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

The elevated blood glucose levels seen in diabetes do not directly damage the feet. What the elevated blood glucose levels do is damage the blood supply, and the nerves to the feet.

The feet are at the extremity of the blood supply and diabetes damages the small blood vescles in the feet and reduces blood circulation. In addition, the nerves in the feet become damages so that there is a 'loss of feeling' (I put this in quotes as the 'loss of feeling' can also be feeling of phantom pain) in the feet. Therefore, with the loss of feeling you are more likely to injure your feet, or not know when you have damaged them.

Due to the reduced blood supply to the feet an injury such as a cut will not heal so well, and it will be more prone to infection as the immune system will struggle to gain access. This can lead to ucleration and more damage. In sever cases amputation may be required.

Hence, the combination of nerve and blood supply damage can lead to increased problems with the feet.

The ability to heal may recover once the sugars are undercontrol, but it depends on the level of damage to the blood supply and for how long the patient has had untreated diabetes, and whether or not the body can reverse any of the damage.