Utilization of low glycemic index foods and associated factors among diabetes mellitus patients in Debre Markos referral and Finote Selam hospitals

Utilization of low glycemic index foods and associated factors among diabetes mellitus patients in Debre Markos referral and Finote Selam hospitals | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Utilization of low glycemic index foods and associated factors among diabetes mellitus patients in Debre Markos referral and Finote Selam hospitals Zelalem Dessie, Habtamu Andualem, Matebe Muche This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9097446/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background Entire populations are at risk of diseases such as diabetes. There is also limiting resources in Ethiopia to control hyperglycemia because of limited catastrophic expenditure for chronic diseases. Due to the importance of balancing blood glucose level in diabetes, low/ few glycemic foods are important to moderate blood glucose in diabetes patients. Objectives To assess the utilization of low glycemic index foods and associated factors among diabetes mellitus patients at Debre Markos referral and Finote Selam hospitals, Northwest Ethiopia, 2019. Methods Institution based cross-sectional study design was conducted. A systematic random sampling technique was used to select study participants. The data was coded and entered to Epi Data version 3.1 and exported to statistical package for social science (SPSS) version 25 for analysis. Binary logistic regression model was used for analysis. The adequacy of the final model was checked using Hosmer and Lemeshow goodness of fit test and an assumption of Binary Logistic Regression such as no multi-co linearity was checked. Both bivariable and multivariable analysis were conducted. Those variables that showed significant association at P < 0.25 were included to multivariable analysis. Variables that showed significant association at P < 0.05 with 95% CI was declared statistically significant factors of utilization of low glycemic index foods. Results A total of 416 diabetic patients were participated in this study with response rate of 98.5%. Among the study participants, 8.9% (95%CI: 6.3, 11.5) of the participants had good utilization of low glycemic index foods. In this study ≤ 3 Km distance from market [AOR: 3.851(95%CI: 1.262, 11.745)], informal education [AOR: 2.509 (95%CI: 1.178, 5.344)], alcohol consumption [AOR, 3.911(1.599, 9.567)], and good knowledge on low glycemic index foods [AOR: 3.354(1.091, 10.309)] were factors associated with utilization of low glycemic index foods. Conclusion and Recommendations: The magnitude of utilization of low glycemic index foods among diabetes mellitus patients attending follow up care service at Debre Markos referral and Finote Selam hospitals was found to be low. Distance to the market, educational status, practice of alcohol consumption, and knowledge on low glycemic index foods were found to be statistically significant with utilization level of low glycemic index foods. Glycemic Index Utilization Finote Selam hospital Debre Markos referral hospital Diabetes Mellitus BACKGROUND Dietary carbohydrate can modify the evolution and complications of postprandial hyperglycemia in a clinically significant long term fashion ( 1 ). This idea encourages the usage of low glycemic index (LGI) carbohydrates. Although focusing on total carbohydrate intake is important for diabetic patients, using LGI carbohydrates may provide additional benefits without increasing the fat content of the diet, and thus increasing plasma free fatty acids (FFAs), with all of their negative consequences ( 2 ). Low-glycemic index (GI) diets have been demonstrated to enhance glucose tolerance in both healthy and diabetic subjects ( 3 ). The glycemic index (GI) ranks foods based on how they affect blood sugar levels. The rates at which different foods elevate blood sugar levels are compared to the absorption of 50 grams of pure glucose, which serves as a reference food with a GI value of 100. Foods with a low-GI value (55gm or less) are the ideal choice since they are slowly digested and absorbed, creating a slower and smaller increase in blood sugar levels ( 4 , 5 ). The glycemic index is sometimes defined as the incremental area under the glucose response curve after consuming a standard amount of carbohydrate from a test food relative to a control food (either white bread or glucose) ( 5 , 6 ). The glycemic index of a given dish or meal is mostly determined by the kind of carbohydrate consumed, as well as other dietary elements that influence nutrient digestion or insulin secretion. Carbohydrates, which are found in breads, cereals, fruits, vegetables, and dairy products, are an essential part of a healthy diet ( 7 , 8 ). The diabetic glycemic index influences diabetes risk, regardless of body weight change, through impacts on hyperinsulinaemia, insulin resistance, beta cell demand, and, ultimately, beta cell function ( 7 , 9 ). Choosing LGI foods over conventional or high-GI diets has a minor but clinically significant influence on medium-term glycemic control in diabetic individuals. The incremental effect is comparable to that provided by pharmaceutical medications that address postprandial hyperglycemia ( 10 ). Low GI meals may improve weight control by increasing satiety, decreasing postprandial insulin secretion, and increasing fat oxidation. Studies have demonstrated that low-GI foods are more satiating, delay the return of hunger, or reduce subsequent food intake ( 11 ). From 2011 to 2012, the proportion of low glycemic index foods consumed by Australian children and adolescents was 3%, according to a national survey done using stratified multistage sampling. Longitudinal trend analysis from a German study also shows that 56.5% of children aged 7–8 years used low glycemic index diets in 2002 ( 13 ). According to a 2016 WHO research, 2% of Ethiopians died from diabetes, 16% from cardiovascular disease, and 7% from cancer as a result of a lack of chronic disease prevention through the use of low glycemic index foods ( 14 ). According to the International Diabetes Federation (IDF) 2015 report, the lack of these low glycemic index foods will have a significant impact on diabetics, who number 2.3 million in South Africa, 1.8 million in the Democratic Republic of Congo, 1.6 million in Nigeria, and 1.3 million in Ethiopia ( 15 ). International research on diabetes and GI identified some dietary terms (low glycemic index foods), such as whole grain-rich foods, cereal fiber, legumes, and green leafy vegetables, as protective against chronic conditions, including diabetes mellitus ( 16 , 17 ). The nutritional content of preventive foods (fiber, vitamins, and minerals) may lower the risk of diabetes by lowering inflammation, increasing glucose metabolism, endothelial function, and insulin sensitivity ( 18 ). 'Slow release' or low GI carbs have been demonstrated to help regulate blood glucose levels, which is especially beneficial in diabetes. The amount you eat is also important and all low GI foods aren’t necessarily good for you. In general, filing lower GI foods such as beans, peas, lentils, porridge, fruit and vegetables are good choices and can help you to manage your weight and keep to an overall healthy eating plan ( 1 ). The type of sugar in foods can impact their glycemic index. It is a myth that all sugars have a high glycemic index. As a result, the type of sugar in a food influences its glycemic index. In other cases, preparation and cooking practices might affect the Glycemic index value of foods. In general, the longer a food is cooked, the faster its sugars are digested and absorbed, increasing the glycemic index. In other cases, unripe fruit contains complex carbohydrates that degrade into sugars as it ripens. The more mature the fruit, the higher its Glycemic index ( 4 , 8 ). The majority of foods are ingested as part of a larger mixed meal, making the GI difficult to anticipate ( 4 ). Knowledge of food attributes such as fat content, type of fat, calorie density, fiber content, food processing, starch structure, and optimum serving size may also influence the value of the glycemic index ( 16 – 18 ). However, in Ethiopia, poor routine health information and a lack of data on diabetic patients' low glycemic indexes have an impact on diabetes management in the long run. As a result, the purpose of this study is to analyze the use of low glycemic index foods and associated factors among diabetes patients at Debre Markos and Finote Selam hospitals. METHODS Study Design and Setting Institutional based cross-Sectional study was conducted in Debre Markos referral and Finote Selam hospitals from September 15, 2019 to October 15, 2019. Debre Markos referral hospital is situated at Debre Markos town found in East Gojjam zone in Amhara region. It serves for the total of 3.5 million populations. Debre Markos city is located in northwest Ethiopia ( 19 ). Finote Selam hospital is situated at Finote Selam Town in western Ethiopia. The hospital provides health service to more than 1.5 million populations in its catchments. The town is Located in the West Gojjam zone of the Amhara region ( 19 ). Debre Markos referral and Finote Selam hospitals are found in the area of same socio- demographic characteristics. Around those hospitals teff is the major food which consumed by the population. In addition to teff, wheat, maize, potatoes, lentils, beans, peas, honey, dairy products, fruits and vegetables are the major food those are common in the areas. Those hospitals were selected randomly to get adequate sample size regarding with this study. Add information. Quantitative data was collected from diabetic patients who are attends services in Debre Markos referral and Finote Selam hospitals. The ethical clearance was obtained from Debre Markos University's Health Science College Ethics Committee. An official letter, together with the ethical clearance, was sent to the Debre Markos referral and Finote Selam hospital offices. This study had no risk implications for the study participants. Participants were also notified that participation was voluntary and that those who rejected consent would be respected. The study participants provided written consent after being briefed on the study's objectives. There were no diabetic patients under the age of 18 in the sample. The anonymity of participant-related data was protected by omitting possible identifiers such as research participants' names and instead using their identification number as a reference. The interviewer's questions were kept safe throughout the research process. During data collection, every diabetic client who had a medical condition, such as a Diabetic complication, was educated and contacted with health specialists at those facilities for support and treatment. Sample size determination and sampling procedure Sample size was calculated by a single population proportion formula: n= [(Zα/2)² *P (1-P)] /d² Since there was no previous study the sample size was calculated by assuming a 50% proportion (P) of utilization of low glycemic index foods, a confidence level of 95% (1.96), and 5% margin of error (d). Based on this assumption the n= (1.96)² \(\:\frac{0.5\left(1-0.5\right)}{0.05²}\) = 384 After substitution the estimated sample size yields 384. By considering a 10% of non-response rate, 422 diabetic patients were planned to be included in the study. Systematic random sampling was used to select 422 study participants from the study population. First 422 samples were proportionally allocated to Debre Markos referral hospital (241) and Finote Selam hospital (181). This data was taken from SMART care of those hospitals by filtering out DM patients specifically. Since there was no well-ordered or separated registration for DM patients, the sample was taken from those hospitals’ patient flow. Then K value was calculated. Based on k value lottery method was used to select the first respondents. Finally, the study participants were selected every K value was 2.4. Then the respondents were selected every 2 individuals until the required samples was full filed or interviewed. Data collection procedure and measurements Data was collected by using interviewer administered structured questionnaire developed from different literatures such as ( 8 , 20 – 22 ). The tool contains socio- demographic characteristics (6 items), food preparation and feeding technique (3 items), market access characteristics (4 items), health status related questions (4 items), life style related questions (6 items), and knowledge-based questions (9 items). There are twenty food types in English version questionnaire and this questionnaire was translated to Amharic language. The respondents were asked to recall all foods and drinks they have taken in the three consecutive day’s meal history prior to the survey ( 17 , 23 ) to assess utilization of low glycemic index foods of the respondents. By using different literatures, the local food items were collected and summarized in twenty items. Six Professional nurses (two supervisors and four data collectors) were recruited to collect data. The data collectors use the codes “1’ for respondents who says yes and “0” for respondents who says no for low glycemic based questionnaire. The supervisors were following the data collection technique and all the data collectors and supervisor were have regular meeting with the principal investigator at the end of each week of data collection period. Operational definition Glycemic Index: is a scientific ranking of how the foods we eat affect our blood sugar levels in the 2 or 3 hours after eating. Foods are measured against pure glucose, which has a value of 100 on the index ( 1 , 4 , 5 ). Low glycemic index: It indicates that the carbohydrates in a given food have a lower effect on postprandial blood glucose and possibly insulin responses. It has a GI value of < 55 gm (e.g., dairy products, fruits, vegetables…) ( 1 , 4 , 5 , 24 ). Utilized: Diabetic patients who are consumed above 75% from the total listed low glycemic index foods ( 25 ). Diabetes Mellitus: is defined as a case identified for having the disease diabetes by the clinician. Good Knowledge: respondents who answer correctly to knowledge related question and those who scored equal and above 75% of the total value. Market access: Access of market measured in time and distance to get low glycemic food groups for study participants. Long distance: If the distance between market and study participants is greater than 3 Km ( 26 ). Adherence to Exercise: If the patient follow recommended level of exercise for more than 3 days in the last seven days ( 27 ). Alcohol Consumption: If reported consumption of alcohol twelve month prior to the survey ( 28 ). Statistical analysis The data collected was coded, entered into Epi Data Version 3.1, and cleaned. The cleaned data set was transferred to the Statistical Package for Social Sciences (SPSS) Version 25 software for analysis. The study participants' use of low glycemic index food groups (used, none utilized), as well as socio-demographic factors and other independent variables that influence low glycemic index food utilization, were presented using relevant descriptive statistics. Binary Logistic Regression was used to investigate the relationship between the dependent and independent variables. The appropriateness of the resultant model was assessed using the Hosmer and Lemeshow goodness of fit test, which had a significance level of 0.740. A Binary Logistic Regression assumption, such as no multi-co linearity, was tested, and all variables had a Variance Inflation Factor (VIF) of less than 5, therefore they were included in the multivariable analyses. Both bivariate and multivariate analyses were performed. The factors that exhibited a significant correlation at p < 0.25 were included in the multivariable analysis. Finally, variables with a significant association at p < 0.05 with 95% confidence intervals were designated statistically significant factors of low glycemic index food consumption. RESULTS Socio-demographic characteristics of the respondents A total of 416 study participants were participated with response rate of 98.5%. The median age of respondents was 46.50 years (IQR 37–56 years). Among the study participants, 283(68%) were males. Regarding place of residence and their educational status, 272(65.4%) and 131(31.5%) of them were urban residents and have diploma and above respectively (Table 1 ). Table 1 Socio-demographic characteristics of Utilization of low glycemic index foods among DM patients in FSH and DMR hospitals, Northwest Ethiopia, 2019(N = 416). Variables Categories Frequency Percent Age of respondents 21–39 140 33.65% 40–64 222 53.37% 65–89 54 12.98% Sex of respondents Male 283 68.0% Female 133 32.0% Educational status Cannot read and write 118 27.9% Can read and write 137 32.4% Grade 1to8 28 6.6% Grade 9to12 65 15.4% Diploma and above 68 16.1% Occupation Merchant 119 28.1% Daily laborer 6 1.4% Government employee 93 22.0% NGO worker 40 9.5% Farmer 142 33.6% Nonemployee 16 3.8% Marital status Single 296 71.2% Married 71 17.1% Divorced 23 5.5% Widowed 26 6.3% Husband educational status Cannot read and write 43 35.6% Can read and write 12 10% Grade 1to8 18 15% Grade 9to12 10 8% Diploma and above 38 31.4% Wife educational status Cannot read and write 57 25.9% can read and write 98 44.5% Grade 1to8 16 7.3% Grade 9to12 17 7.7% Diploma and above 32 14.5% Place of residence Urban 297 71.4% Rural 119 28.6% Food preparation and feeding technique of respondents In this study 307(73.8%) of study participants had practice of feeding processed foods. On the other hand 64(15.4%) feeding sweet fruits instead of unripe fruits (Table 2 ). Table 2 Food preparation and feeding technique of low glycemic food utilization among diabetes patients in FS and DMR hospitals, Northwest Ethiopia, 2019 (N = 416) Variables Categories Frequency Percent Feeding processed foods Yes 307 73.8% No 109 26.2% Feed foods prepared with malt sugar Yes 64 15.4% No 352 84.6% Feed sweet fruits instead of un riper fruits Yes 198 47.6% No 218 52.4% Market access related characteristics of respondents From here 263(63.2%) of diabetic patients were found less than or equals to three Km distance to the local market. Regarding with other characteristics 230(55.3%) of respondents were going on foot to the local market for food exchange and sale purpose (Table 3 ). Table 3 Market access measuring characteristics of Low glycemic index food utilization among diabetic patients in FS and DMR hospitals, Northwest Ethiopia, 2019 (N = 416) Variables Categories Frequency Percent How far home to market ≤ 3 Km 263 63.2% > 3 Km 153 36.8% Have employee at off farm activity? Yes 242 58.2% No 174 41.8% Do you have food exchange and sale practices in the market Yes 389 93.5% No 27 6.5% Way of transport On foot 230 55.3% Horse and cart 33 7.9% Vehicles 153 36.8% Health status related characteristics of respondents The median age of study participants with diabetes were 4 years (IQR 2–7 years). Regardless of health status related characteristics 123(29.6%) of study participants had developed chronic disease other than diabetes (Table 4 ). Table 4 Health status related characteristics of utilization of low glycemic index foods among diabetic patients in FS and DMR hospitals, Northwest Ethiopia, 2019(N = 416) Variables Categories Frequency Percent Years of patients live with diabetes after diagnosis by physicians < 5 years 201 48.3% ≥ 5 years 215 51.7% chronic disease other than diabetes Yes 123 29.6% No 293 70.4% Hypertension Yes 113 27.2% No 303 72.8% Renal disease Yes 11 2.6% No 405 97.4% Cancer Yes 4 1.0% No 412 99.0% Cardiovascular disease Yes 16 3.8% No 400 96.2% Epilepsy Yes 2 0.5% No 414 99.5% Losses of appetite after diabetes Yes 148 35.6% No 268 64.4% Life style related characteristics of respondents A total of three hundred and ninety (93.8%) respondents consumed alcohol in their life time. From here 178(42.8%) of study participants were consume alcohol in the past twelve months. The study also indicates 193(46.%) of study participants were have greater than or equals to three days of practice in a week of physical activity in a specific exercise session (Table 5 ). Table 5 Life style related characteristics of low glycemic index food utilizations among diabetic patients in FS and DMR hospitals, Northwest Ethiopia, 2019 (N = 416) Variables Categories Frequency Percent Consumed alcohol in life time Yes 390 93.8% No 26 6.3% Consumed alcohol in past 12 months Yes 178 42.8% No 238 57.2% Cigarette smoking in the past seven days Yes 23 5.5% No 393 94.5% Number of cigarettes in average over a day Nothing 394 94.7% Even one puff 22 5.3% Physical activity over seven days ≥ 3 days/week 361 86.8% < 3 days/ week 55 13.2% Physical activity over seven days in a specific exercise session ≥ 3 days/ week 193 46.4% < 3 days/ week 223 53.6% Knowledge related characteristics of respondents In this study there were nine questions to measure knowledge about utilization of low glycemic index foods. Based on this, each question has many alternatives and were summed and coded to one. After that, all questions were also summed and coded as ≥ 75% for good and < 75% poor knowledge about utilization of low glycemic index foods. From a total of 416 study participants included in the study 273(65.6%) of respondents had good knowledge on low glycemic index foods. From the study participants 73(17.5%), 116(27.9%), and 181(43.5%) were know the importance of low glycemic index foods as they use to prevent hypoglycemia, hyperinsulinaemia and their ability to delay return of hunger respectively. In addition to the above ideas 279(67.1%) and 197(47.4%) of respondents have good knowledge on feeding of the small portion of carbohydrate foods and the effect of feeding processed foods on blood glucose level among diabetic patients (Table 6 ). Table 6 Knowledge based characteristics of utilization of low glycemic index foods among diabetic patients in FS and DMR hospitals, Northwest Ethiopia, 2019 (N = 416) Variables Categories Frequency Percent What does mean term low glycemic index to you? Correctly answered 210 50.5% Wrongly answered 157 37.7% Says I don’t know 49 11.8% Which is the importance of low glycemic index foods for DM patients? Correctly answered 132 31.7% Wrongly answered 284 68.3% Which one is do you think have low GI value in related with fruit ripeness? Correctly answered 187 45.0% Wrongly answered 141 33.9% Says I don’t know 88 21.2% Which one do you think have low GI value in related with time of cooking? Correctly answered 239 57.5% Wrongly answered 87 20.9% Says I don’t know 90 21.6% Which types of sugar do you think have low GI value? Correctly answered 143 34.4% Wrongly answered 273 65.6% As a diabetic patient how you feed in day to day feeding system? On my own prepared food 367 88.2% With my family 49 11.8% Can you list any problems on persons those are decreased by due to low glycemic index foods consumption? Correctly answered 262 63.0% Wrongly answered 154 37.0% How you feed carbohydrate foods? In small portion 137 32.9% In large portion 279 67.1% Which of the following food groups have affect blood glucose by increasing blood glucose level quickly? Correctly answered 219 52.6% Wrongly answered 197 47.4% Magnitude of utilization of low glycemic index food groups In this study there were twenty types of food groups those are adapted from different studies according to their availability in Ethiopia including the study area and these food groups were coded and summed. Among the respondents that had ≥ 75% were considered as good utilization of low glycemic index foods and < 75% were considered as poor utilization of low glycemic index foods. Finally, 37(8.9%) respondents had good utilization of low glycemic index foods (95%CI: 6.3, 11.5) (Table 7 ) Table 7 Magnitude of low glycemic index foods among diabetic patients in FS and DMR hospitals, Northwest, Ethiopia, 2019(N = 416) Variables Categories Frequency Percent Lamp Yes 52 12.5% No 364 87.5% Olive oil Yes 111 26.7% No 305 73.3% Collard greens Yes 280 67.3% No 136 32.7% Fish Yes 18 4.3% No 398 95.7% Chicken Yes 26 6.3% No 390 93.8% Kitifo Yes 56 13.5% No 360 86.5% Eggs Yes 183 44.0% No 233 56.0% Butter Yes 296 71.2% No 120 28.8% Bell peppers Yes 335 80.5% No 81 19.5% Carrots Yes 217 52.2% No 199 47.8% Broccoli Yes 56 13.5% No 360 86.5% Onion Yes 393 94.5% No 23 5.5% Whole grains (beans, peas, lentils) Yes 358 86.1% No 58 13.9% Tomatoes Yes 253 60.8% No 163 39.2% Cabbage Yes 261 62.7% No 155 37.3% Mustard greens Yes 65 15.6% No 351 84.4% Kale Yes 83 20.0% No 333 80.0% Lettuce Yes 133 32.0% No 283 68.0% Water Yes 100 100.0% Spicy foods Yes 397 95.4% No 19 4.6% Factors of utilization of low glycemic index foods In this study the constants coded for 1 as they are protective based on literature. At Bivariable analysis, variables such as place of residence, educational status, distance to market, doing physical activity, alcohol consumption, employee at off farm activity, feeding processed foods, losses of appetite, developing chronic disease other than diabetes, and knowledge on low glycemic index foods were have P value less than 0.25 and included to multivariable analysis. At multivariable analysis, variables such as distance less than three Km to market is 3.85 times more likely to utilize low glycemic index foods, AOR: 3.851(95%CI: 1.262, 11.745), formal education were 2.509 times more likely to utilize low glycemic index foods, AOR: 2.509(95%CI: 1.178, 5.344), no history of alcohol consumption in the past twelve months prior to the survey were 3.991 times more likely utilize low glycemic index foods, AOR, 3.911(1.599, 9.567), and good knowledge of respondents in related to low glycemic index foods were 3.354 times more likely to utilize low glycemic index foods, AOR, 3.354(1.091, 10.309) were significantly associated with utilization of low glycemic index foods at P < 0.05 with 95% CI (Table 8 ). Table 8 Bivariable and Multivariable analysis of factors of utilization of low glycemic index foods among diabetic patients in FS and DMR hospitals, Northwest Ethiopia, 2019 (N = 416) Variables Categories Utilization of low glycemic index foods COR with 95% CI AOR with 95% CI P value Yes No Place of residence Urban 31 266 2.195(0.891–5.406) 0.915(0.310–2.700) 0.872 Rural 6 113 1 1 Distance to the market ≤ 3 Km 32 231 4.100(1.562–10.761) 3.851(1.262–11.745) 0.018* > 3 Km 5 148 1 1 feeding processed foods Yes 31 276 1 1 No 6 103 1.928(0.782–4.757) 1.362(0.469–3.951) 0.570 Chronic disease other than diabetes Yes 11 106 1 1 No 26 273 1.090(0.520–2.283) 0.905(0.402–2.039) 0.810 Appetite losses after diabetes Yes 9 139 1 1 No 28 240 0.555(0.255–1.210) 2.171(0.938–5.023) 0.070 Knowledge Good 32 240 3.707(1.658–13.771) 3.354(1.091–10.309) 0.035* Poor 5 139 1 1 Educational status Formal education 21 140 2.241(1.132–4.436) 2.509(1.178–5.344) 0.017* Informal education 16 239 1 1 Physical activity Good 26 190 2.351(1.129–4.894) 1.955(0.862–4.434) 0.109 Poor 11 189 1 1 Alcohol consumption Not consumed 30 183 4.590(1.968–10.707) 3.911(1.599–9.567) 0.003* Consumed 7 196 1 1 Employee at off farm activity Yes 32 240 3.707(1.412–9.733) 2.689(0.913–7.924) 0.073 No 5 139 1 1 DISCUSSION Low glycemic index foods have a great public health importance in related to the prevention of chronic diseases like diabetes mellitus, hypertension, and cancer. This study finding showed that magnitude of utilization of low glycemic index foods were 8.9% (95%CI: 6.3–11.5). This finding less than the research conducted in German, 56.5% ( 13 , 17 ). The difference may be due to the difference of socio-demographic characteristics, way of life, countries growth and development difference, age difference of the respondents because they were study on school children. The difference also may be due to the way of research conducted that was done by longitudinal trend analysis. In other ways this study magnitude higher than study conducted in Australia, 3% ( 12 ). This may also due to difference of age group that were children’s, difference of study subjects that was not specifically diabetic patients, time of research conducted that was conducted by using twelve years data and also conducted eight years ago, and method of research conducted that was trend analysis on the Australian health survey. The diabetic patients with formal education were 2.509 times more likely to utilize low glycemic index foods than that of respondents who attained informal education. This was due to respondents who had informal education had incomplete interpretation of instructions, patients tend to forget the advices given by the health care providers, and unable to understand uses of low glycemic index foods. This study supported by the studies conducted in Southern Ethiopia, India, and USA ( 29 – 31 ). This study found that diabetic patients who had no history of alcohol consumption in the past twelve months prior to the survey were 3.991 times more likely utilize low glycemic index foods than that of respondents who had practice of alcohol consumption. This was due to drinking alcohol leads to low intake of fiber, fruits ( 19 ), nutritional distortion due to infections caused by drinking alcohol ( 32 ). In this case drinking alcohol leads to poor appetite in users and secondary to infection causes poor food intake and adherence to foods like low glycemic index foods. This study supported by the study conducted in Addis Ababa, Finland, and USA ( 19 , 28 , 33 ). This study also showed that diabetic patients who live in less than or equals to three Km to the local market were 3.851 times more likely utilize low glycemic index foods than who were live in greater than three Km among diabetic patients. This may be due to > 3 Km to the local market had inability to practice food exchange and sale foods especially low glycemic index food groups and also persons who were live in long distance to local market have not go to local market for only the purpose of exchange of fruits, vegetables, eggs and so on, since those food commodities are usually found in the market. This study similar with the study conducted in South Gondar zone ( 26 ). In this study respondents who had good knowledge of respondents in related to low glycemic index foods were 3.354 times more likely utilize low glycemic index foods among diabetic patients. It has been observed that good knowledge among respondents may use to easily recognize the impact of unhealthy diet, use to differentiate low glycemic food groups easily, and can fill gaps which facing in use of low glycemic foods. This study supported by other studies conducted in Jimma University specialized hospital, Ethiopia, India, and Australia ( 17 , 21 , 31 , 34 ). CONCLUSION The magnitude of utilization of low glycemic index foods among diabetes mellitus patients attending follow up care service at Debre Markos referral and Finote Selam hospitals was found to be low. Distance to the market, educational status, practice of alcohol consumption, and knowledge on low glycemic index foods were found to be statistically significant with utilization level of low glycemic index foods. Abbreviations GDP Gross Domestic Product, GI Glycemic Index, HGL High Glycemic Index, IDF International Diabetes Federation, LGI Low Glycemic Index, NCD Non-Communicable Disease, NGO’s Non- Governmental Organizations, SMART Specific, Measurable, Achievable, Realistic, and Time bounded, SPSS Statistical Package for Social Sciences, T2DM Type 2 Diabetes Mellitus, WHO World Health Organization Declarations Ethics approval The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The ethical clearance was obtained from Debre Markos University, Health science college ethical committee. Official letter was written along with the ethical clearance and was submitted to Debre Markos referral and Finote Selam hospital office. This study was not had any risk consequence for study participants. Clinical trial number: not applicable. Consent to participate Participants were also informed that participation was voluntary and participants who refused the consent had respect. Written consent was taken from the study participants after briefing them the objective of the study. Written informed consent was obtained from all participants before enrolment in the study. There was no age of less than 18 years diabetes patients in the sample included. The confidentiality of participant’s related data was maintained by avoiding possible identifiers such as name of study participants only identification number was used as a reference. The interviewer administered questionnaires was kept safe throughout the whole process of the research work. During data collection time any diabetic client with medical problem findings such as any Diabetic complication, education was provided and contacted with health professionals found in those hospitals for support and treatment. Consent for publication Not applicable Availability of data and material The datasets used and/or analyzed during the current study are available from the corresponding author. The data will not be shared in order to preserve participant anonymity. Conflict of interests The authors have declared that no competing interests exist. Funding No funding was obtained for this study. Acknowledgments We thank Debre Markos University college of Health science for providing ethical clearance, data collectors, supervisor and study participants for their willingness to participate in the study. Author Contributions Conceptualization: ZD. Formal analysis: ZD, HA, and MM. Development or design of methodology: ZD. Entering data into computer software: ZD. Supervision: ZD, HA, MM. Validation: ZD, HA, MM. Writing original draft: ZD. Writing review and editing: ZD, HA, MM. All authors read and approved the final manuscript. References Azmina Govindji D. Glycemic Index (GI). 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The glycemi index: Physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. Google Scholar, American Medical Association. May 2002;287(18). www.LowGIHealth.com.au. Glycemic index Food List. Water Willet JM, and Simin Liu. Glycemic index, Glycemic load, and risk of type 2 diabetes American Jornal for clinical Nutrition,. 2002;76. Jennie Brand- Miller P, Susan Hayne B, PeterPetocz P, Stephen Colagiuri M. Low glycemic index diets in the management of diabetes, A Meta analysis of randomized controlled trials. Google Scholar,. August 2003;26. Janette C. Brand- Miller PD. glycemic load and chronic disease. International life sciences institute,. 2003;61(5). Molly Jones AWB, Jennie C. Brand Miller, Jimmy Chun Yu Louie,. Dietary glycemic index and glycemic load among Australian children and adolescents: results from the 2011-2012 Australian health survey.,. British Journal of Nutrition. October 2015;116:178-87. Buyken AED, W.; Kersting, M.; Kroke, . A. Glycaemic index and glycaemic load in the diet of healthy schoolchildren: Trends from 1990 to 2002, contribution of different carbohydrate sources and relationships to dietary quality. British Journal of Nutrition,. 2005,;94,:796-803,. WHO. None communicable diseases (NCDs) country profile.,. 2018,. FMOH. National Training on Diabetes Mellitus for health care workers. October, 2016. BJ venn TG. Glycemic index and glycemic load; measurment issues and their effect on diet- disease relationships. Europian Jornal of Clinical Nutrition. 2007;61:22-31. Chris Ho Ching Yeung DTLK, Alan Winston Barclay, Jennie Cecile Brand-Miller, and Jimmy Chun Yu Louie. The Decreasing Trend in Dietary Glycaemic Index and Glycaemic Load in Australian Children and Adolescents between 1995 and 2012. MDPI. 22 August 2018;10. Kris Y. Lok RC, Dicken Chan, Liz Li, Grace Leung, Jean Woo, Helen J. Lightowler, C. Jeya K. Henry,. Glycemic index and glycemic load values of a selection of popular foods consumed in Hong Kong,. British Journal of Nutrition,. 2010;103,:556-60,. Thimothy O F, Jenni Ilomaki, Sari Voutilainen, Jussi Kauhanen,. Alcohol consumption and dietary patterns: The FinDrink study,. Google Scholar,. 2012;7(6). Woo MY. How Foods Affect Blood Sugar: A Guide for Ethiopian and Eritrean Patients with Diabetes EthnoMed. http://ethnomed.org/patient-education/diabetes accessed at January 20 ,2019. Meaza Assefa, Melaku Umeta, Natesan Gnanaseknram. Glycemic index of some traditional Ethiopian foods International Journal of Biochemistry research and review. 2017;18(4). Kaye Foster- Powell, Susanna HA Holt, Janette C. Brand- Miller PD. International table of glycemic index and glycemic load values. American Jornal for clinical Nutrition,. 2002;76. Huseyin Gumus YA, Sidika Bulduk,. Determination of factors effected dietary glycemic index in Turkish university students.,. European journal of educational research,. 2014;3(1):1-7. Sluijs I., Beulens J.W.J., Van Der A.D.L., Spijkerman A.M.W., Grobbee D.E., Van Der Schouw Y.T. Dietary intake of total animal,and vgetable protien and risk of T2DM in the europian prospective investigationin to cancer and nutrition (EPIC)- NL study. Diabetes care. 2010;33:43-8. Harborview Medical College HPaFE. Diabetes Meal Plan Basics, . HMC,. 2015, . Girma Nega BDU, Melkie Endris UoG, Degnet Teferri BDU, Amanual Nana BDU, Rigbe W/Michael BDU, . Dietary diversity and associated factors among rural households in south gondar zone, Northwest Ethiopia. Feed the future. November 2015. T/Michael T. Diatery pattern of type 2 diabetes mellitus patients on follow up in public hospitals in Addis Ababa, Ethiopia. PubMed, NCBI,. June, 2016. Tekalign Y. Assessment of the magnitude of glycemic control and its associated factors among patients with type 2 diabetes at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. PubMed, NCBI,. June, 2015. Alemayehu zekewos, Eskindir Loha, Tariku Egeno, Kindie Wubshet, Zelalem Merga. Prevalence of diabetes mellitus and associated factors in southern Ethiopia; a community based study. Ethiop J health. Feb, 2017. Tonja R. Nancel P, Lauren Gellar, Linda Zeitzoff. Acceptability of lower glycemic index foods in the diabetes camp setting. PubMed, NCBI,. 2006;38(3):143-50. Garima Bhutani, Sanjay Kalra, Sonika Lamba, Prem Kumar Verma, Rahul Saini, Meenakshi grewal. Effect of diabetic education on the knowledge, attitude and practices of diabetic patients towards prevention of hypoglycemia. Indian jornal of endocrinology and metabolism. 2015,;19(3):383- 6. Bunout O. Nutritional and metabolic effectes of alcoholism: their relationship with alcoholic liver disease,. PubMed, Google Scholar. 1999;15(583-589). Emmanuelle Kesse FC-C, Nadia Slimani, Marti Van Liere,. Do eating habits differ according to alcohol consumption? Results a study of the french cohort of the european prospective investigation in to cancer and nutrition,. American Jornal for clinical Nutrition,. September 2001;74(3):322-7. Endalew Hailu, Wudneh H. Mariam, Tefera Belachew, Birhanu Z. self care practice and glycemic control amongst adults with diabetes at the Jimma university specialized hospital in southwest Ethiopia. African Journal of primary health care and family medicine. may 2011 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9097446","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":631319954,"identity":"187b57ec-4eb2-4cd0-94e0-943f78bea4c2","order_by":0,"name":"Zelalem Dessie","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCElEQVRIie2PsWrDMBCGTwQyCbpqCX4FQ0B0MM6DdJEwpEu7Z/AgE7CXgFf3IQqdslZBEC+mXgVabPoCGlsooaqHLsVOuhWqb7nj+D9+DsDj+ZPMBHQASLhVwiZyA2VyWnFh9q006+FyuQIoV8NtUgmKLLNss1+UV3Uv7byNHwvlWtLoZrRjd9gS1pjlQ3UXHipskn3DnXJc34sRZUa4IDw3/EljUJiYhEqnIKFGlXnQb9/4yfDntu7UR/iS0LafVjBBuStyLcBCBUzGVJ9pIZjn1+xolpV2v+xkwqh2LWzil6BQStvULMqyfrXvp3hF29u+s2k0qvyAD0l2afyL1W/CHo/H8z/4BAVdcHMXYTUhAAAAAElFTkSuQmCC","orcid":"","institution":"Debre Markos University","correspondingAuthor":true,"prefix":"","firstName":"Zelalem","middleName":"","lastName":"Dessie","suffix":""},{"id":631319955,"identity":"65723cbc-5df9-415f-b18a-dd3c043f703a","order_by":1,"name":"Habtamu Andualem","email":"","orcid":"","institution":"St. Peters Specialized Hospital","correspondingAuthor":false,"prefix":"","firstName":"Habtamu","middleName":"","lastName":"Andualem","suffix":""},{"id":631319957,"identity":"57db1c20-26d2-4417-84af-604b7885d75a","order_by":2,"name":"Matebe Muche","email":"","orcid":"","institution":"Debre Berhan University","correspondingAuthor":false,"prefix":"","firstName":"Matebe","middleName":"","lastName":"Muche","suffix":""}],"badges":[],"createdAt":"2026-03-11 18:38:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9097446/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9097446/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108182821,"identity":"fc7e6162-4b15-4541-a992-b50067e797f5","added_by":"auto","created_at":"2026-04-30 08:59:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":632639,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9097446/v1/5b697fd3-c6d8-4110-88a2-aa1c143d4cd9.pdf"},{"id":108139855,"identity":"ca9a68ed-549b-40a2-9edd-1af442291b6c","added_by":"auto","created_at":"2026-04-29 18:41:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":340746,"visible":true,"origin":"","legend":"","description":"","filename":"InterviewQuestionnaire.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9097446/v1/b791f005368c2db65a3f4e80.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Utilization of low glycemic index foods and associated factors among diabetes mellitus patients in Debre Markos referral and Finote Selam hospitals","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eDietary carbohydrate can modify the evolution and complications of postprandial hyperglycemia in a clinically significant long term fashion (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). This idea encourages the usage of low glycemic index (LGI) carbohydrates. Although focusing on total carbohydrate intake is important for diabetic patients, using LGI carbohydrates may provide additional benefits without increasing the fat content of the diet, and thus increasing plasma free fatty acids (FFAs), with all of their negative consequences (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Low-glycemic index (GI) diets have been demonstrated to enhance glucose tolerance in both healthy and diabetic subjects (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe glycemic index (GI) ranks foods based on how they affect blood sugar levels. The rates at which different foods elevate blood sugar levels are compared to the absorption of 50 grams of pure glucose, which serves as a reference food with a GI value of 100. Foods with a low-GI value (55gm or less) are the ideal choice since they are slowly digested and absorbed, creating a slower and smaller increase in blood sugar levels (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The glycemic index is sometimes defined as the incremental area under the glucose response curve after consuming a standard amount of carbohydrate from a test food relative to a control food (either white bread or glucose) (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). The glycemic index of a given dish or meal is mostly determined by the kind of carbohydrate consumed, as well as other dietary elements that influence nutrient digestion or insulin secretion. Carbohydrates, which are found in breads, cereals, fruits, vegetables, and dairy products, are an essential part of a healthy diet (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe diabetic glycemic index influences diabetes risk, regardless of body weight change, through impacts on hyperinsulinaemia, insulin resistance, beta cell demand, and, ultimately, beta cell function (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Choosing LGI foods over conventional or high-GI diets has a minor but clinically significant influence on medium-term glycemic control in diabetic individuals. The incremental effect is comparable to that provided by pharmaceutical medications that address postprandial hyperglycemia (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Low GI meals may improve weight control by increasing satiety, decreasing postprandial insulin secretion, and increasing fat oxidation. Studies have demonstrated that low-GI foods are more satiating, delay the return of hunger, or reduce subsequent food intake (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFrom 2011 to 2012, the proportion of low glycemic index foods consumed by Australian children and adolescents was 3%, according to a national survey done using stratified multistage sampling. Longitudinal trend analysis from a German study also shows that 56.5% of children aged 7\u0026ndash;8 years used low glycemic index diets in 2002 (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). According to a 2016 WHO research, 2% of Ethiopians died from diabetes, 16% from cardiovascular disease, and 7% from cancer as a result of a lack of chronic disease prevention through the use of low glycemic index foods (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). According to the International Diabetes Federation (IDF) 2015 report, the lack of these low glycemic index foods will have a significant impact on diabetics, who number 2.3\u0026nbsp;million in South Africa, 1.8\u0026nbsp;million in the Democratic Republic of Congo, 1.6\u0026nbsp;million in Nigeria, and 1.3\u0026nbsp;million in Ethiopia (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eInternational research on diabetes and GI identified some dietary terms (low glycemic index foods), such as whole grain-rich foods, cereal fiber, legumes, and green leafy vegetables, as protective against chronic conditions, including diabetes mellitus (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). The nutritional content of preventive foods (fiber, vitamins, and minerals) may lower the risk of diabetes by lowering inflammation, increasing glucose metabolism, endothelial function, and insulin sensitivity (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). 'Slow release' or low GI carbs have been demonstrated to help regulate blood glucose levels, which is especially beneficial in diabetes. The amount you eat is also important and all low GI foods aren\u0026rsquo;t necessarily good for you. In general, filing lower GI foods such as beans, peas, lentils, porridge, fruit and vegetables are good choices and can help you to manage your weight and keep to an overall healthy eating plan (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The type of sugar in foods can impact their glycemic index. It is a myth that all sugars have a high glycemic index. As a result, the type of sugar in a food influences its glycemic index. In other cases, preparation and cooking practices might affect the Glycemic index value of foods. In general, the longer a food is cooked, the faster its sugars are digested and absorbed, increasing the glycemic index. In other cases, unripe fruit contains complex carbohydrates that degrade into sugars as it ripens. The more mature the fruit, the higher its Glycemic index (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe majority of foods are ingested as part of a larger mixed meal, making the GI difficult to anticipate (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Knowledge of food attributes such as fat content, type of fat, calorie density, fiber content, food processing, starch structure, and optimum serving size may also influence the value of the glycemic index (\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). However, in Ethiopia, poor routine health information and a lack of data on diabetic patients' low glycemic indexes have an impact on diabetes management in the long run. As a result, the purpose of this study is to analyze the use of low glycemic index foods and associated factors among diabetes patients at Debre Markos and Finote Selam hospitals.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Setting\u003c/h2\u003e \u003cp\u003eInstitutional based cross-Sectional study was conducted in Debre Markos referral and Finote Selam hospitals from September 15, 2019 to October 15, 2019. Debre Markos referral hospital is situated at Debre Markos town found in East Gojjam zone in Amhara region. It serves for the total of 3.5\u0026nbsp;million populations. Debre Markos city is located in northwest Ethiopia (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Finote Selam hospital is situated at Finote Selam Town in western Ethiopia. The hospital provides health service to more than 1.5\u0026nbsp;million populations in its catchments. The town is Located in the West Gojjam zone of the Amhara region (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDebre Markos referral and Finote Selam hospitals are found in the area of same socio- demographic characteristics. Around those hospitals teff is the major food which consumed by the population. In addition to teff, wheat, maize, potatoes, lentils, beans, peas, honey, dairy products, fruits and vegetables are the major food those are common in the areas. Those hospitals were selected randomly to get adequate sample size regarding with this study. Add information. Quantitative data was collected from diabetic patients who are attends services in Debre Markos referral and Finote Selam hospitals.\u003c/p\u003e \u003cp\u003eThe ethical clearance was obtained from Debre Markos University's Health Science College Ethics Committee. An official letter, together with the ethical clearance, was sent to the Debre Markos referral and Finote Selam hospital offices. This study had no risk implications for the study participants. Participants were also notified that participation was voluntary and that those who rejected consent would be respected. The study participants provided written consent after being briefed on the study's objectives. There were no diabetic patients under the age of 18 in the sample.\u003c/p\u003e \u003cp\u003eThe anonymity of participant-related data was protected by omitting possible identifiers such as research participants' names and instead using their identification number as a reference. The interviewer's questions were kept safe throughout the research process. During data collection, every diabetic client who had a medical condition, such as a Diabetic complication, was educated and contacted with health specialists at those facilities for support and treatment.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSample size determination and sampling procedure\u003c/h3\u003e\n\u003cp\u003eSample size was calculated by a single population proportion formula:\u003c/p\u003e \u003cp\u003en= [(Zα/2)\u0026sup2; *P (1-P)] /d\u0026sup2;\u003c/p\u003e \u003cp\u003eSince there was no previous study the sample size was calculated by assuming a 50% proportion (P) of utilization of low glycemic index foods, a confidence level of 95% (1.96), and 5% margin of error (d). Based on this assumption the\u003c/p\u003e \u003cp\u003en= (1.96)\u0026sup2;\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{0.5\\left(1-0.5\\right)}{0.05\u0026sup2;}\\)\u003c/span\u003e\u003c/span\u003e = 384\u003c/p\u003e \u003cp\u003eAfter substitution the estimated sample size yields 384. By considering a 10% of non-response rate, 422 diabetic patients were planned to be included in the study.\u003c/p\u003e \u003cp\u003eSystematic random sampling was used to select 422 study participants from the study population. First 422 samples were proportionally allocated to Debre Markos referral hospital (241) and Finote Selam hospital (181). This data was taken from SMART care of those hospitals by filtering out DM patients specifically. Since there was no well-ordered or separated registration for DM patients, the sample was taken from those hospitals\u0026rsquo; patient flow. Then K value was calculated. Based on k value lottery method was used to select the first respondents. Finally, the study participants were selected every K value was 2.4. Then the respondents were selected every 2 individuals until the required samples was full filed or interviewed.\u003c/p\u003e\n\u003ch3\u003eData collection procedure and measurements\u003c/h3\u003e\n\u003cp\u003eData was collected by using interviewer administered structured questionnaire developed from different literatures such as (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). The tool contains socio- demographic characteristics (6 items), food preparation and feeding technique (3 items), market access characteristics (4 items), health status related questions (4 items), life style related questions (6 items), and knowledge-based questions (9 items). There are twenty food types in English version questionnaire and this questionnaire was translated to Amharic language. The respondents were asked to recall all foods and drinks they have taken in the three consecutive day\u0026rsquo;s meal history prior to the survey (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) to assess utilization of low glycemic index foods of the respondents. By using different literatures, the local food items were collected and summarized in twenty items. Six Professional nurses (two supervisors and four data collectors) were recruited to collect data. The data collectors use the codes \u0026ldquo;1\u0026rsquo; for respondents who says yes and \u0026ldquo;0\u0026rdquo; for respondents who says no for low glycemic based questionnaire. The supervisors were following the data collection technique and all the data collectors and supervisor were have regular meeting with the principal investigator at the end of each week of data collection period.\u003c/p\u003e\n\u003ch3\u003eOperational definition\u003c/h3\u003e\n\u003cp\u003eGlycemic Index: is a scientific ranking of how the foods we eat affect our blood sugar levels in the 2 or 3 hours after eating. Foods are measured against pure glucose, which has a value of 100 on the index (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eLow glycemic index: It indicates that the carbohydrates in a given food have a lower effect on postprandial blood glucose and possibly insulin responses. It has a GI value of \u0026lt;\u0026thinsp;55 gm (e.g., dairy products, fruits, vegetables\u0026hellip;) (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eUtilized: Diabetic patients who are consumed above 75% from the total listed low glycemic index foods (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDiabetes Mellitus: is defined as a case identified for having the disease diabetes by the clinician.\u003c/p\u003e \u003cp\u003eGood Knowledge: respondents who answer correctly to knowledge related question and those who scored equal and above 75% of the total value.\u003c/p\u003e \u003cp\u003eMarket access: Access of market measured in time and distance to get low glycemic food groups for study participants.\u003c/p\u003e \u003cp\u003eLong distance: If the distance between market and study participants is greater than 3 Km (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAdherence to Exercise: If the patient follow recommended level of exercise for more than 3 days in the last seven days (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlcohol Consumption: If reported consumption of alcohol twelve month prior to the survey (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe data collected was coded, entered into Epi Data Version 3.1, and cleaned. The cleaned data set was transferred to the Statistical Package for Social Sciences (SPSS) Version 25 software for analysis. The study participants' use of low glycemic index food groups (used, none utilized), as well as socio-demographic factors and other independent variables that influence low glycemic index food utilization, were presented using relevant descriptive statistics. Binary Logistic Regression was used to investigate the relationship between the dependent and independent variables. The appropriateness of the resultant model was assessed using the Hosmer and Lemeshow goodness of fit test, which had a significance level of 0.740. A Binary Logistic Regression assumption, such as no multi-co linearity, was tested, and all variables had a Variance Inflation Factor (VIF) of less than 5, therefore they were included in the multivariable analyses. Both bivariate and multivariate analyses were performed. The factors that exhibited a significant correlation at p\u0026thinsp;\u0026lt;\u0026thinsp;0.25 were included in the multivariable analysis. Finally, variables with a significant association at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 with 95% confidence intervals were designated statistically significant factors of low glycemic index food consumption.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic characteristics of the respondents\u003c/h2\u003e \u003cp\u003eA total of 416 study participants were participated with response rate of 98.5%. The median age of respondents was 46.50 years (IQR 37\u0026ndash;56 years). Among the study participants, 283(68%) were males. Regarding place of residence and their educational status, 272(65.4%) and 131(31.5%) of them were urban residents and have diploma and above respectively (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic characteristics of Utilization of low glycemic index foods among DM patients in FSH and DMR hospitals, Northwest Ethiopia, 2019(N\u0026thinsp;=\u0026thinsp;416).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge of respondents\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.65%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u0026ndash;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.37%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65\u0026ndash;89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.98%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex of respondents\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducational status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCannot read and write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCan read and write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGrade 1to8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGrade 9to12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMerchant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDaily laborer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGovernment employee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNGO worker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNonemployee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e296\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHusband educational status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCannot read and write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCan read and write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGrade 1to8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGrade 9to12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWife educational status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCannot read and write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ecan read and write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGrade 1to8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGrade 9to12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePlace of residence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eFood preparation and feeding technique of respondents\u003c/h3\u003e\n\u003cp\u003eIn this study 307(73.8%) of study participants had practice of feeding processed foods. On the other hand 64(15.4%) feeding sweet fruits instead of unripe fruits (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFood preparation and feeding technique of low glycemic food utilization among diabetes patients in FS and DMR hospitals, Northwest Ethiopia, 2019 (N\u0026thinsp;=\u0026thinsp;416)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFeeding processed foods\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFeed foods prepared with malt sugar\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e352\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e84.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFeed sweet fruits instead of un riper fruits\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e198\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eMarket access related characteristics of respondents\u003c/h2\u003e \u003cp\u003eFrom here 263(63.2%) of diabetic patients were found less than or equals to three Km distance to the local market. Regarding with other characteristics 230(55.3%) of respondents were going on foot to the local market for food exchange and sale purpose (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMarket access measuring characteristics of Low glycemic index food utilization among diabetic patients in FS and DMR hospitals, Northwest Ethiopia, 2019 (N\u0026thinsp;=\u0026thinsp;416)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHow far home to market\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;3 Km\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e263\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;3 Km\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHave employee at off farm activity?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you have food exchange and sale practices in the market\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e389\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e93.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWay of transport\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOn foot\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e55.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHorse and cart\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVehicles\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eHealth status related characteristics of respondents\u003c/h2\u003e \u003cp\u003eThe median age of study participants with diabetes were 4 years (IQR 2\u0026ndash;7 years). Regardless of health status related characteristics 123(29.6%) of study participants had developed chronic disease other than diabetes (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHealth status related characteristics of utilization of low glycemic index foods among diabetic patients in FS and DMR hospitals, Northwest Ethiopia, 2019(N\u0026thinsp;=\u0026thinsp;416)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYears of patients live with diabetes after diagnosis by physicians\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003echronic disease other than diabetes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e70.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHypertension\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e303\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e72.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRenal disease\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e405\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e97.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCancer\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e412\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e99.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCardiovascular disease\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e96.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEpilepsy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e414\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e99.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLosses of appetite after diabetes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e268\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e64.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eLife style related characteristics of respondents\u003c/h2\u003e \u003cp\u003eA total of three hundred and ninety (93.8%) respondents consumed alcohol in their life time. From here 178(42.8%) of study participants were consume alcohol in the past twelve months. The study also indicates 193(46.%) of study participants were have greater than or equals to three days of practice in a week of physical activity in a specific exercise session (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLife style related characteristics of low glycemic index food utilizations among diabetic patients in FS and DMR hospitals, Northwest Ethiopia, 2019 (N\u0026thinsp;=\u0026thinsp;416)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eConsumed alcohol in life time\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e390\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e93.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eConsumed alcohol in past 12 months\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e238\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCigarette smoking in the past seven days\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e393\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e94.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of cigarettes in average over a day\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNothing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e394\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e94.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEven one puff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical activity over seven days\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;3 days/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e361\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;3 days/ week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical activity over seven days in a specific exercise session\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;3 days/ week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e46.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;3 days/ week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e223\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e53.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eKnowledge related characteristics of respondents\u003c/h2\u003e \u003cp\u003eIn this study there were nine questions to measure knowledge about utilization of low glycemic index foods. Based on this, each question has many alternatives and were summed and coded to one. After that, all questions were also summed and coded as \u0026ge;\u0026thinsp;75% for good and \u0026lt;\u0026thinsp;75% poor knowledge about utilization of low glycemic index foods.\u003c/p\u003e \u003cp\u003eFrom a total of 416 study participants included in the study 273(65.6%) of respondents had good knowledge on low glycemic index foods. From the study participants 73(17.5%), 116(27.9%), and 181(43.5%) were know the importance of low glycemic index foods as they use to prevent hypoglycemia, hyperinsulinaemia and their ability to delay return of hunger respectively. In addition to the above ideas 279(67.1%) and 197(47.4%) of respondents have good knowledge on feeding of the small portion of carbohydrate foods and the effect of feeding processed foods on blood glucose level among diabetic patients (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKnowledge based characteristics of utilization of low glycemic index foods among diabetic patients in FS and DMR hospitals, Northwest Ethiopia, 2019 (N\u0026thinsp;=\u0026thinsp;416)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhat does mean term low glycemic index to you?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCorrectly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e50.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWrongly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSays I don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhich is the importance of low glycemic index foods for DM patients?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCorrectly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWrongly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e284\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhich one is do you think have low GI value in related with fruit ripeness?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCorrectly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWrongly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSays I don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhich one do you think have low GI value in related with time of cooking?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCorrectly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWrongly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSays I don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhich types of sugar do you think have low GI value?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCorrectly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWrongly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e273\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAs a diabetic patient how you feed in day to day feeding system?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOn my own prepared food\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e367\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e88.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWith my family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCan you list any problems on persons those are decreased by due to low glycemic index foods consumption?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCorrectly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWrongly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHow you feed carbohydrate foods?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIn small portion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIn large portion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e279\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhich of the following food groups have affect blood glucose by increasing blood glucose level quickly?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCorrectly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWrongly answered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eMagnitude of utilization of low glycemic index food groups\u003c/h2\u003e \u003cp\u003eIn this study there were twenty types of food groups those are adapted from different studies according to their availability in Ethiopia including the study area and these food groups were coded and summed. Among the respondents that had\u0026thinsp;\u0026ge;\u0026thinsp;75% were considered as good utilization of low glycemic index foods and \u0026lt;\u0026thinsp;75% were considered as poor utilization of low glycemic index foods. Finally, 37(8.9%) respondents had good utilization of low glycemic index foods (95%CI: 6.3, 11.5) (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMagnitude of low glycemic index foods among diabetic patients in FS and DMR hospitals, Northwest, Ethiopia, 2019(N\u0026thinsp;=\u0026thinsp;416)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eLamp\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e87.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eOlive oil\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eCollard greens\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eFish\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e398\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e95.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eChicken\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e390\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e93.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eKitifo\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e360\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eEggs\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eButter\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e296\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eBell peppers\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e335\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eCarrots\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eBroccoli\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e360\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOnion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e393\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e94.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eWhole grains (beans, peas, lentils)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eTomatoes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eCabbage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e261\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eMustard greens\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e84.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eKale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eLettuce\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWater\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eSpicy foods\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e397\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e95.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eFactors of utilization of low glycemic index foods\u003c/h2\u003e \u003cp\u003eIn this study the constants coded for 1 as they are protective based on literature. At Bivariable analysis, variables such as place of residence, educational status, distance to market, doing physical activity, alcohol consumption, employee at off farm activity, feeding processed foods, losses of appetite, developing chronic disease other than diabetes, and knowledge on low glycemic index foods were have P value less than 0.25 and included to multivariable analysis.\u003c/p\u003e \u003cp\u003eAt multivariable analysis, variables such as distance less than three Km to market is 3.85 times more likely to utilize low glycemic index foods, AOR: 3.851(95%CI: 1.262, 11.745), formal education were 2.509 times more likely to utilize low glycemic index foods, AOR: 2.509(95%CI: 1.178, 5.344), no history of alcohol consumption in the past twelve months prior to the survey were 3.991 times more likely utilize low glycemic index foods, AOR, 3.911(1.599, 9.567), and good knowledge of respondents in related to low glycemic index foods were 3.354 times more likely to utilize low glycemic index foods, AOR, 3.354(1.091, 10.309) were significantly associated with utilization of low glycemic index foods at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 with 95% CI (Table \u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariable and Multivariable analysis of factors of utilization of low glycemic index foods among diabetic patients in FS and DMR hospitals, Northwest Ethiopia, 2019 (N\u0026thinsp;=\u0026thinsp;416)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eUtilization of low glycemic index foods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR with 95% CI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR with 95% CI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003ePlace of residence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e266\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.195(0.891\u0026ndash;5.406)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.915(0.310\u0026ndash;2.700)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.872\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eDistance to the market\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;3 Km\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.100(1.562\u0026ndash;10.761)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.851(1.262\u0026ndash;11.745)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.018*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;3 Km\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003efeeding processed foods\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e276\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.928(0.782\u0026ndash;4.757)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.362(0.469\u0026ndash;3.951)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.570\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eChronic disease other than diabetes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e273\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.090(0.520\u0026ndash;2.283)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.905(0.402\u0026ndash;2.039)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.810\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eAppetite losses after diabetes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.555(0.255\u0026ndash;1.210)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.171(0.938\u0026ndash;5.023)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.070\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eKnowledge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.707(1.658\u0026ndash;13.771)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.354(1.091\u0026ndash;10.309)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.035*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eEducational status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFormal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.241(1.132\u0026ndash;4.436)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.509(1.178\u0026ndash;5.344)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.017*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInformal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003ePhysical activity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.351(1.129\u0026ndash;4.894)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.955(0.862\u0026ndash;4.434)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.109\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eAlcohol consumption\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot consumed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.590(1.968\u0026ndash;10.707)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.911(1.599\u0026ndash;9.567)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.003*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eConsumed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eEmployee at off farm activity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.707(1.412\u0026ndash;9.733)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.689(0.913\u0026ndash;7.924)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eLow glycemic index foods have a great public health importance in related to the prevention of chronic diseases like diabetes mellitus, hypertension, and cancer. This study finding showed that magnitude of utilization of low glycemic index foods were 8.9% (95%CI: 6.3\u0026ndash;11.5).\u003c/p\u003e \u003cp\u003eThis finding less than the research conducted in German, 56.5% (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). The difference may be due to the difference of socio-demographic characteristics, way of life, countries growth and development difference, age difference of the respondents because they were study on school children. The difference also may be due to the way of research conducted that was done by longitudinal trend analysis.\u003c/p\u003e \u003cp\u003eIn other ways this study magnitude higher than study conducted in Australia, 3% (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). This may also due to difference of age group that were children\u0026rsquo;s, difference of study subjects that was not specifically diabetic patients, time of research conducted that was conducted by using twelve years data and also conducted eight years ago, and method of research conducted that was trend analysis on the Australian health survey.\u003c/p\u003e \u003cp\u003eThe diabetic patients with formal education were 2.509 times more likely to utilize low glycemic index foods than that of respondents who attained informal education. This was due to respondents who had informal education had incomplete interpretation of instructions, patients tend to forget the advices given by the health care providers, and unable to understand uses of low glycemic index foods. This study supported by the studies conducted in Southern Ethiopia, India, and USA (\u003cspan additionalcitationids=\"CR30\" citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study found that diabetic patients who had no history of alcohol consumption in the past twelve months prior to the survey were 3.991 times more likely utilize low glycemic index foods than that of respondents who had practice of alcohol consumption. This was due to drinking alcohol leads to low intake of fiber, fruits (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), nutritional distortion due to infections caused by drinking alcohol (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). In this case drinking alcohol leads to poor appetite in users and secondary to infection causes poor food intake and adherence to foods like low glycemic index foods. This study supported by the study conducted in Addis Ababa, Finland, and USA (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study also showed that diabetic patients who live in less than or equals to three Km to the local market were 3.851 times more likely utilize low glycemic index foods than who were live in greater than three Km among diabetic patients. This may be due to \u0026gt;\u0026thinsp;3 Km to the local market had inability to practice food exchange and sale foods especially low glycemic index food groups and also persons who were live in long distance to local market have not go to local market for only the purpose of exchange of fruits, vegetables, eggs and so on, since those food commodities are usually found in the market. This study similar with the study conducted in South Gondar zone (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn this study respondents who had good knowledge of respondents in related to low glycemic index foods were 3.354 times more likely utilize low glycemic index foods among diabetic patients. It has been observed that good knowledge among respondents may use to easily recognize the impact of unhealthy diet, use to differentiate low glycemic food groups easily, and can fill gaps which facing in use of low glycemic foods. This study supported by other studies conducted in Jimma University specialized hospital, Ethiopia, India, and Australia (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e).\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe magnitude of utilization of low glycemic index foods among diabetes mellitus patients attending follow up care service at Debre Markos referral and Finote Selam hospitals was found to be low. Distance to the market, educational status, practice of alcohol consumption, and knowledge on low glycemic index foods were found to be statistically significant with utilization level of low glycemic index foods.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eGDP \u0026nbsp; \u0026nbsp;Gross Domestic Product, GI \u0026nbsp; Glycemic Index, HGL \u0026nbsp; \u0026nbsp;High Glycemic Index, IDF \u0026nbsp; \u0026nbsp; International Diabetes Federation, LGI \u0026nbsp; \u0026nbsp;Low Glycemic Index, NCD \u0026nbsp; \u0026nbsp;Non-Communicable Disease, NGO\u0026rsquo;s \u0026nbsp; \u0026nbsp; Non- Governmental Organizations, SMART \u0026nbsp; Specific, Measurable, Achievable, Realistic, and Time bounded, SPSS \u0026nbsp; \u0026nbsp; Statistical Package for Social Sciences, T2DM \u0026nbsp; \u0026nbsp;Type 2 Diabetes Mellitus, WHO \u0026nbsp; \u0026nbsp; World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The ethical clearance was obtained from Debre Markos University, Health science college ethical committee. \u0026nbsp;Official letter was written along with the ethical clearance and was submitted to Debre Markos referral and Finote Selam hospital office. This study was not had any risk consequence for study participants.\u0026nbsp;\u003cstrong\u003eClinical trial number:\u0026nbsp;\u003c/strong\u003enot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Participants were also informed that participation was voluntary and participants who refused the consent had respect. Written consent was taken from the study participants after briefing them the objective of the study.\u0026nbsp;Written informed consent was obtained from all participants before enrolment in the study.\u0026nbsp;There was no age of less than 18 years diabetes patients in the sample included. The confidentiality of participant\u0026rsquo;s related data was maintained by avoiding possible identifiers such as name of study participants only identification number was used as a reference. The interviewer administered questionnaires was kept safe throughout the whole process of the research work. During data collection time any diabetic client with medical problem findings such as any Diabetic complication, education was provided and contacted with health professionals found in those hospitals for support and treatment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author. The data will not be shared in order to preserve participant anonymity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have declared that no competing interests exist.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was obtained for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank Debre Markos University college of Health science for providing ethical clearance, data collectors, supervisor and study participants for their willingness to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization: ZD. Formal analysis: \u0026nbsp;ZD, HA, and MM. Development or design of methodology: ZD. Entering data into computer software: ZD. Supervision: ZD, HA, MM. Validation: ZD, HA, MM. Writing original draft: ZD. Writing review and editing: ZD, HA, MM. All authors read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAzmina Govindji D. Glycemic Index (GI). British Dietetic Association. January 2017.\u003c/li\u003e\n\u003cli\u003eSalwa W. Rizkalla MD P, Laika Taghrid M, Muriel Laromiguiere P, PHD, Dorothee Huet M, JosetteBoillot P, Aude Regoir M, et al. Improved plasma glucose control, whole- body glucose utilization, and lipid profile on a low glycemic index diet in type 2 diabetic men. GoogleScholar,. August 2004;27.\u003c/li\u003e\n\u003cli\u003eHelena GM Liljeberg AKA, Inger ME Bjorck. Effects of the glycemic index and content of indigestible carbohydretes oof cereal based breakfast meals on glucose tolerance at lunch in healthy subjects. American Journal for clinical Nutrition,. 1999;69:647-55.\u003c/li\u003e\n\u003cli\u003eDaisy coyle A. A beginner\u0026apos;s guide to the low glycemic diet. Health Care,. November 2017.\u003c/li\u003e\n\u003cli\u003eGr. i. Glycemic index defined. Google Scholar,. 2012.\u003c/li\u003e\n\u003cli\u003eGross L.S., Li L., Ford E.S., Liu S. Increased consumption of refined carbohydrets and the epidemic of T2DM in the united states; An ecologic assessment American Jornal for clinical Nutrition,. 2004;79.\u003c/li\u003e\n\u003cli\u003eDavid S. Ludwig M, PHD. The glycemi index: Physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. Google Scholar, American Medical Association. May 2002;287(18).\u003c/li\u003e\n\u003cli\u003ewww.LowGIHealth.com.au. Glycemic index Food List.\u003c/li\u003e\n\u003cli\u003eWater Willet JM, and Simin Liu. Glycemic index, Glycemic load, and risk of type 2 diabetes American Jornal for clinical Nutrition,. 2002;76.\u003c/li\u003e\n\u003cli\u003eJennie Brand- Miller P, Susan Hayne B, PeterPetocz P, Stephen Colagiuri M. Low glycemic index diets in the management of diabetes, A Meta analysis of randomized controlled trials. Google Scholar,. August 2003;26.\u003c/li\u003e\n\u003cli\u003eJanette C. Brand- Miller PD. glycemic load and chronic disease. International life sciences institute,. 2003;61(5).\u003c/li\u003e\n\u003cli\u003eMolly Jones AWB, Jennie C. Brand Miller, Jimmy Chun Yu Louie,. Dietary glycemic index and glycemic load among Australian children and adolescents: results from the 2011-2012 Australian health survey.,. British Journal of Nutrition. October 2015;116:178-87.\u003c/li\u003e\n\u003cli\u003eBuyken AED, W.; Kersting, M.; Kroke, . A. Glycaemic index and glycaemic load in the diet of healthy schoolchildren: Trends from 1990 to 2002, contribution of different carbohydrate sources and relationships to dietary quality. British Journal of Nutrition,. 2005,;94,:796-803,.\u003c/li\u003e\n\u003cli\u003eWHO. None communicable diseases (NCDs) country profile.,. 2018,.\u003c/li\u003e\n\u003cli\u003eFMOH. National Training on Diabetes Mellitus for health care workers. October, 2016.\u003c/li\u003e\n\u003cli\u003eBJ venn TG. Glycemic index and glycemic load; measurment issues and their effect on diet- disease relationships. Europian Jornal of Clinical Nutrition. 2007;61:22-31.\u003c/li\u003e\n\u003cli\u003eChris Ho Ching Yeung DTLK, Alan Winston Barclay, Jennie Cecile Brand-Miller, and Jimmy Chun Yu Louie. The Decreasing Trend in Dietary Glycaemic Index and Glycaemic Load in Australian Children and Adolescents between 1995 and 2012. MDPI. 22 August 2018;10.\u003c/li\u003e\n\u003cli\u003eKris Y. Lok RC, Dicken Chan, Liz Li, Grace Leung, Jean Woo, Helen J. Lightowler, C. Jeya K. Henry,. Glycemic index and glycemic load values of a selection of popular foods consumed in Hong Kong,. British Journal of Nutrition,. 2010;103,:556-60,.\u003c/li\u003e\n\u003cli\u003eThimothy O F, Jenni Ilomaki, Sari Voutilainen, Jussi Kauhanen,. Alcohol consumption and dietary patterns: The FinDrink study,. Google Scholar,. 2012;7(6).\u003c/li\u003e\n\u003cli\u003eWoo MY. How Foods Affect Blood Sugar: A Guide for Ethiopian and Eritrean Patients with Diabetes EthnoMed. http://ethnomed.org/patient-education/diabetes accessed at January 20 ,2019.\u003c/li\u003e\n\u003cli\u003eMeaza Assefa, Melaku Umeta, Natesan Gnanaseknram. Glycemic index of some traditional Ethiopian foods International Journal of Biochemistry research and review. 2017;18(4).\u003c/li\u003e\n\u003cli\u003eKaye Foster- Powell, Susanna HA Holt, Janette C. Brand- Miller PD. International table of glycemic index and glycemic load values. American Jornal for clinical Nutrition,. 2002;76.\u003c/li\u003e\n\u003cli\u003eHuseyin Gumus YA, Sidika Bulduk,. Determination of factors effected dietary glycemic index in Turkish university students.,. European journal of educational research,. 2014;3(1):1-7.\u003c/li\u003e\n\u003cli\u003eSluijs I., Beulens J.W.J., Van Der A.D.L., Spijkerman A.M.W., Grobbee D.E., Van Der Schouw Y.T. Dietary intake of total animal,and vgetable protien and risk of T2DM in the europian prospective investigationin to cancer and nutrition (EPIC)- NL study. Diabetes care. 2010;33:43-8.\u003c/li\u003e\n\u003cli\u003eHarborview Medical College HPaFE. Diabetes Meal Plan Basics, . HMC,. 2015, .\u003c/li\u003e\n\u003cli\u003eGirma Nega BDU, Melkie Endris UoG, Degnet Teferri BDU, Amanual Nana BDU, Rigbe W/Michael BDU, . Dietary diversity and associated factors among rural households in south gondar zone, Northwest Ethiopia. Feed the future. November 2015.\u003c/li\u003e\n\u003cli\u003eT/Michael T. Diatery pattern of type 2 diabetes mellitus patients on follow up in public hospitals in Addis Ababa, Ethiopia. PubMed, NCBI,. June, 2016.\u003c/li\u003e\n\u003cli\u003eTekalign Y. Assessment of the magnitude of glycemic control and its associated factors among patients with type 2 diabetes at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. PubMed, NCBI,. June, 2015.\u003c/li\u003e\n\u003cli\u003eAlemayehu zekewos, Eskindir Loha, Tariku Egeno, Kindie Wubshet, Zelalem Merga. Prevalence of diabetes mellitus and associated factors in southern Ethiopia; a community based study. Ethiop J health. Feb, 2017.\u003c/li\u003e\n\u003cli\u003eTonja R. Nancel P, Lauren Gellar, Linda Zeitzoff. Acceptability of lower glycemic index foods in the diabetes camp setting. PubMed, NCBI,. 2006;38(3):143-50.\u003c/li\u003e\n\u003cli\u003eGarima Bhutani, Sanjay Kalra, Sonika Lamba, Prem Kumar Verma, Rahul Saini, Meenakshi grewal. Effect of diabetic education on the knowledge, attitude and practices of diabetic patients towards prevention of hypoglycemia. Indian jornal of endocrinology and metabolism. 2015,;19(3):383- 6.\u003c/li\u003e\n\u003cli\u003eBunout O. Nutritional and metabolic effectes of alcoholism: their relationship with alcoholic liver disease,. PubMed, Google Scholar. 1999;15(583-589).\u003c/li\u003e\n\u003cli\u003eEmmanuelle Kesse FC-C, Nadia Slimani, Marti Van Liere,. Do eating habits differ according to alcohol consumption? Results a study of the french cohort of the european prospective investigation in to cancer and nutrition,. American Jornal for clinical Nutrition,. September 2001;74(3):322-7.\u003c/li\u003e\n\u003cli\u003eEndalew Hailu, Wudneh H. Mariam, Tefera Belachew, Birhanu Z. self care practice and glycemic control amongst adults with diabetes at the Jimma university specialized hospital in southwest Ethiopia. African Journal of primary health care and family medicine. may 2011 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Glycemic Index, Utilization, Finote Selam hospital, Debre Markos referral hospital, Diabetes Mellitus","lastPublishedDoi":"10.21203/rs.3.rs-9097446/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9097446/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEntire populations are at risk of diseases such as diabetes. There is also limiting resources in Ethiopia to control hyperglycemia because of limited catastrophic expenditure for chronic diseases. Due to the importance of balancing blood glucose level in diabetes, low/ few glycemic foods are important to moderate blood glucose in diabetes patients.\u003c/p\u003e\u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003eTo assess the utilization of low glycemic index foods and associated factors among diabetes mellitus patients at Debre Markos referral and Finote Selam hospitals, Northwest Ethiopia, 2019.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eInstitution based cross-sectional study design was conducted. A systematic random sampling technique was used to select study participants. The data was coded and entered to Epi Data version 3.1 and exported to statistical package for social science (SPSS) version 25 for analysis. Binary logistic regression model was used for analysis. The adequacy of the final model was checked using Hosmer and Lemeshow goodness of fit test and an assumption of Binary Logistic Regression such as no multi-co linearity was checked. Both bivariable and multivariable analysis were conducted. Those variables that showed significant association at P\u0026thinsp;\u0026lt;\u0026thinsp;0.25 were included to multivariable analysis. Variables that showed significant association at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 with 95% CI was declared statistically significant factors of utilization of low glycemic index foods.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 416 diabetic patients were participated in this study with response rate of 98.5%. Among the study participants, 8.9% (95%CI: 6.3, 11.5) of the participants had good utilization of low glycemic index foods. In this study\u0026thinsp;\u0026le;\u0026thinsp;3 Km distance from market [AOR: 3.851(95%CI: 1.262, 11.745)], informal education [AOR: 2.509 (95%CI: 1.178, 5.344)], alcohol consumption [AOR, 3.911(1.599, 9.567)], and good knowledge on low glycemic index foods [AOR: 3.354(1.091, 10.309)] were factors associated with utilization of low glycemic index foods.\u003c/p\u003e\u003ch2\u003eConclusion and Recommendations:\u003c/h2\u003e \u003cp\u003eThe magnitude of utilization of low glycemic index foods among diabetes mellitus patients attending follow up care service at Debre Markos referral and Finote Selam hospitals was found to be low. Distance to the market, educational status, practice of alcohol consumption, and knowledge on low glycemic index foods were found to be statistically significant with utilization level of low glycemic index foods.\u003c/p\u003e","manuscriptTitle":"Utilization of low glycemic index foods and associated factors among diabetes mellitus patients in Debre Markos referral and Finote Selam hospitals","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-29 18:41:21","doi":"10.21203/rs.3.rs-9097446/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"153837866761741860883681962107230099903","date":"2026-04-28T14:19:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263405476583147842687594032313233327254","date":"2026-04-26T16:09:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"16775638930619833396425124998109127458","date":"2026-04-24T07:03:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"111771617161664808262197397443665305247","date":"2026-04-22T09:59:10+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-21T06:14:53+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-30T15:47:50+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-26T14:29:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-23T16:07:37+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2026-03-23T14:32:29+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"18b22435-4967-4fa0-9bb9-7fafa1844044","owner":[],"postedDate":"April 29th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-29T18:41:21+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-29 18:41:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9097446","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9097446","identity":"rs-9097446","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}