Why does diabetes affect the feet? Once your sugars are under control, will your ability to heal at a normal pace come back?

The blood supply and nerves that supply the feet are harmed by the elevated blood glucose levels associated with diabetes, not the feet themselves.

Since the feet are the extremities of the blood supply, diabetes damages the small blood vessels in the feet, reducing blood circulation. It also damages the nerves in the feet, causing a "loss of feeling" (which I quote because it can also refer to the perception of phantom pain). As a result, you are more likely to injure your feet or fail to recognize when you have injured them.

An injury such as a cut will not heal as well and will be more susceptible to infection because the immune system will find it difficult to get access. This can result in ucerration and further damage; in extreme cases, amputation may be necessary.

Therefore, a combination of damage to the nerves and blood supply may result in more foot issues.

Depending on the extent of blood supply damage, the length of time the patient has had untreated diabetes, and whether or not the body can undo any of the damage, the patient's ability to heal may return once the sugars are under control.

Diabetes increases the risk of foot injuries and slows down the healing process because it can cause nerve damage (neuropathy) and poor blood circulation (peripheral vascular disease). Controlling blood sugar levels can improve blood flow and nerve function, which may help to restore the ability to heal at a more normal pace, though the degree of recovery may vary depending on individual factors and the severity of diabetic complications.