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!
we do insulin before after even during. check blood sugar regularly until you figure out the reaction of each individual pt( and then they change) we have glucometers 1 for every 4 patients. we do about 50-55 pt a day