McGinigle KL, Kindell DG, Strassle PD, et al. - Researchers investigated how hemoglobin A_1c (HbA_1c) management in diabetics associate with surgical outcomes after open infrainguinal bypass. Adult patients (≥ 18 years) with a history of diabetes who underwent bypass for PAD between 2011 and 2018 were identified using the Vascular Quality Initiative infrainguinal bypass module. In the final sample, 30,813 operations (27,988 unique patients) were included: 17,517 (57%) nondiabetic patients, 5,194 patients with low-severity/controlled diabetes, and 8,102 (26%) patients with poorly controlled diabetes, including 5,531 (70%) treated with insulin. Outcomes revealed significantly worse 30-day surgical outcomes in correlation with uncontrolled diabetes with an HbA_1c value > 10.0%. The same rate of complications was not observed among patients with incrementally better glycemic control (HbA_1c level of 7.0%-10.0%), inferring that surgical outcomes in open infrainguinal bypass patients could be improved even with slight preoperative attempts at improving diabetes management.