(l) Poor tissue repair, inhibition of fibroblast maturation and collagen synthesis, and reduced granulation tissue production in patients with diabetes are risk factors for non-healing or dehiscence of the incision. (2) The reduced ability of tissues to inhibit microbial invasion in diabetes is a high risk factor for superficial and deep infections after total knee replacement. Therefore, prophylactic application of antibiotics with glycemic control is important; minimizing the operative time, which is greater than 2 hours, is an important factor for deep joint infection; and intraoperative application of antibiotic bone cement is considered. (3) The incidence of deep vein thrombosis (DvT) after total knee replacement in diabetic patients can be as high as 50% or more, and diabetes can be considered an independent risk factor for DVT. Preoperatively, D-dimer and B-ultrasound of both lower extremities should be routinely checked; if local abnormal swelling and pain, skin temperature, skin erythema, superficial varicose veins and Homan’s sign appear after surgery, B-ultrasound of both lower extremities should be performed immediately. In order to prevent deep vein thrombosis, preventive anticoagulation with low molecular heparin, the use of plantar venous pump, active and passive functional exercises of the knee joint, and the combination of flexion, extension, and internal and external rotation of the calf joint should be performed to increase the speed of blood flow in the femoral vein. (4) For the blood glucose that cannot be controlled by basic treatment, insulin should be considered first, with the ideal target: fasting blood glucose 6-8 mm0L/L, postprandial blood glucose 8-10 mmoL/L, and intraoperative blood glucose control under 13.9 mmoL/L. 9 mmoL/L or less. The impact of diabetes on surgery mainly depends on the control of blood glucose within 2 weeks after surgery, which should be controlled at 6-8 mm0L/L. At the time of discharge, it is recommended to purchase a blood glucose meter to monitor the change of blood glucose, so as to guide the application of out-of-hospital hypoglycemic drugs.