How to Care For Your Diabetes

Caring for your Diabetes

Caring for your Diabetes

Diabetes Care Testimonials

Frequently asked Questions

Proper care for your diabetes

Diabetes Testing

Are you prediabetic, or do you have diabetes? You're not alone. Roughly 10.5% of the population of the United States has diabetes, and it's estimated that over 21% are undiagnosed.

When you get diagnosed with diabetes or prediabetes it’s important to learn how to best care for your body. The spread of diabetes awareness has helped many people with this care, but there are still questions that patients have about what to do to maintain their health. 

This is a resource for you to get a basic idea of what you should do to care for yourself. Whether you’re wondering about the differences between the types of diabetes, how to identify your diabetes symptoms, or how to manage different diabetic problems, we have the answers.

What Is Diabetes?

Diabetes is a disease. It occurs when your glucose levels (or blood sugar) is too high. Insulin from the pancreas supplies the body with insulin. This insulin is used to keep blood sugar manageable and it helps to transfer glucose to the cells so that it can be used for energy.

When the body is unable to create enough insulin, the glucose is unable to reach the cells and provide that energy. This means that the blood sugar remains high. 

How to Care for Your Diabetes

When you’re diagnosed with diabetes, your life is going to change. You’ll have to pay more attention to your health, your diet, and your body in general in order to avoid further complications. 

There are several ways that you can care for your diabetes aside from the obvious insulin treatments, but be sure to consult with your physician frequently to check your progress.


Dr Saleh treating a patient

People with diabetes often develop numbness in their extremities. Feet are the most frequently affected part of the body.

It’s important to check your feet daily. Even a small check in the morning is enough if you’re in good health. 

If you find scrapes, cuts, or blisters that won’t heal you should make an appointment with your doctor for an analysis. Unchecked, poor foot health and a lack of diabetic wound care in the feet can result in amputation. 

 Getting frequent diabetic foot checks at your doctor’s appointments is a good idea, as well as wearing well-fitting shoes, staying off of your feet when possible, and wearing orthopedic shoes. Make sure to attend to your diabetic nail care as you may not feel sharp or too-long toenails causing damage to your feet.

If you find that you’re dealing with problems in your feet, a specialist may conduct your foot checks to assess your options.

Diabetic Wound Care

Foot ulcers are common amongst diabetics. They’re open sores or abrasions on the bottoms of the feet.

Because diabetes impacts your wound-healing ability, you need to pay special attention to diabetic foot ulcers. Seeing a specialized foot doctor can help with this. 

If you have neuropathy in your feet you may not immediately notice the wound. This is why diabetic foot checks are so crucial. You may notice visible swelling or drainage from the foot before you feel discomfort. 

Seeing a foot doctor will help you avoid complications that come from diabetic foot ulcers such as infection or amputation. You should not attempt to treat an ulcer on your own.

Managing Nerve Damage

Diabetes Testing tools

Between 60% and 70% of people with diabetes suffer from neuropathy or nerve damage. It’s important to get nerve damage assessments with you visit your specialist to see how your condition is developing. 

A doctor may refer you for this kind of assessment. The specialist will perform a nerve conduction velocity test to evaluate the situation and see how it’s progressing. Getting these nerve checks can help you better manage your condition and know what parts of your body need more attention. 

Laser Therapy

MLS laser therapy is an innovative method of therapy that can stimulate the body to heal itself.

It minimizes pain and inflammation caused by diabetes and it’s often used in addition to or as a replacement of certain medications and physical therapy. MLS therapy has long-term results, though some patients prefer to come in for regular “checkups” to maintain the positive effects.

It’s cleared by the FDA and painless, though the patients may experience a warm sensation during the treatment.

Healthy Lifestyle Changes

One of the first things that you can do on your own to help your diabetes is making healthy lifestyle changes.

Diabetes often results from poor lifestyle choices. Many people with diabetes also suffer from obesity, and the lifestyles associated with the two are similar. 

Adjusting your diet is important. You need to cut back on sugary and fatty foods, as well as simple carbohydrates. Your doctor will likely give you a diet plan so make the adjustment period easy. Be sure to check your blood sugar regardless of your diet.

It’s also important to get more exercise when you have diabetes. You don’t need to go all-in as soon as you’re diagnosed, but you can lead a healthy and active lifestyle without ever setting foot in a gym. 

It’s helpful to go for walks or jobs outside or do more low-impact activities such as yoga or pilates at home. 

Your lifestyle is going to change when you’re diagnosed with diabetes, but you’ll feel better and improve your long-term outlook. 

tabby's story: "'It's really nice to be able to come to one place for my diabetic needs."

Frequently Asked Questions on diabetes

Whether you have diabetes or prediabetes, or you have a loved one who has one of these conditions, you probably have some questions. 

These are the most common questions that people ask about diabetes.

Diabetes comes in two primary forms, type 1 and type 2. There is also another common form of diabetes that’s temporary: gestational diabetes. 

Type 1 diabetes is a form of diabetes that you can be born with. It’s an autoimmune condition that causes the body to not produce enough insulin. 

Type 2 diabetes is developed over time. The body may not produce enough insulin, or it may not be capable of absorbing the insulin that is produced. Put simply, the difference between type 1 vs type 2 diabetes is primarily when it’s developed.

Gestational diabetes is temporary. It results from high blood sugar in someone who is pregnant and it goes away when the pregnancy is over. 

You can identify diabetes by noticing several potential diabetes symptoms that include, but are not limited to:

  • persistent thirst
  • Fatigue
  • Frequent urination
  • Weight gain
  • blurred vision
  • poor healing ability
  • frequent infections 

If you notice these symptoms and you have not been diagnosed with diabetes it’s important to see a doctor. 

The symptoms of prediabetes are similar to the symptoms of diabetes. They include:

  • skin tags
  • patches of darkened skin
  • fatigue
  • numbness in the fingers, hands, and feet
  • poor focus
  • poor sleep
  • persistent hunger

Catching prediabetes early on can change your life. See a doctor right away if you notice these symptoms. 

Diabetes, when untreated, can lead to serious health complications (including premature death). It can lead to heart failure, a need for amputation of the extremities, strokes, and kidney failure. 

When treated, the risks associated with diabetes are minimized. 

If you take care of your diabetes you will be able to lead a happy and healthy life. Diabetes is currently not curable, but maintaining a healthy lifestyle will help you keep your symptoms in check (and potentially reverse them) so your condition doesn’t limit you. 

Prediabetes doesn’t have to lead to diabetes when it’s caught early. It can reverse through healthy lifestyle changes under the supervision of a doctor. This is why it’s so important to catch the symptoms early. 

Diabetic shock isn’t a medical term, but it’s what people use to describe extreme hypoglycemia. 

While normal hypoglycemia results in mild symptoms such as headaches or chills, diabetic shock can result in a loss of consciousness, double vision, or a diabetic coma if left untreated.

Many people carry snacks with them for this reason. 

High blood sugar is most often caused by a diet heavy in sugar. In people with diabetes, not taking your medications or attending to your care will result in high blood sugar. 

You may also develop high blood sugar from an inactive lifestyle or certain medical conditions. 

Diabetes can be managed through a healthy diet. Keep portions small and avoid fatty or sugary foods.

Low carb and ketogenic diets are popular amongst diabetics. They also help with weight-loss and overall health. 

Your Diabetes Is Manageable

With attention to your diabetes and frequent medical care, you can lead a healthy lifestyle. Your life will change. You’ll need to check your blood sugar, inject yourself with insulin, and be more attentive to your extremities, but there’s no reason that you can’t continue living your life as normal. 

We aim to help ease pain and discomfort for those suffering from diabetes. We believe that foot care is important and that you don’t have to suffer. 

If you’re a diabetic patient or a prediabetic patient in Washington, we have clinics for you. Visit us for a nerve damage assessment so that we can develop a treatment plan for you. 

Healthy eating is essential to lowering the risks of Diabetes
Welcome to FASA Family Wellness

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bryan alvarez


Bryan graduated from Stetson University, a small private university located north of Orlando, with a Bachelors degree in Accounting. He worked at One Stop Cooling & Heating in Orlando as their Chief Financial Officer for nearly 7 years until moving to Olympia in early 2019. He moved to Olympia so that he can enjoy the beautiful environment and all of the rainy days.

Marta Bushay

HR Manager

With just under a decade of experience in the HR field. Marta Bushay serves as the HR Coordinator, Co-leading the HR team for FASA Family Wellness.

Marta offers a unique blend of leadership, vision and Knowledge of the HR world. She has helped increase productivity through implementing policies and procedures and employee growth and satisfaction.

Marta has a diverse HR background and is a subject matter expert in the areas of HR administrative, HR compliance, handbook development, policy and procedures, reviews and updates, employee relations issues and training and development.

Prior to taking on her current role with FASA. Marta spent the first 7 years of her career serving as an Hr Manager for the Olympia Toys,r,us in Washington State. There she provided strategic HR support and acting as a team mentor.

Marta earned her HR Business Professional Certification in November 2019. She is currently working on receiving her SHRM Certification as well as completing her Global Professional HR Certification.

She resides in Tumwater, WA, with her three children Zander, Romen and Scarlett 

Destini Martinez

Marketing Coodinator

Destini is born and raised in Washington state. She is currently pursuing her bachelors degree in elementary education to follow her dream of becoming an elementary school teacher. Helping and bonding with children is one of her passions. She began working at Foot and Ankle Surgical Associates as a receptionist, but found herself helping in the marketing department more and more and eventually fell for the work related to the department. You may see her driving around in the FASA foot car, popping into local offices regularly or maybe at a local event. She rarely sits still! She just welcomed a beautiful baby girl to the world and has been enjoying spending time as a family with her husband, daughter and golden retriever, Diamond.

Taylor Reed


I’m from Olympia born and raised, I graduated from Olympia High School and did my PTA program up in Bellingham at Whatcom Community College. I decided to get into physical therapy after injuring myself and becoming interested in healing people as a career. When I’m not nerding out on Marvel Comic books, my hobbies include skateboarding, snowboarding, hiking, camping, really anything being outdoors and active; injuries are nothing new to my friends and I! Physical therapy has and continues to be a fun and fascinating world that I continue to learn and grow from every day. I love our FASA team here and am excited to be part of our family. 

Kali Beaird


Kali Beaird graduated from the Massage Studies program at Clover Park Technical College in 2008. She worked at Chiropractic offices for 8 years before joining FASA in 2016. 
 Kali incorporates a relaxing environment and touch with deep tissue treatment to areas of concern while treating other muscles that could be contributing to the problem. She specializes in injury treatment with years of experience treating patients with chronic back pain, migraines, surgeries and more.  
 In Kali’s spare time she enjoys gardening, cooking and home renovation projects. She also teaches continuing education to massage therapists. Kali lives in Tumwater with her son and daughter. 

Joelene Gioulis


As the CEO of FASA Family Wellness, Joelene is responsible for the strategic growth and innovation of the company. Joelene came on board in 2014 to create the foundation for Foot & Ankle Surgical Associates to grow and help more patients, not only in expanding podiatry but also in areas that serve the wellness of the entire patient like physical therapy, family practice, nutrition and massage and in 2015 FASA Family Wellness was born.

Since joining FASA Family Wellness she has succeeded in growing the company by 103%. Her strategic plans for the company moving forward is providing a world class patient experience by achieving operational efficiencies and continually investing in the staff and the community.

Joelene believes that investing in the lives of others ultimately positively affects the bottom line of business.

Joelene has a proven executive management track record and over 20 years of experience in the leadership field. Prior to joining FASA Family Wellness, Joelene worked in the health and wellness field with a history in Human Resources and regulatory compliance.

 Joelene is a Washington native with three amazing grown children. In her spare time, she has a passion for mentoring incarcerated youth and youth at risk. For fun she loves the lake life of wake surfing, paddle boarding and enjoying the sunsets, when there is no sun to be found you can find her on the slopes, hiking or traveling to the sun.

Adam Saleh


Doctor Saleh is a highly energetic and motivated foot and ankle surgeon with over three years of practice under his belt. With his captivating personality and motivation to succeed, he has a remarkably promising future in medicine. He finished his three-year Podiatric Medicine and Surgical residency in Harrisburg, Pennsylvania, and is coming up on his 1 year anniversary at Foot & Ankle Surgical Associates.

Not only is he board eligible in foot and ankle surgery, he is also impressively certified in Hyperbaric Oxygen treatment. In addition, Doctor Saleh carries prestige certifications in microvascular surgery from the Cleveland Clinic, and advanced lower extremity orthopedics from the Rubin Institute.

With Foot & Ankle Surgical associates recent PIE partnership with the North Thurston school district Dr. Saleh has also been avidly working with students as a coach and mentor for those interested in entering into the medical field.

When Doctor Saleh is not working towards his career in medicine, he embraces his love for traveling and experiencing what the world has to offer. He is also avid in his physical health, proudly entering in competitive weightlifting competitions.

He is an extremely determined, caring, and patient-driven person. Foot & Ankle Surgical Associates is lucky to have such an ambitious and talented team member like Doctor Saleh.

Michael Lundborg


Born and raised in Colorado, Doctor Lundborg has had a lifelong passion for medicine. Over the course of the last four years, he has successfully performed well over 1,300 surgeries in areas such as diabetic wound care, forefoot and bunion procedures, and trauma and reconstruction.  He is adamant in giving every one of his patients the best solutions to ensure their confidence that they are in the best care.

After earning his Integrative Physiology Degree from the University of Colorado at Boulder, he shadowed a wide variety of experienced physicians, where he ultimately gravitated towards foot and ankle specialization as his desired career path.

Doctor Lundborg received his Doctor of Podiatric Medicine Degree at the Temple University School of Podiatric Medicine, where he proudly graduated at the top of his class. In order to complete his residency training, he traveled to Boston, where he spent three years focusing on trauma and reconstructive surgery at Beth Israel Deaconess Medical Center, a teaching hospital of Harvard Medical School.

Doctor Lundborg is an extremely hard-working individual and always looking to better himself. However, to make sure he is able to thrive every day with recharged batteries, he invests time into his other interests. In this spare time, he happily spends it with his wife and dog as well as enjoying diverse outdoor activities such as golfing, hiking and skiing.

It is no secret that Doctor Lundborg is an excellent care provider, with a wide array of experience adding to his diversity as a foot and ankle surgeon. Though he is fully capable of handling any challenge, his favorite cases are flatfoot and cavus reconstructive surgery, trauma, sports medicine, biomechanics, and diabetic foot ulcers. When you come to Foot & Ankle Surgical Associates, you can be confident that your needs and expectations will be exceeded with a patient-focused person like Doctor Lundborg.

Huy Dang


Originally from Chicago, Illinois, Doctor Dang is a podiatric physician that has been proudly practicing medicine in the Northwest for over 13 years. He has a variety of specialties that patients can benefit from, which include wound care, pediatrics, and foot and ankle reconstruction. With his skill and experience he ensures each and every patient’s needs are met completely.

Doctor Dang always knew he wanted to become a surgeon someday. To make this passion come to life, he started his journey by graduating from Dr. Scholl Podiatric Medical School at Finch University/Chicago Medical School in 2004. Upon earning his degree, he decided to relocate to the Northwest, where he successfully completed a three-year foot and ankle reconstructive surgical residency. During this time, he also impressively served as a chief resident for two out of those three years.

When not in the office or focusing on his work, Doctor Dang immerses himself in the outdoors, participating in sports and other activities that involve fresh air. His love for being outdoors and rigorous sports also sparked his special interest in sports medicine and becoming proactively involved in community services. It brings him great joy to be able to serve the community with his podiatric services and humanitarian efforts. Doctor Dang has a monumental aspiration to start his own non-profit canine sanctuary and rehabilitation center in the future.

Doctor Dang is excited and looking forward to becoming an integral part of the Foot & Ankle Surgical Associates involvement in the community. He is always learning and avidly improving himself professionally and personally to enhance his skills in order to give his patients the best experience they can possibly have.

Scott Duncan


Doctor Duncan brings his physical therapy expertise to enhance every patient’s experience at Foot & Ankle Surgical Associates.  He has worked with innumerable physical therapy situations and firmly believes that every patient deserves to reach the highest level of clinical outcomes.

In 2001, Doctor Duncan graduated from Creighton University, where he successfully earned his Doctorate Degree in Physical Therapy. Afterwards, he decided to relocate to Washington State to begin his career as a physical therapist at Riverside Nursing Home in Centralia. This is when Doctor Duncan first met Doctor Hess and started to form their working relationship, bounded by mutual respect for patient care.  

While in Centralia, Doctor Duncan started to work for Foster Farms in Kelso, treating all work-related injuries for those who were employed there. Later, he started working for Costco in Tumwater, providing similar services.

In 2003, Doctor Duncan took on a new journey and opened a clinic called Physiotherapy Associates, where he was proudly the clinic director who provided orthopedic outpatient physical therapy for his patients. What makes this so ironic is that his clinic was directly across the parking lot from Doctor Hess’s prior clinic, which only sharpened their patient-focused relationship.

In 2010, Doctor Duncan decided that he wanted to be a part of the Foot & Ankle Surgical Associates team, expanding his practice at what he believes is the best association for communication between physical therapists and doctors in the area.  In addition, on the weekends, Doctor Duncan started working at Shelton’s Mason General Hospital, where he provides care to the patients there.

Doctor Duncan is incredibly diverse and willing to take on any challenge he faces with confidence and determination. His philosophy is to provide every patient with individual care while obtaining the highest level of manual therapy and therapeutic exercises so they can return to their healthy lifestyles.


Casey Bowles


Born and raised in Lacey/Olympia, WA, Doctor Bowles is extremely patient-driven and actively demonstrates his passion for foot and ankle surgery. With his extensive background he gives every patient a positive experience when they come to Foot & Ankle Surgical Associates.

After graduating from North Thurston High School with honors, Doctor Bowles attended Brigham Young University, successfully obtaining his Bachelor’s Degree in Biology with a minor in Chemistry. During this time, he also actively served at his church in Buenos Aires, Argentina. For two years, he was able to help the community there and become fluent in Spanish.

Doctor Bowles has always shown a particular interest in Biomechanics and Pathology and knew he would choose a career in medicine. Initially, he had his eye on becoming a Dentist and almost attended dental school instead.

While studying for his Dental Admission Test, Doctor Bowles had the opportunity to work at Foot & Ankle Surgical Associates as a back-office assistant. During this position, he had the fantastic opportunity to travel to Nicaragua for a medical mission. This gave him the ability to observe surgical practices and methods, which drove him down a new inspirational path to become a surgeon himself. With his new career mission in sight, he quickly started his education at the Temple University School of Podiatric Medicine, where he proudly achieved his Doctor of Podiatric Medicine Degree.

It is not all work and no play for Doctor Bowles. During his downtime, he enjoys attending musicals and symphonies quite frequently. He is also an avid hiker, embracing the outdoors and challenging himself to a variety of different terrains.

Doctor Bowles has a significant background that helped shape him to become the incredible foot and ankle surgeon he is today. He is extremely compassionate and is always provides excellent service to each and every one of his patients.

David Huebner


Prior to joining Foot and Ankle Surgical Associates, Dr. Huebner was in Great Falls, Montana.  Dr. Huebner has his undergraduate degree from the University of Illinois, with a B.S. degree in Physiology, where he had a full scholarship for football.  He then attended the Scholl College of Podiatric Medicine, earning his DPM degree.  After completing a residency in foot and ankle surgery at St. Anne’s Hospital West in Northlake, IL, he practiced in the suburbs of Chicago for two years.   He then moved to Great Falls, MT, where he practiced for twenty three years.  While in Montana, he served on the Board of Medical Examiners for eight years by appointment from the Governor.  He is board certified in foot and ankle surgery by the American Board of Podiatric Surgery. He is a Fellow in the American College of Foot and Ankle Surgery, and maintains active memberships in the American Podiatric Medical Association and state affiliates.



Former president of the Washington State Podiatric Medical Association, and serving on the board of trustees for the Podiatric Association for eight years, Doctor Burghardt is an excellent board-certified physician and surgeon. He is not only extremely proficient in his field, he always ensures to put his patients first to come up with the best treatments for their needs.

Doctor Burghardt began his career by earning his Bachelor of Science Degree in Microbiology at the University of Washington. From there, he enrolled in Podiatric Medical School in San Francisco, proudly graduating with honors. To complete his training, he went to the University of Southern California Medical Center and Whittier Medical Center, where he became a specialist in foot and ankle reconstructive surgery and diabetic foot care.

Doctor Burghardt established his own private practice at Foot & Ankle Surgical Associates at the Tumwater location, providing incredible service to everyone who consults with him. Though he enjoys all of his patients, his favorite area of interest is treating and assisting athletes. This passion stems from his athletic children, who immensely inspired him to go down this specialized route.

In addition to his dedication to medical practice, Doctor Burghardt is a travel enthusiast, avidly preparing and hosting lectures to physician groups, nurses, and non-medical groups to enlighten them on diagnosis and treatments regarding foot and ankle problems. He thoroughly enjoys sharing his knowledge and opening the doors to brainstorming with other Podiatrists on seeking out perfect and customized solutions for difficult cases.

Patients describe Doctor Burghardt as a caring, enthusiastic, and extremely motivated person. His intensive background with surgical procedures and personality make him a perfect person to thrive at Foot & Ankle Surgical Associates. He is always pushing himself to improve and actively seeks out innovative ideas to make excellent treatment options for his patients.



Since 1995, Dr Hess has dedicated his time and fed his passion for Podiatric Medicine in the Northwest to improve the lives of his patients, staff and the community.

Doctor Hess started his career by obtaining his degree in Pharmacy at the University of Washington. He diligently worked in the pharmaceutical industry for three years before discovering that becoming a Podiatrist was his real desire in life. In 1992, he graduated from California College of Podiatric Medicine in San Francisco with honors. Continuing his career path, Doctor Hess flourishingly completed his residency training, specializing in foot and ankle surgery at Lakewood Regional Medical Center and Kaiser Foundation Hospital in Portland, Oregon. He then finished out strong and perfected his abilities at Harborview Medical Center, which gave him the drive to establish Foot & Ankle Surgical Associates in 2002.

As the years went by, Doctor Hess’s private practice has only grown and expanded, with now impressively containing six offices in Tumwater, Centralia, Yelm, Olympia, Tacoma, and Lacey Washington. In addition, he now has seven exceptional Podiatric Physicians working with him to ensure every patient has a positive experience.

Doctor Hess not only dedicates his time to his practice, he also is avid in helping and preparing other Podiatrists to understand the evolving and upcoming healthcare transitions. Throughout his career, he has shared his knowledge by giving numerous lectures to physicians, nursing groups, and patients to shed light on foot and ankle pathologies and treatment options. During this time, he also embraced his love for traveling, frequently heading to Central America on surgical mission trips in El Salvador and Nicaragua.

When Doctor Hess is not on duty, he enjoys engaging in water and snow sporting activities, travelling and working on his collection of cars. He also loves spending time with his children, making sure to seize every moment to create beautiful memories with them.

Doctor Hess is passionate about what he does and always puts his patients first. Between his extensive skill set and experience, you will undeniably be in excellent hands with him.