The prevalence of diabetes is rising and so too is the complexity of diabetes management. Modern perioperative management of patients with diabetes focuses on thorough pre-operative assessment and optimisation of their diabetes. Most people with diabetes are managed in primary care settings and anesthetists are increasingly needing to take on the burden of ensuring optimal glycaemic assessment and management. The 2022 ADS-ANZCA Perioperative Diabetes and Hyperglycaemia Guidelines have been co-developed therefore by both diabetes and anesthetist specialists with particular focus for anesthetists but also for primary care and diabetes health care providers in order to guide optimal assessment, management and support for people living with diabetes.