<p>Diabetes mellitus and bronchopulmonary disease are common. They increase in frequency over the course of life, often occur together and can influence each other. Surgical interventions influence the respiratory function through anesthesia and the kind of incision. Postoperative pain can also affect respiratory mechanics. This can lead to perioperative complications. In order to evaluate the risk, to optimize the treatment of the respiratory disease and to choose the adequate surgical procedure and anesthesia, a&#xa0;preoperative respiratory evaluation is recommended in case of known respiratory diseases and in case of major surgical procedures. Sleep apnea should be diagnosed preoperatively in order to prepare especially in the wake-up phase for adequate surveillance and—if necessary—therapy. Pre- and, if necessary, post-operatively, rehabilitative measures are useful for larger and near diaphragmatic and thoracic procedures as well as higher severity of the pre-existing condition.</p>