Diabetes is one of the most common causes of kidney failure, and a significant number of patients receiving dialysis also have diabetes. We understand how managing both conditions together can feel overwhelming. But with the right care plan, lifestyle habits, and support from your medical team, you can maintain good health and improve your quality of life.
Whether you have just started dialysis or have been managing it for some time, controlling your diabetes is just as important now as it was before. Left unmanaged, it can still harm other organs and systems, including your heart, eyes, feet, and nerves—even after you have started dialysis.
Why Diabetes and Dialysis Go Hand in Hand
Many patients on dialysis are there because of a condition called diabetic kidney disease. Over time, high blood sugar damages the small blood vessels in the kidneys, impairing their ability to filter waste and fluids. Eventually, this damage can lead to end-stage renal disease (ESRD), requiring dialysis or a kidney transplant.
But dialysis is not the finish line for managing diabetic conditions. High blood sugar levels can still lead to complications such as:
- Heart attacks
- Strokes
- Vision loss (diabetic retinopathy)
- Nerve damage
- Foot ulcers or even amputations
That’s why continued management is essential, even while receiving dialysis treatments.
Why A1c Testing May Not Tell the Full Story
You may be used to tracking your blood sugar control through a test called Hemoglobin A1c (HbA1c). This test reflects your average blood sugar over the past 2–3 months. However, for people on dialysis, the A1c test may not be as accurate. It can sometimes give falsely low readings, leading doctors to believe your diabetes is better controlled than it actually is.
That’s why finger stick glucose checks remain an important part of your diabetes care plan. Monitoring your blood sugar regularly—as advised by your doctor—helps prevent both highs and lows, and gives your care team a clearer picture of your health.
Care and Control: What You Should Do
As a dialysis patient with a diabetic condition, your care plan must be proactive and personalized. Here are the most important steps to take:
- See the Right Specialists
- Visit your primary care doctor or endocrinologist regularly to help manage your diabetes medications and track blood sugar trends.
- Schedule yearly eye exams with an eye doctor (ophthalmologist) to screen for diabetic retinopathy.
- See a podiatrist (foot doctor) regularly to prevent infections or ulcers that can lead to serious complications.
- Track Blood Sugar and Take Medications
- Check your glucose as often as your doctor recommends.
- Take medications or insulin as prescribed.
- Discuss any changes in blood sugar levels on dialysis days, especially if you feel unusually tired or lightheaded.
- Eat a Renal-Friendly Diabetic Diet
Working with a dietitian is essential. Your diet needs to balance both your diabetic condition and kidney health. Here are a few tips:
- Eat three balanced meals a day with healthy snacks if needed.
- Avoid fried foods and sugary drinks.
- Choose low-potassium fruits and vegetables like apples and cabbage.
- Opt for sugar-free alternatives (like Stevia or Splenda) in drinks and desserts.
- Sodium and protein intake, based on your doctor’s guidance.
- Stay Active
Exercise helps with blood sugar control, weight management, and overall well-being. Just be sure to:
- Get your doctor’s approval before starting.
- Aim for moderate exercise like walking or stretching 3–5 times a week.
- Include resistance training to support muscle health.
Can Diabetics Get a Kidney Transplant?
Yes—many patients with diabetes are eligible for kidney transplants. After a successful transplant, you may need more insulin as your appetite improves and your new kidney processes insulin better. Some individuals may also qualify for a pancreas transplant, often done at the same time as the kidney transplant. Your nephrologist can help you explore these options.
We are here to Help
Managing diabetes during dialysis takes commitment, support, and the right team by your side. At Clinical Renal Associates (CRAL), we partner with you to provide the tools, education, and care you need to stay in control of your health.
Whether it’s adjusting your medications, planning a dialysis-friendly diet, or coordinating care with your other doctors, our compassionate team is here every step of the way.
If you are looking for a trusted dialysis center in Philadelphia that understands the challenges of managing diabetes and kidney disease together, we’re here for you.
Living with a diabetic condition while on dialysis is challenging, but manageable with the right steps:
- Monitor your blood sugar daily
- See your specialists regularly
- Stick to a balanced, kidney-friendly diet
- Stay active
- Communicate openly with your care team
By following these steps, you can reduce complications, improve your quality of life, and keep moving forward—one day at a time.