Before Byetta became available, most of the so-called experts thought that its biggest problem would be that it has to be taken by injection. But for almost all users it’s no problem, probably because it is much less painful than the fingersticks to test our blood glucose.

Instead, the biggest problem for many people with taking Byetta is the nausea that it often causes. In the clinical trials nausea was the most common adverse reaction. Almost half – 44 percent – said that they had nausea.

When I started on Byetta six months ago, I dreaded the nausea. But I felt a little nauseous for only about three hours after my first injection, and it never returned.

So I am no expert on nausea. I’m not a doctor either, so I can’t give medical advice. But I know a lot of people who use Byetta and know how to dig out information. (I also own a few shares of Amylin Pharmaceuticals, which developed the drug.)

When Joe commented on one of my earlier blog entries, “Are there any OTC meds for nausea that are safe with Byetta?” he got me thinking again about nausea and inspired me to write this blog entry.

My first thought was to ask the professionals who staff the Amylin Lilly Customer Support Center at 1-800-868-1190. Amylin and Lilly jointly market Byetta.

“We don’t make any treatment recommendations for nausea,” the doctor I spoke to there told me. “We always leave that up to the physician.”

Since that approach didn’t pan out, I turned instead to the real experts. The people who use it know best how to deal with the nausea that Byetta sometimes causes.

Many of these people are easy to find on the Internet on three large discussion group. The largest is technically a blog, but it functions just like a Web-based discussion group. My friend and associate, Dr. Bill Quick, set up a series of Byetta discussion forums more than a year ago on his blog. Hundreds, if not thousands, of people have posted there.

Two Yahoo groups, Diabetes_And_Byetta and ByettaSupport as I write have 291 and 217 members respectively.

When I searched these groups for Byetta and nausea, I found hundreds of messages. Quite a few of them tell what works for them.

While some people find success with either prescription or over-the-counter (OTC) drugs, many more minimize the nausea with different eating strategies. I am in the second camp.

My guess is that more people take Byetta to lose weight than to reduce blood glucose. That is certainly my motivation.

The weight loss comes naturally and easily from the reduction in hunger. If we listen to our body, we know when our stomachs are full.

But if we keep on eating anyway – like we always did in the bad old days before Byetta – we are bound to feel the nausea. The first eating strategy is small meals and maybe more meals or snacks.

What to eat is the second eating strategy. “I have to remember to keep the fat and spices miniscule,” one Byetta user wrote.