I've never removed the fiber from a total carb count - I always look at total carbs and dose according to my ratio. However, if I'm eating a significant amount of carbs, I may use an extended bolus dose since that will take longer to digest. I may need insulin several hours later if I'm using Symlin at that meal as well as consuming something high fiber.

Carbohydrate calories are calculated in the same way for everyone, including those who have Type 1 or Type 2 Diabetes. When counting carbohydrates for a diabetic meal plan however, 15 grams of carbohydrate equal 1 carb serving. When reading the nutritional info on a food label, it is important to know that even though grams of sugars, sugar alcohols or fiber may be listed individually, they are all included in the grams of total carbohydrate listed on the label at a value of 4 calories per gram.
There are two types of dietary fiber: insoluble and soluble.
Insoluble fiber is neither digested nor absorbed by the body and does not contribute carbohydrate calories to the diet; soluble fiber does contribute carbohydrate calories to foods.
So, can you decrease the total number of grams of carbohydrate in a serving of food when fiber is present? According to the American Association of Diabetes Educators and the American Diabetes Association, if a food has more than 5 grams of "fiber" (includes insoluble & soluble) per serving, subtract half of the fiber from the total grams of carbohydrate. For example, if a serving of bean salad contains 40 grams of carbohydrate including 10 grams of fiber, reduce the total grams of carbohydrate counted for that serving by 5, to equal 35 grams of available carbohydrate per serving of bean salad.
Also affecting the total carbohydrate count are sugar alcohols (also known as polyols). They occur naturally in plants (such as berries, fruits) and are used as replacements for sugar or fat in food products. If listed on a food label, they are also included in the total grams of carbohydrate per serving of that food (at 4 calories per gram). However, sugar alcohols only provide 2 calories per gram. When they are present and counted, only count half of their grams in your carbohydrate count. For example, for a cookie with 28 grams of carbohydrate including 10 grams of sugar alcohols, you would reduce the total carbohydrate by 5 grams to equal 23 grams of carbohydrate per cookie.
Hope this helps!

Lynn M. Blocker MA, RD, CDN