cut in front of me. But, if the worst I do is vent my anger and frustration at the retreating cabby through a blue verbal tirade, I'm not doing so bad. At the end of the day that’s just one more thing to add to my list of positives and that’s what’s called putting a positive spin on things. The obvious good things are easy to put on the list. The harder work is finding ways to turn the crap into positives. If you do the work, it makes getting through the day a lot easier. Just knowing that most of the bad stuff can be turned into something positive helps in finding more and more positive things. It's called an upward spiral.

You may ask how this helps with making treatment choices. By practicing this and other techniques for positive living, it starts to become second nature to see the positives in the choices that have to be made, including treatment choices. I’m not yet the perfect practitioner of positive thought, but by committing myself to not giving up on it, I get better at it every day. I still suffer from depression as anyone who, long term, has experienced the AIDS epidemic. But it gradually becomes easier to count on my instincts. I made one of the scariest choices possible: I waited as long as I could before starting anti-virals. Because of my exercises in positive thought, my anxiety level was greatly reduced. I’m prepared to trust the choices I’ve made. And I feel assured that even if I’ve made a wrong or bad choice, somewhere in that choice is a positive if I look hard enough.

Should we talk among ourselves?
I've told you about some of my tricks, now I'd love to hear how you keep it positive even when the pit of negativity is so very tempting. If you write to us we’ll share your tips with everyone.

Author's Note: There is a fine line between negative thoughts and depression. If you and/or your loved ones suspect that the trouble you’re having maintaining a positive out look is due to a legitimate depression, it’s time to seek professional help. Start with talk therapy and work with your therapist to determine if medical intervention is needed. If it is, your therapist will recommend a Psychiatrist who may prescribe a mood elevator or anti-depressant and you may be pleasantly surprised to find out that life no longer sucks.

A prime example: sold in retail stores and over the internet for an average of $42/bottle, NYBC stocks the amino acid supplement Acetyl-L-Carnitine for just $10!

Based on a sliding scale, annual NYBC memberships range from $5to $25. Click here for more information!