Question: What should someone with FH eat if they also have prediabetes?
So first of all, it's a separable component of the diet so you need a low-saturated fat, low-cholesterol diet without necessarily eating a low-fat diet. Then second of all, the effect of that on blood lipids is dependent on the healthfulness of your insulin pathway. And so over time, that's something where you can play the balance between those two things and as you improve your blood glucose handling, you can fit in more carbohydrates to have a fuller dietary effect.
For managing blood glucose, and I don't think it's a good idea to condemn all carbohydrates as a means of managing that. I think the best thing would be to get a continuous glucose monitor or a regular glucose monitor. If you're using a regular glucose monitor, use 30 minute, one hour, two hour, three hour, four hour time intervals after a meal and collect a baseline before a meal and look at how do different starches that you don't have an immunological response to... so you don't have to test grains because you don't tolerate them, but other foods that are rich in starches, whether it's carrots, or potatoes, or sweet potatoes, or whatever it is.
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DISCLAIMER: I have a PhD in Nutritional Sciences and my expertise is in performing and evaluating nutritional research. I am not a medical doctor and nothing herein is medical advice.