Consultant General Physician & Diabetologist

Dr. B. Seetharam brings a compassionate, evidence-driven approach to general medicine and diabetes care. Trained in internal medicine with a Master of Health Sciences (M.HSc) and a Diploma in Diabetes Care, Dr. Seetharam combines decades of clinical experience in outpatient, inpatient and metabolic disease management. His practice emphasizes early detection, individualized treatment plans, and empowering patients to self-manage diabetes and associated chronic conditions through structured education, lifestyle modification and judicious use of modern pharmacotherapy.

Patients consult Dr. Seetharam for routine and complex problems including newly-diagnosed diabetes, poorly controlled type 2 diabetes, insulin initiation and titration, management of hypoglycaemia, metabolic syndrome, hypertension, dyslipidemia and multimorbidity in adults. He works closely with dietitians, physiotherapists, cardiology, nephrology and ophthalmology teams to deliver coordinated, multidisciplinary care.

Clinical Philosophy & Approach

Dr. Seetharam believes in an integrated care model: accurate diagnosis, clear goals agreed with the patient, stepwise medication optimization when needed, and robust self-management education. He places strong emphasis on:

Individualized glycaemic targets and therapy (not a one-size-fits-all approach).
Early screening for microvascular and macrovascular complications (eye, kidney, foot, heart).
Lifestyle first — structured diet, weight management and graded exercise — with medication added when necessary.
Shared decision-making: explaining options, risks and expected outcomes so patients are partners in care.

Areas of Expertise

Outpatient management of Type 1 and Type 2 Diabetes — diagnosis, initial workup, medication selection, and long-term follow-up.
Insulin therapy initiation, basal-bolus planning, premix regimens, and caregiver training for injections and pen devices.
Oral and injectable anti-diabetic medications: initiation, side-effect monitoring and safe combination strategies.
Continuous Glucose Monitoring (CGM) & SMBG education and interpretation (where available).
Diabetic emergencies & escalation: recognition and prompt referral for DKA/HHS and severe hypoglycaemia.
Cardio-metabolic risk management: hypertension, dyslipidemia, weight management, smoking cessation.
Diabetic foot screening & prevention; coordination with podiatry/orthopedics for advanced care.
Chronic disease management (COPD/asthma comorbidity, infections, multi-morbidity in older adults).
Preventive care: vaccinations, screening tests and health maintenance.
Telemedicine & follow-up care for routine titration and counselling.

Comprehensive Procedure & Service Details

1) Initial Consultation & Diagnostic Workup (first visit)

Detailed medical history & focused physical exam — diabetes history, symptom review, medications, cardiovascular risk factors, family history, lifestyle and barriers to care.
Baseline investigations ordered (typical):
- Fasting Plasma Glucose (FPG) / Random Plasma Glucose (RPG)
- HbA1c (glycaemic control marker) — used to assess long-term control and to guide therapy adjustments.
- Urine albumin (albuminuria) and urine routine (kidney screening).
- Serum creatinine, eGFR (renal function).
- Lipid profile (cardio-metabolic risk).
- Liver function tests.
- ECG if cardiovascular risk is present or symptomatic.
- Fundus exam referral for diabetic retinopathy screening (dilated eye exam).
- Foot assessment for neuropathy, pulses and skin integrity.
  (Investigations adjusted per presentation; urgent cases prioritized.)

Goal of first visit: diagnose or confirm diabetes status, identify complications or comorbidities, and create an initial individualized care plan.

2) Structured Diabetes Education & Self-Management Training

Blood glucose monitoring training — how to perform SMBG, frequency, recording, recognizing hypo- and hyperglycaemia.
Insulin injection technique — hands-on demonstration, storage, pen vs vial technique, rotating injection sites.
Hypoglycaemia prevention & action plans — recognition, immediate treatment, when to contact emergency services.
Dietary counselling — basic carbohydrate counting, portion control, meal timing for insulin users (coordinated with hospital dietitian).
Exercise advice — safe initiation and progression, precautions for peripheral neuropathy or cardiac disease.
Sick-day rules — medication adjustments and when to seek urgent care.

This program is offered during the first few follow-ups and reinforced at each visit.

3) Medication Initiation & Optimization

Start and titration of oral antidiabetic agents with explanation of mechanism, side effects, monitoring needs.
Initiation of insulin therapy when indicated: protocols for basal insulin start, step-up to basal-bolus if required, and safe titration schedules. Dr. Seetharam provides practical plans and follow-up support (phone/teleconsult) for early titration.
Use of modern injectables (GLP-1 receptor agonists, SGLT2 inhibitors) discussed where appropriate considering comorbidities; benefits and safety monitoring explained.
Blood-pressure and lipid optimization — start/adjustment of antihypertensives and statins as per risk profile.

4) Ongoing Monitoring & Follow-Up (standard pathway)

Early follow-up: 2–4 weeks after medication changes to check tolerability and SMBG logs.
Short-term monitoring: monthly or as needed for dose adjustments.
HbA1c monitoring: typically every 2–3 months after therapy change, then every 3–6 months when stable (individualized).
Complication screening schedule: annual retinal screening, urine albumin and renal function at least annually (more often if abnormal), foot checks at each visit.
Telemedicine follow-ups available for stable patients and medication titration.

5) Diabetic Foot Care & Screening

Comprehensive foot screening at each visit: sensory testing (monofilament), inspection for callus, ulcer, deformity, vascular pulses.
Wound triage & referral: early referral to wound care/podiatry or orthopedics for non-healing ulcers.
Education on footwear, daily self-inspections, and early reporting of injuries.

6) Acute & Emergency Management Protocols

Hypoglycaemia plan: immediate home management and thresholds for urgent care.
Referral criteria for DKA/HHS: recognition of red flags and immediate emergency referral to hospital critical care.
Dr. Seetharam coordinates with the Revive Hospital emergency & critical care team for admissions when required. therevivehospitals.in

7) Multidisciplinary Care Coordination

In-house collaboration with: dietitian/nutritionist (meal planning), cardiology (cardio-metabolic risk), nephrology (renal dysfunction), ophthalmology (retina clinic), physiotherapy (exercise & mobility), and podiatry/wound care.
Referral and joint clinics for complex cases (e.g., pregnancy with diabetes, renal impairment, or recurrent hypoglycaemia).

8) Preventive Health & Health Check Packages

Routine adult health checks integrating diabetes screening, cardiovascular risk profiling, and age-appropriate preventive screening (vaccinations, cancer screening as per age and risk). These packages can be customized.