Should Prediabetics Count Net Carbs or Total Carbs?

Diabetics are often taught to focus on counting net carbs, as they exclude the indigestible fiber that has a minimal impact on blood sugar levels. However, as a seasoned SEO expert, I believe that prediabetics should consider counting all carbs, rather than just net carbs. This approach not only simplifies management but also aligns with current nutritional knowledge and practice.

No Such Thing as Being Prediabetic

It's important to recognize that the term “prediabetic” is somewhat of a misnomer. Historically, the focus was on caloric intake, but now, we prioritize the understanding and utilization of nutritional knowledge. By embracing a more informed approach, we can make more meaningful changes in our dietary habits.

A Clarification on Total Carbs

To be clear, total carbs include both digestible and indigestible fibers. Andrew Gumperz's statement that total carbs include fiber which cannot be digested and does not impact blood sugar is a common misconception. Fiber, particularly soluble fiber, does indeed impact blood sugar levels and diabetes risk. This is a significant factor that prediabetics need to consider in their diet.

Impact of Fiber on Prediabetics

A number of studies have shown that fiber can have a positive impact on blood sugar levels and diabetes risk. For example, a study involving 8 weeks of intervention and participants with an average BMI of 31 demonstrated remarkable results:

Fasting blood sugar dropped from 163 mg/dl to 119 mg/dl, a reduction of 27 mg/dl. Insulin levels reduced from 279 μIU/mL to 19.7 μIU/mL, a decrease of 30 μIU/mL.

Another study, conducted over 10 weeks, involved a low-carb diet with participants having a similar BMI of 32. The results showed:

Fasting blood sugar dropped from 113 mg/dl to 104 mg/dl, a reduction of 9 mg/dl. Insulin levels reduced from 23.7 μIU/mL to 16.9 μIU/mL, a decrease of 6.8 μIU/mL.

These studies, particularly the one showing that 10 grams of fiber per day can be as effective as a ketogenic diet, highlight the importance of fiber in managing prediabetic conditions.

Other Evidence Supporting the Importance of Fiber

Additional research provides further support for the role of fiber in diabetes prevention:

The results support evidence that a high intake of dietary fiber is associated with enhanced insulin sensitivity and therefore may have a role in the prevention of type 2 diabetes.

Large prospective cohort studies consistently show associations of a high dietary fiber intake (25 g/d in women and 38 g/d in men) with a 20-30% reduced risk of developing type 2 diabetes T2D after correction for confounders.

While these effects are more pronounced with whole grains and insoluble cereal fibers, even a moderate increase in fiber intake can significantly benefit prediabetics.

Conclusion

In summary, prediabetics should consider the total carbohydrate content in their diet, including fiber. This approach not only simplifies carb counting but also leverages the known benefits of fiber in managing blood sugar levels and reducing the risk of developing type 2 diabetes. By focusing on a diet rich in fiber and whole grains, prediabetics can make informed choices that lead to better health outcomes.