The primary factor determining the success of a TMA was the quality of glucose control. The results of this study can be extrapolated to diabetic patients undergoing other types of surgery, with preoperative diabetic control as measured by HbA1c being an important determinant of the outcome of surgery. As a result of this study we currently do not perform any elective, trauma or emergency surgery on diabetic patients with an HbA1c of over 8 unless the need for surgery is to save life or limb.