insulin levels (43). However this route of administration promotes a more atherogenic lipid profile and may cause focal hepatic fat accumulation, and there also remains a theoretical risk of peritonitis.
As the prevalence of diabetes grows so will the need for renal replacement therapies.
The dietary management of patients as they approach ESRF should focus on minimising uraemic symptoms while ensuring a sufficient protein and energy intake to prevent malnutrition.
Both the nutritional status and the glycaemic control of an individual as they start dialysis are independent important predictors of their future morbidity and mortality.
Achieving glycaemic control in patients undergoing regular dialysis requires a careful balance between the dialysis prescription and meal planning.
While the nutritional requirements, constraints and demands are by and large similar for the diabetic and non-diabetic patient, the need to address atherosclerotic cardiovascular risk factors is still greater in the diabetic patient.
Today many of the diabetic patients undergoing dialysis are malnourished with poor glycaemic, lipid and metabolic profiles.
There is a real need for well- constructed nutritional studies in the diabetic dialysed population to formulate evidence-based dietary interventions that will help to extend the patient’s life expectancy to that of a non-diabetic dialysed subject.