Metabolic commonalities exists between diabetes, chronic kidney disease and non-alcoholic fatty liver disease. Additionally, evidence-based guidelines often inform clinical practice. These three often co-existing conditions require the RDN to recognize and understand the basis behind the clinical guidelines, how to individualize treatment, reduce treatment disparities and provide the right care for the right patient at the right time. This issue of OTCE updates the RDN on the differences and similarities between KDIGO and KDOQI and how these guidelines impact the care of persons with diabetes. Fatty liver disease also has implications for the person with diabetes and identifying appropriate treatments can help reduce the severity of complications from these two conditions.