We try to avoid our pts. having big meals while on dialysis. Diabetics on 5 and a half hour dialysis do need a light meal. We try to take off as much fluid as early as possible to minimize hypotension. They have their insulin + calcium supp. @ home as on a non dialysis day. We only serve fluids and a weekly treat of a muffin. Some bring a small snack like fruit or cookies. Some we don't feed at all as they tend to choke. We've had too many vomit and /or go hypo...so we avoid big meals like the plague. Hope this helps!