Liu JW, Ahn J, Nakonezny PA, et al. - Relative to patients without diabetes mellitus, those with diabetes mellitus experience higher postoperative complication rates following ankle fracture surgery. In this study, insulin-dependent diabetes mellitus patients, non-insulin-dependent diabetes mellitus patients, and patients without diabetes are compared with respect to the rate of complications in a 30-day postoperative period following ankle fracture surgery. From the American College of Surgeons National Surgical Quality Improvement Program database, they identified a total of 19,547 patients undergoing ankle surgery from 2012-2016 using Current Procedural Terminology codes. These patients comprised 989 patients (5.06%) with insulin-dependent diabetes mellitus, 1,256 (6.43%) with noninsulin-dependent diabetes mellitus, and 17,302 (88.51%) with no diabetes mellitus. Observations revealed significantly greater adjusted odds of superficial surgical site infections, deep surgical site infections, osteomyelitis, wound dehiscence, pneumonia, unplanned intubation, mechanical ventilation, urinary tract infection, cardiac arrest, bleeding requiring transfusion, sepsis, hospital length of stay, unplanned readmission, unplanned reoperation, and death following ankle fracture surgery among patients with insulin-dependent diabetes mellitus vs those without diabetes. Insulin-dependent diabetes mellitus is thus suggested to be a strong predictor of 30-day postoperative complications, unplanned readmission, unplanned reoperation, and death following ankle fracture surgery.