Diabetics: do you count fiber in your carb totals? [View all]

[NickB79]

My wife was recently diagnosed with diabetes. She's 41, BMI of 40, A1C of 8.5ish. Her doctor put her on 1000 mg of Metformin twice a day, and told her to keep breakfast, lunch and dinner under 45g of carbs. She can also have 3 between-meal snacks a day between 0-30g of carbs. Her doctor didn't tell her to make any exceptions for fiber, just total carbs. And to be honest, we're both struggling with this in the past few months.

I'm the main cook in the house, and while our meals are 90% home cooked, with lots of vegetables and proteins, they do typically have a good amount of carbs. My wife is having trouble with portion control, and since I'm a pretty active guy, grew up on a farm, who does a lot of manual labor and weight lifting, my portions are pretty large since I'm burning 2500-2600 calories most days just to maintain my weight. When I'm trying to gain muscle, I can hit 3000 calories a day. To be honest, I feel guilty about her diabetes diagnosis because she only started eating these huge portions when we started dating.

She's lost 15 lb in the past 2 months, mostly from trying to control her portions and the undesirable effects of the Metformin, but I don't feel she's in a good place mentally. She's constantly stressed from work, and can't stress-eat like she used to to compensate. I've been trying to get her to work out with me, to limited effect. The best we can do is go for walks in the evening. Yesterday she started talking about how badly she wants pizza and truffles, and she had this manic tone to her voice that really freaked me out. I've told her she could benefit from seeing a counselor, but she's adamantly against talking to one at this point.

I'm trying to research recipes that are lower in carbs, and keep wondering if her dietician was wrong to say she should count fiber as part of her carb intake? I see a lot of references to net carbs, which simply subtract the fiber carbs. Our lives would be so much easier if I could discount the fiber carbs, because a lot of what we used to eat (brown rice, whole-grain pasta, beans, lentils) are high in fiber already. But I don't want to second-guess her dietician, who clearly has an educational background in this.

Any help would be appreciated!