Diabetic nephropathy is the leading cause of end-stage renal disease in many countries, including Taiwan. Diabetic patients characteristically experience more hemodynamic change during hernodialysis treatments. Hypotension develops rapidly and frequently in these patients. This problem becomes increasingly important as the growing population of diabetic patients are receiving (OR- are being maintained with HD treatments) maintenance hemodialysis. Sugar control also is a major issue for diabetic hemodialysis patients, since the glucose metabolism in the diabetic uremic patient is greatly altered. The alteration of the metabolic process in these patients has made daily control of blood sugar a difficult task in the care of the diabetic uremic patient. We reviewed the intra-dialytic hemodynamic change and sugar control in diabetic patients undergoing regular hemodialysis.