Diabetes mellitus is the leading cause of chronic kidney disease and end-stage kidney disease. Optimal glycemic control would slow the progression of chronic kidney disease. When it progressed to end-stage disease which dialysis is required, it is uncertain whether intensive glycemic control is still associated with better outcomes. This article focuses on the goals and approaches of glycemic control in dialysis patients, the difference between dialysis patients and those with normal renal function, and evaluating the risk of hypoglycemia.