The global prevalence and incidence of diabetes is steadily rising in all populations and at the current rate the International Diabetes Foundation (IDF) estimates a prevalence of 9.9% worldwide by 2030. With population growth, this represents a 50.7% increase in people affected over a 19-year period [1]. A person with diabetes is more likely to require surgery than a person without and this is particularly notable for orthopedic surgery, which has seen an overall increase in procedures in this population as a whole [2]. Observational studies show that in the surgical patient, diabetes is associated with a higher rate of peri-operative complications such as need for transfusion, pneumonia, delayed discharge, surgical site infections, and in-hospital mortality [3]. These poorer outcomes are in part due to higher rates of co-morbid conditions such as ischemic heart disease, renal impairment, and hypertension in patients with diabetes [4]. Dysglycemia, which encompasses hyperglycemia, hypoglycemia, stress-induced hyperglycemia, and excessive glucose variability, is increasingly observed and associated with poorer post-operative outcomes even in those without a prior diagnosis of diabetes. In fact, several studies have shown postoperative complications occur more frequently in people with stress-induced hyperglycemia with no prior diagnosis of diabetes than in those with diabetes [5–۷].