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Michel Roden RN; NN; Nadia Gammar HN; NN; Hop. Erasme, Universite Libre [...], The frequency of diabetic nephropathy, as a primary cause of chronic renal failure, is almost 35% in the USA and about 25% in Europe. Almost 50% of these diabetic ESRD patients die within 3 years after initiating their kidney replacing therapy. To avoid most of the cardiovascular instability problems a peritoneal dialysis treatment seems the most favourable. The variable use of the different dialysate glucose concentrations to treat the patient's fluid overload creates an unstable diabetes treatment. A matrix or flowchart to help the patients in their continuous struggle to adjust their insulin in interaction with their PD treatment can substantially improve the diabetes control. One of our diabetic patients' (F55Y) did indeed decrease her HbA1c (DCCT) from 10,5 % to 8,7 % in less than 6 months time. Better control and insulin adjustments will prevent the appearance of dangerous DM complications such as micro - macro-angiopathy, neuropathy and retinopathy. Refining the diabetes therapy to prevent these life-threatening complications decreases the morbidity and mortality and increases the personal liberty and the quality of life of the IDDM ESRD patient.