Physician here. Some of these posts are near the target, but not completely. Basically chronic high blood sugar causes non enzymatic glycosylation of arteries. That’s a big fancy word that means that sugar at high levels can damage your arteries, even very small ones that supply nerves. If those tiny arteries to nerves get too damaged, then blood (and thus oxygen) cannot get to the nerves and the nerves die. If nerves die, then you can’t feel your feet or toes as well which makes you more susceptible to bumping them on things and causing injuries/cuts. When you get a cut though, now your body can’t heal it as well because the tiny arteries that would normally bring cells, nutrients etc are also damaged. So the repairing things in your body can’t be delivered where they need to be, so then those tiny cuts become big cuts or ulcers. Those ulcers get infected with bacteria, say from a shoe. Your body still can’t heal it because the arteries are so damaged. The ulcer gets deeper. The bone in your foot is now infected. You can die from that. Foot has to go.
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