Background: Diabetes is one of the most prevalent metabolic disorders affecting the population globally and affects multiple organ systems. Diabetes is also one of the most common causes of ESRD (end-stage renal disease) globally. Aim: The present study aimed to comparatively assess the outcomes in diabetic subjects managed with dialysis to non-diabetic subjects. Methods: The study assessed 266 hemodialysis maintenance subjects prospectively for 14 months. In all the included subjects, hemodialysis exit, hospitalization, and cause of death were assessed and compared to non-diabetic subjects. Results: In 266 subjects, diabetes was reported in 40.97% (n=109) subjects. In diabetic subjects, significantly worse SF36 scores, high LDL and serum triglycerides, lower iPTH, low serum albumin, high CRP, higher cardiovascular morbidities, lower dialysis duration, and higher age were seen compared to non-diabetic subjects. Hazard risk of death was 1.9 times higher in diabetics compared to non-diabetics. Death secondary to cardiovascular diseases with infection and other causes was 80% in diabetics and 54% in non-diabetics. The annual admission rate was also significantly higher in diabetics. Conclusions: The present study concludes that HRQOL (health-related quality of life) and clinical outcomes were much worse in diabetic subjects compared to non-diabetic subjects on hemodialysis which is primarily attributed to the higher frequency of cardiovascular diseases.