Net Carbs vs. Carbs: Which to Follow for Diabetes?

Last modified on May 21st, 2024

The difference between net carbs and carbs (also known as carbohydrates) can be a confusing topic, especially when you have diabetes and you’re trying to count carbs.

As a diabetes dietitian living with type 1 diabetes, patients have asked me, “Do I count net carbs or total carbs? What are net carbs? Why are net carbs and carbs on my food package?”

In this post, we’ll answer the above questions so you can be confident in managing your diabetes by knowing the difference between net carbs and carbs.

**This article is for general informational and educational purposes only and is not intended to treat, cure, or diagnose any disease. The information in this article is not a substitute for medical care or advice provided by your healthcare team. Please consult your doctor or dietitian for specific, personalized treatment.***

Nutrition basics

Before diving into net carbs vs. carbs, let’s make sure you have a basic understanding of nutrition

All foods consist of micronutrients (vitamins and minerals) and macronutrients (carbs, fat, and protein). All three categories are important and needed by the body. 

Aim to include a variety of carb sources in your diet and pair these with protein and/or fat at meals and snacks for better diabetes management. 

What are carbs?

Carbs are the part of food your body breaks down into sugar during digestion for energy (1). There are three main types of carbs found in food: starch, fiber, and sugar. 

Starch: A complex carb, a carb that takes longer to digest leading to a more gradual rise in blood sugar, found in vegetables, potatoes, grains, beans, and legumes.

Fiber: Another complex carb in fruits, vegetables, beans, legumes, nuts, and whole grains.

Sugar: A simple carb (digests very quickly leading to a rapid rise in blood sugar) found naturally in fruits and milk or added to food products like cereal, soda, candy, ice cream, etc

What is protein?

Protein is a macronutrient found mainly in foods like eggs, meat, fish, soy, cheese, yogurt, and beans. It’s important for bone and muscle health as well as your immune system. 

What is fat?

The third macronutrient, fat, is found in foods such as nuts, seeds, oils, butter, avocados, egg yolks, and fatty fish like salmon. Fat is necessary for certain vitamin absorption and brain health. 

What are net carbs?

Now that you know the nutrition basics, let’s see what these net carbs are all about.

When people talk about net carbs, they’re referring to the “leftover” carbs on a nutrition label, after the carbs from fiber and sugar alcohols are subtracted. The idea behind net carbs is that fiber and sugar alcohols do not raise blood sugar at all, but this is not always the case.

What are sugar alcohols?

Sugar alcohols are sweeteners found naturally in tiny amounts in fruits and vegetables. They are also chemically made for sugar-free/no-sugar-added foods such as ice cream, gum, and candy and dental products like toothpaste. (2)

Examples of sugar alcohols include xylitol, sorbitol, maltitol, and erythritol. 

Why are sugar alcohols in sugar-free foods?

Sugar alcohols replace the ingredient, sucrose, or table sugar, in sugar-free/no-sugar-added foods to keep the sweet flavor while lowering the sugar and potentially calorie content of the products. 

Our bodies do not process sugar alcohols like regular sugar; we only partially break them down and absorb them into the bloodstream, which leads to a smaller rise in blood sugar.

The key phrase here is smaller rise, not zero rise. Sugar alcohols are low glycemic, which means they still impact blood sugar, but at a slower rate than real sugar.

The exception to this is when a product has erythritol. This sugar alcohol has zero impact on blood sugar and contains 0 calories per gram as compared to 2.4 calories per gram from other sugar alcohols (2) (3). 

What is fiber?

As mentioned above, fiber is another type of carbohydrate important in digestion and cholesterol management. It’s found naturally in many foods and synthetically made for functional purposes in food that otherwise wouldn’t have fiber such as ice cream and baked goods (4).

Fiber is often considered a nutrient that cannot be digested. But, just like sugar alcohols, digestion and absorption of fiber varies between different people and types of fiber (4). 

How to review net carbs and carbs on a nutrition label

Let’s take a peak at a nutrition label so you know what to look for in terms of net carbs vs. carbs.

Infographic showing a nutrition label and explaining how to identify serving size, total carbs, and subcategories of carbs on a nutrition label

First, look at the serving size located at the top of the label in bold. This tells you how much of that food contains the nutrients listed below (calories, fat, etc.). In this example, the serving size is one cookie. 

Second, look down at the total carbohydrate in bold. One cookie contains 19 grams of total carbs. Below total carbs are typically fiber, sugar, and sugar alcohols. These are subcategories, or what make up the total carbs. 

This cookie has 9 grams of fiber, 6 grams of erythritol (sugar alcohol), and less than 1 gram of sugar. We can assume the remaining 4 grams of carbs are from starch to equal the total of 19 grams of carbs.

How to find sugar alcohols and added fiber ingredients on a label

After checking out the numbers on the label, look further down at the ingredients. We know this cookie has erythritol and quite a bit of fiber for a cookie. 

Infographic showing an ingredient label with red circles around the sugar alcohol and fiber ingredients. A list of common added fibers and sugar alcohols is below the ingredient image.

If the label above just had ‘sugar alcohol’ listed under total carbohydrate, you would scan the ingredient list searching for the type(s) of sugar alcohol(s). Hint: it’s usually a word ending in -tol (xylitol, sorbitol, maltitol).

For added fibers, look for words such as soluble corn fiber, xanthan gum, guar gum, inulin, chicory root, psyllium, or pectin to name a few. In this cookie, it looks like the fiber sources are from soluble corn fiber and xanthan gum. 

Should people with diabetes count net carbs or total carbs?

So, what in the world should you count if you have diabetes? Net carbs or total carbs?

Current guidelines from the American Diabetes Association recommend using the total carbohydrate amount on the nutrition label for monitoring carb intake, not net carbs. 

In fact, net carbs isn’t even a recognized legal term nor is it accepted by the Food and Drug Administration (FDA). It’s simply a marketing word to influence people who are following very low carb diets, like Keto, to buy certain products. 

The variations in digestion, absorption, and metabolism of different sugar alcohols and fibers between individuals is why you shouldn’t rely on net carbs for diabetes nutrition management. 

Type 1 diabetes

For those of you like me with type 1 diabetes or type 2 diabetes using meal time insulin, it’s important to account for every gram of carbohydrate to estimate the correct insulin dose using your personal insulin-to-carb ratio. 

This includes using total carbohydrates for counting AND scanning the subcategories and ingredients below to see if an ingredient like erythritol is contributing to the carb number.

You are a unique person, and your blood sugar may respond differently to various sugar alcohols and added fibers, so some experimentation and blood sugar monitoring is a must. 

Personal experience 

For me personally, I typically only subtract the grams of carbs coming from erythritol, as it has zero impact on blood sugar. If a different sugar alcohol is in a product, I’ll use the total carbohydrate grams for my insulin dosing. 

So, for the above cookie example, I would have only subtracted the 6 grams of erythritol from the total carbs, making the actual total 13 grams of carbs. I would use this to calculate my insulin dose. 

If I didn’t take any insulin at all for this cookie and followed the instructions on the package touting “4 grams of net carbs”, I would personally experience about a 50 mg/dL rise in blood sugar. 

This may not seem like a huge deal to some people, but let’s say my blood sugar before eating the cookie was 150 mg/dL. That means I’d be sitting around 200 mg/dL after eating the cookie which is above my personal goal range. 

Type 2 diabetes

If you have type 2 diabetes and are not using insulin, count carbs using the total carbohydrate category on the nutrition label.

Some people with type 2 diabetes may choose not to count carbs at all. They will instead follow a meal planning regimen like the Diabetes Plate Method. 

It really just depends on what works best for you!

Final Thoughts

The term, net carbs, is mainly just a marketing scheme to get you to buy a product with the idea that it won’t impact your blood sugar at all. A product can still raise your blood sugar even if it’s label reads ‘sugar-free’ or ‘no-sugar-added’.

With that in mind, it is absolutely ok to eat and try foods that promote net carbs! Just don’t expect these foods to not impact your blood sugar at all. Take a peek at the nutrition label, especially the ingredient list, to see what ingredients make up the total carbs. When dosing insulin for meals/snacks, this will help you figure out the amount of insulin you’ll need to cover the carbs.

If erythritol is on the nutrition label, it’s best to subtract only that as this sugar alcohol has zero impact on blood sugar. If erythritol is not on the label, it’s likely ok to just stick with total carbs, but remember to monitor your blood sugar and your personal response to  sugar alcohols and fibers. 

Need more help with diabetes nutrition? Check out these resources:

Leave a Comment

Your email address will not be published. Required fields are marked *

Shopping Cart
en_USEnglish
Scroll to Top