Previous studies have demonstrated increased complication rate and infection rate after hindfoot fusion in patients with poorly controlled diabetes.9 Similarly, previous work has demonstrated higher rates of complications with ankle fracture management in uncontrolled diabetics as compared to controlled diabetics.7 GLP-1 agonists have previously been shown to reduce perioperative glucose and insulin administration without the risk for hypoglycemia.6 Perhaps less well known are the immunologic and anti-inflammatory effects of GLP-1 agonists,1 which may raise concern for infectious risk. The gene discussed is GLP1R; the disease is diabetes mellitus.