What can you do , how reliable are you , what are your features useful

What can you do , how reliable are you , what are your features useful for me as a final year student and are you free

Here's a clear breakdown of what I am, what I can do, and how useful I'll be for you as a final year student:

What I Am

I'm Orris, an AI assistant built on a large language model. I'm designed to help with a wide range of academic, research, and practical tasks. I'm available right now, in this chat - no app download needed.

What I Can Do (Features Useful for a Final Year Student)

📚 Academic Research & Writing

Summarize research papers, textbooks, and articles
Help you write, structure, and refine your thesis, dissertation, or final year project (FYP)
Generate literature reviews, abstracts, introductions, and conclusions
Explain complex concepts in simple terms (across any subject)

🔬 Medical / Clinical Knowledge (if you're in a health field)

I have access to a medical textbook library with rich clinical content
Can answer questions on anatomy, pharmacology, pathology, physiology, clinical procedures, and more
Retrieves content from authoritative medical textbooks with citations

📊 Data, Spreadsheets & Code

Help you analyze data and write Python, R, SQL, JavaScript, etc.
Create or fix Excel/CSV spreadsheets
Explain statistical methods for your research methodology

📄 Document Creation

Create or edit Word documents (.docx), PowerPoint presentations (.pptx), PDFs, and Excel files (.xlsx)
Format reports, CVs, cover letters, and project proposals
These files are downloadable directly from our chat

🧠 Exam Preparation

Explain topics for exams (including CA Final, ACCA, medical licensing, engineering exams)
Summarize chapters and create study notes
Generate practice questions and flashcards

🔍 Real-Time Research

Search the web for current news, guidelines, and information
Search PubMed for peer-reviewed medical and scientific studies
Extract content from specific URLs or documents you share

🖼️ Images & Visuals

Generate original images, diagrams, posters, and flashcards
Analyze and describe images or PDFs you upload

💼 Practical / Career Help

Draft emails, applications, and professional letters
Help with LinkedIn profiles, CVs, and interview prep

How Reliable Am I?

Strengths:

I pull from authoritative sources (textbooks, PubMed, live web) rather than guessing
I cite sources so you can verify what I say
For medical questions, I consult a curated textbook library before answering
I flag uncertainty - if I don't know something, I'll say so rather than make something up

Limitations (be aware):

My base training has a knowledge cutoff, so for very recent events I rely on web search
I can make mistakes, especially on highly specific numerical data or niche topics - always cross-check critical information
I'm not a substitute for a doctor, lawyer, or licensed professional for high-stakes decisions

Bottom line: I'm reliable for learning, research, writing, and analysis. Treat my outputs as a knowledgeable study partner, not an infallible authority.

Am I Free?

That depends on the platform you're accessing me through. The AI itself (this conversation) is provided through whatever service or platform you're currently using. If your institution, app, or platform offers this chat, it may be free for you as a student. I don't control billing - check with whoever gave you access to this chat.

Quick Summary for a Final Year Student

Need	Can I Help?
FYP / Thesis writing	✅ Yes
Literature review & citations	✅ Yes
Exam notes & concept explanations	✅ Yes
Data analysis & coding	✅ Yes
Creating reports/presentations	✅ Yes
Medical/clinical study	✅ Yes (textbook library)
Real-time research	✅ Yes
Career documents (CV, cover letter)	✅ Yes

Just tell me what subject or project you're working on and I'll get started.

Can you make a ppt on GDM

Asking for Preferences

Reading File

Finding Sources

Searching PubMed

"gestational diabetes mellitus"[MeSH Terms] AND management

Reading File

Searching PubMed

"gestational diabetes"[MeSH Terms] AND screening diagnosis

Reading File

Running Command

mkdir -p /home/daytona/workspace/gdm-ppt && ls /home/daytona/workspace/gdm-ppt

Writing File

~/gdm-ppt/gdm.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE";
pres.title = "Gestational Diabetes Mellitus (GDM)";
pres.author = "Medical Education";

// ─── COLOR PALETTE ───────────────────────────────────────────────────────────
const C = {
  navy:    "0D2B55",   // dominant dark
  teal:    "1A7A8A",   // supporting
  aqua:    "2EC4C4",   // accent / highlights
  white:   "FFFFFF",
  offWhite:"F0F5FA",
  light:   "D6EAF0",
  lightGray:"E8EFF5",
  textDark:"12243A",
  textMid: "2B4A6B",
  warn:    "E05C2A",   // orange-red for warnings/alerts
  green:   "1E8A5E",   // positive outcomes
};

// ─── HELPER: dark slide header band ──────────────────────────────────────────
function headerBand(slide, text, sub) {
  // Full-width top band
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 13.3, h: 1.35,
    fill: { color: C.navy },
    line: { color: C.navy }
  });
  // Accent stripe
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 1.35, w: 13.3, h: 0.07,
    fill: { color: C.aqua },
    line: { color: C.aqua }
  });
  slide.addText(text, {
    x: 0.4, y: 0.08, w: 12.5, h: 0.78,
    fontSize: 28, bold: true, color: C.white, fontFace: "Calibri", margin: 0
  });
  if (sub) {
    slide.addText(sub, {
      x: 0.4, y: 0.85, w: 12.5, h: 0.45,
      fontSize: 14, color: C.aqua, fontFace: "Calibri", margin: 0
    });
  }
}

// ─── HELPER: small section label pill ────────────────────────────────────────
function sectionPill(slide, label, x, y, w) {
  slide.addShape(pres.ShapeType.roundRect, {
    x, y, w: w || 2.8, h: 0.32,
    fill: { color: C.teal }, line: { color: C.teal }, rectRadius: 0.08
  });
  slide.addText(label, {
    x, y, w: w || 2.8, h: 0.32,
    fontSize: 11, bold: true, color: C.white, fontFace: "Calibri",
    align: "center", margin: 0
  });
}

// ─── HELPER: bullet block ────────────────────────────────────────────────────
function bulletBlock(slide, items, x, y, w, h, fontSize) {
  const rows = items.map((item, i) => ({
    text: item,
    options: { bullet: { type: "bullet" }, breakLine: i < items.length - 1 }
  }));
  slide.addText(rows, {
    x, y, w, h,
    fontSize: fontSize || 14,
    color: C.textDark, fontFace: "Calibri",
    valign: "top", paraSpaceAfter: 4, lineSpacingMultiple: 1.15
  });
}

// ─── HELPER: info card ───────────────────────────────────────────────────────
function infoCard(slide, x, y, w, h, title, body, titleColor, bgColor) {
  slide.addShape(pres.ShapeType.roundRect, {
    x, y, w, h,
    fill: { color: bgColor || C.offWhite },
    line: { color: C.teal, pt: 1.5 },
    rectRadius: 0.12
  });
  if (title) {
    slide.addText(title, {
      x: x + 0.12, y: y + 0.08, w: w - 0.24, h: 0.38,
      fontSize: 13, bold: true, color: titleColor || C.teal,
      fontFace: "Calibri", margin: 0
    });
  }
  slide.addText(body, {
    x: x + 0.12, y: y + (title ? 0.44 : 0.1), w: w - 0.24, h: h - (title ? 0.55 : 0.2),
    fontSize: 12.5, color: C.textDark, fontFace: "Calibri",
    valign: "top", lineSpacingMultiple: 1.2
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE SLIDE
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  // Full dark background
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color: C.navy}, line:{color:C.navy} });
  // Decorative teal block right side
  s.addShape(pres.ShapeType.rect, { x:9.2, y:0, w:4.1, h:7.5, fill:{color: C.teal}, line:{color:C.teal} });
  // Aqua accent bar
  s.addShape(pres.ShapeType.rect, { x:0, y:3.5, w:9.0, h:0.08, fill:{color:C.aqua}, line:{color:C.aqua} });

  s.addText("Gestational", { x:0.5, y:1.0, w:8.6, h:1.1, fontSize:52, bold:true, color:C.white, fontFace:"Calibri", margin:0 });
  s.addText("Diabetes Mellitus", { x:0.5, y:2.05, w:8.6, h:1.1, fontSize:52, bold:true, color:C.aqua, fontFace:"Calibri", margin:0 });
  s.addText("GDM", { x:0.5, y:3.1, w:8.6, h:0.5, fontSize:28, bold:false, color:C.light, fontFace:"Calibri", margin:0 });
  s.addText("A Comprehensive Clinical Review", { x:0.5, y:3.9, w:8.6, h:0.45, fontSize:18, color:C.light, fontFace:"Calibri", margin:0 });
  s.addText("For Medical Students", { x:0.5, y:4.4, w:8.6, h:0.38, fontSize:14, color:C.aqua, fontFace:"Calibri", margin:0 });

  // Right panel content
  s.addText("KEY FACTS", { x:9.4, y:1.0, w:3.7, h:0.4, fontSize:13, bold:true, color:C.white, fontFace:"Calibri", align:"center", margin:0 });
  const facts = [
    "~6–8% of all pregnancies",
    "Leading metabolic complication in pregnancy",
    "50% risk of future T2DM",
    "Preventable adverse outcomes with treatment",
    "Screening at 24–28 weeks"
  ];
  facts.forEach((f, i) => {
    s.addShape(pres.ShapeType.rect, { x:9.3, y:1.55 + i*0.9, w:3.8, h:0.72, fill:{color:"1C6A78"}, line:{color:"1C6A78"} });
    s.addText(f, { x:9.35, y:1.6 + i*0.9, w:3.7, h:0.62, fontSize:12.5, color:C.white, fontFace:"Calibri", valign:"middle", margin:4 });
  });

  s.addText("Sources: Creasy & Resnik MFM | Goldman-Cecil Medicine | Harrison's 22e", {
    x:0.5, y:6.9, w:12.3, h:0.4,
    fontSize:10, color:"4A7A9B", fontFace:"Calibri", align:"center", margin:0
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 2 — TABLE OF CONTENTS
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  headerBand(s, "Contents", "Overview of Topics Covered");

  const topics = [
    ["01", "Definition & Background"],
    ["02", "Epidemiology & Prevalence"],
    ["03", "Pathophysiology"],
    ["04", "Risk Factors"],
    ["05", "Clinical Features & Complications"],
    ["06", "Screening & Diagnosis"],
    ["07", "Diagnostic Criteria (IADPSG / ADA / ACOG)"],
    ["08", "Management – Lifestyle"],
    ["09", "Management – Pharmacological"],
    ["10", "Glycemic Targets & Monitoring"],
    ["11", "Fetal Surveillance & Delivery"],
    ["12", "Postpartum Care & Long-term Prognosis"],
    ["13", "Prevention & Future Directions"],
    ["14", "Summary & Key Take-Aways"],
  ];

  const cols = [topics.slice(0,7), topics.slice(7)];
  cols.forEach((col, ci) => {
    col.forEach(([num, title], ri) => {
      const x = 0.35 + ci * 6.5;
      const y = 1.6 + ri * 0.74;
      s.addShape(pres.ShapeType.roundRect, { x, y, w:6.2, h:0.62,
        fill:{color: ri%2===0 ? C.white : C.lightGray}, line:{color:C.light, pt:0.8}, rectRadius:0.08 });
      s.addShape(pres.ShapeType.roundRect, { x:x+0.05, y:y+0.1, w:0.42, h:0.42,
        fill:{color:C.teal}, line:{color:C.teal}, rectRadius:0.06 });
      s.addText(num, { x:x+0.05, y:y+0.1, w:0.42, h:0.42,
        fontSize:11, bold:true, color:C.white, fontFace:"Calibri", align:"center", valign:"middle", margin:0 });
      s.addText(title, { x:x+0.56, y:y+0.12, w:5.5, h:0.38,
        fontSize:13.5, color:C.textDark, fontFace:"Calibri", valign:"middle", margin:0 });
    });
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 3 — DEFINITION & BACKGROUND
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.white}, line:{color:C.white} });
  headerBand(s, "Definition & Background", "What is GDM?");

  // Large definition box
  s.addShape(pres.ShapeType.roundRect, { x:0.35, y:1.6, w:12.6, h:1.45,
    fill:{color:"EAF6F9"}, line:{color:C.aqua, pt:2}, rectRadius:0.15 });
  s.addText([
    {text:"Definition: ", options:{bold:true, color:C.teal}},
    {text:"Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance that is first diagnosed during pregnancy and is not clearly pre-existing diabetes.", options:{color:C.textDark}}
  ], { x:0.55, y:1.68, w:12.2, h:1.3, fontSize:16, fontFace:"Calibri", valign:"middle", margin:4, lineSpacingMultiple:1.3 });

  const points = [
    ["WHO / ADA Classification", "GDM is categorized separately from Type 1 and Type 2 diabetes. It typically resolves after delivery but signals future metabolic risk."],
    ["Timing", "Hyperglycemia is usually detected in the late second (13–26 weeks) or third trimester (27–40 weeks) of pregnancy."],
    ["Underlying Mechanism", "Pathophysiology is similar to T2DM: inadequate insulin response to progressive insulin resistance caused by placental hormones."],
    ["Not All the Same", "A small subset (~6%) of women with apparent GDM actually have pre-existing Type 1 diabetes that manifests during pregnancy (Finland cohort data)."],
  ];

  points.forEach(([title, body], i) => {
    const x = 0.35 + (i%2)*6.5;
    const y = 3.25 + Math.floor(i/2)*1.72;
    s.addShape(pres.ShapeType.roundRect, { x, y, w:6.2, h:1.55,
      fill:{color:C.offWhite}, line:{color:C.teal, pt:1}, rectRadius:0.1 });
    s.addShape(pres.ShapeType.rect, { x, y, w:0.28, h:1.55,
      fill:{color:C.teal}, line:{color:C.teal} });
    s.addText(title, { x:x+0.36, y:y+0.1, w:5.7, h:0.35,
      fontSize:13, bold:true, color:C.teal, fontFace:"Calibri", margin:0 });
    s.addText(body, { x:x+0.36, y:y+0.44, w:5.7, h:1.0,
      fontSize:12, color:C.textDark, fontFace:"Calibri", valign:"top", lineSpacingMultiple:1.2, margin:0 });
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 4 — EPIDEMIOLOGY
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  headerBand(s, "Epidemiology & Prevalence", "Global & National Burden");

  // Big stat boxes
  const stats = [
    { num:"6–8%", label:"of all pregnancies\nworldwide affected", color:C.teal },
    { num:"~90%", label:"of diabetes in\npregnancy is GDM", color:"1A6A7A" },
    { num:"1–25%", label:"prevalence varies by\nethnicity & criteria", color:C.navy },
    { num:"50%", label:"will develop T2DM\nwithin 10 years", color:C.warn },
  ];
  stats.forEach((st, i) => {
    const x = 0.35 + i*3.15;
    s.addShape(pres.ShapeType.roundRect, { x, y:1.6, w:2.9, h:1.85,
      fill:{color:st.color}, line:{color:st.color}, rectRadius:0.15 });
    s.addText(st.num, { x, y:1.7, w:2.9, h:0.9,
      fontSize:36, bold:true, color:C.white, fontFace:"Calibri", align:"center", margin:0 });
    s.addText(st.label, { x, y:2.55, w:2.9, h:0.8,
      fontSize:12, color:C.white, fontFace:"Calibri", align:"center", lineSpacingMultiple:1.2, margin:4 });
  });

  // Subheadings
  s.addText("Ethnic & Geographic Variation", { x:0.35, y:3.65, w:6.3, h:0.38,
    fontSize:15, bold:true, color:C.teal, fontFace:"Calibri", margin:0 });
  bulletBlock(s, [
    "Higher prevalence in Hispanic, Native American, Asian, and African American populations",
    "South Asian women have disproportionately high GDM rates due to insulin resistance phenotype",
    "Criteria used (IADPSG vs NDDG) significantly affects reported prevalence (2-fold difference)",
    "Rising global incidence driven by obesity epidemic and advancing maternal age at conception",
  ], 0.35, 4.02, 6.2, 3.0, 13);

  s.addText("Trend Over Time", { x:6.9, y:3.65, w:6.0, h:0.38,
    fontSize:15, bold:true, color:C.teal, fontFace:"Calibri", margin:0 });
  bulletBlock(s, [
    "GDM incidence has risen by ~50% over the past two decades",
    "Parallel trends with rising obesity, sedentary lifestyles, and older maternal age",
    "Anesthesia records: ~7% of all pregnancies complicated by diabetes; ~90% are GDM",
    "Recurrence rate in subsequent pregnancies: up to 50–84%",
  ], 6.9, 4.02, 6.0, 3.0, 13);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 5 — PATHOPHYSIOLOGY
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.white}, line:{color:C.white} });
  headerBand(s, "Pathophysiology", "Why Does GDM Develop?");

  // Flow diagram simulation
  const steps = [
    { label:"Normal Pregnancy", body:"Placenta secretes\ndiabetogenic hormones:\nhPL, progesterone,\ncortisol, GH", color:C.teal },
    { label:"↑ Insulin Resistance", body:"~60% reduction in\ninsulin sensitivity by\n3rd trimester", color:"1A6A7A" },
    { label:"β-Cell Compensation", body:"Normal pancreas\nincreases insulin\nsecretion 2–3x\nto compensate", color:C.navy },
    { label:"β-Cell Failure (GDM)", body:"Insufficient β-cell\nreserve → inadequate\ncompensation →\nhyperglycemia", color:C.warn },
  ];

  steps.forEach((st, i) => {
    const x = 0.3 + i*3.2;
    s.addShape(pres.ShapeType.roundRect, { x, y:1.6, w:2.9, h:2.4,
      fill:{color:st.color}, line:{color:st.color}, rectRadius:0.12 });
    s.addText(st.label, { x, y:1.68, w:2.9, h:0.5,
      fontSize:13, bold:true, color:C.white, fontFace:"Calibri", align:"center", margin:0 });
    s.addText(st.body, { x:x+0.1, y:2.22, w:2.7, h:1.7,
      fontSize:12.5, color:C.white, fontFace:"Calibri", align:"center",
      lineSpacingMultiple:1.3, valign:"top", margin:0 });
    // Arrow (except last)
    if (i < 3) {
      s.addShape(pres.ShapeType.rightArrow, { x:3.15+i*3.2, y:2.45, w:0.35, h:0.58,
        fill:{color:C.aqua}, line:{color:C.aqua} });
    }
  });

  // Hormones explanation
  s.addText("Placental Diabetogenic Hormones", { x:0.35, y:4.2, w:12.6, h:0.4,
    fontSize:15, bold:true, color:C.teal, fontFace:"Calibri", margin:0 });

  const hormones = [
    ["Human Placental Lactogen (hPL)", "Main diabetogenic hormone; increases with placental mass and gestational age; induces lipolysis and promotes insulin resistance"],
    ["Progesterone", "Reduces insulin secretion and increases peripheral insulin resistance"],
    ["Cortisol", "Counter-regulatory hormone; rises throughout pregnancy; stimulates hepatic gluconeogenesis"],
    ["Growth Hormone variant", "Placental GH variant suppresses pituitary GH; promotes insulin resistance"],
  ];

  hormones.forEach(([h, b], i) => {
    const x = 0.35 + (i%2)*6.5;
    const y = 4.65 + Math.floor(i/2)*1.28;
    s.addShape(pres.ShapeType.roundRect, { x, y, w:6.2, h:1.15,
      fill:{color:C.offWhite}, line:{color:C.light, pt:1}, rectRadius:0.08 });
    s.addText(h, { x:x+0.1, y:y+0.06, w:6.0, h:0.32,
      fontSize:12, bold:true, color:C.teal, fontFace:"Calibri", margin:0 });
    s.addText(b, { x:x+0.1, y:y+0.38, w:6.0, h:0.72,
      fontSize:11.5, color:C.textDark, fontFace:"Calibri", lineSpacingMultiple:1.2, valign:"top", margin:0 });
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 6 — RISK FACTORS
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  headerBand(s, "Risk Factors for GDM", "Who Is at Highest Risk?");

  const categories = [
    {
      title:"Maternal Factors",
      color: C.teal,
      items:["Age >30 years", "Obesity (BMI >30 kg/m²)", "Excessive weight gain in pregnancy", "Sedentary lifestyle / low physical activity", "Short stature (in some populations)"]
    },
    {
      title:"Medical History",
      color:"1A6A7A",
      items:["Previous GDM in prior pregnancy", "Impaired glucose tolerance (prediabetes)", "Polycystic ovary syndrome (PCOS)", "Hypertension or cardiovascular disease", "Glucosuria on routine urine dipstick"]
    },
    {
      title:"Obstetric History",
      color:C.navy,
      items:["Prior macrosomic infant (>4 kg)", "Unexplained stillbirth or perinatal loss", "Recurrent miscarriage", "Prior infant with congenital malformation", "Polyhydramnios in prior pregnancy"]
    },
    {
      title:"Family & Ethnic Factors",
      color:"4A3E8C",
      items:["First-degree relative with T2DM", "Hispanic, South Asian, African American, Native American ethnicity", "Pacific Islander descent", "Family history of GDM in mother/sister", "High-prevalence geographic origin"]
    },
  ];

  categories.forEach((cat, i) => {
    const x = 0.3 + (i%2)*6.5;
    const y = 1.6 + Math.floor(i/2)*2.7;
    s.addShape(pres.ShapeType.roundRect, { x, y, w:6.2, h:2.5,
      fill:{color:C.white}, line:{color:cat.color, pt:1.5}, rectRadius:0.12 });
    s.addShape(pres.ShapeType.roundRect, { x, y, w:6.2, h:0.42,
      fill:{color:cat.color}, line:{color:cat.color}, rectRadius:0.12 });
    // Fix corners on bottom of header
    s.addShape(pres.ShapeType.rect, { x, y:0.28+y, w:6.2, h:0.14, fill:{color:cat.color}, line:{color:cat.color} });
    s.addText(cat.title, { x:x+0.1, y:y+0.05, w:6.0, h:0.35,
      fontSize:14, bold:true, color:C.white, fontFace:"Calibri", margin:0 });
    const rows = cat.items.map((item, idx) => ({
      text: item,
      options: { bullet:true, breakLine: idx < cat.items.length-1, fontSize:12.5, color:C.textDark }
    }));
    s.addText(rows, { x:x+0.1, y:y+0.5, w:6.0, h:1.9,
      fontFace:"Calibri", valign:"top", paraSpaceAfter:2, lineSpacingMultiple:1.15, margin:0 });
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 7 — CLINICAL FEATURES & MATERNAL COMPLICATIONS
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.white}, line:{color:C.white} });
  headerBand(s, "Clinical Features & Complications", "Maternal and Fetal Consequences");

  s.addText("⚠  GDM is usually ASYMPTOMATIC — diagnosis relies entirely on screening", {
    x:0.35, y:1.55, w:12.6, h:0.48,
    fontSize:14, bold:true, color:C.white, fontFace:"Calibri", align:"center",
    fill:{color:C.warn}, margin:6
  });

  // Maternal
  s.addText("MATERNAL COMPLICATIONS", { x:0.35, y:2.2, w:5.9, h:0.38,
    fontSize:14, bold:true, color:C.teal, fontFace:"Calibri", margin:0 });
  const maternalComps = [
    "Gestational hypertension & preeclampsia",
    "Polyhydramnios (excess amniotic fluid)",
    "Increased risk of cesarean section",
    "Urinary tract infections",
    "Pre-term labour in some cases",
    "50% lifetime risk of developing T2DM",
    "Cluster of cardiovascular risk factors",
    "Recurrent GDM in future pregnancies (~50–84%)",
  ];
  bulletBlock(s, maternalComps, 0.35, 2.6, 5.9, 4.6, 13);

  // Fetal
  s.addText("FETAL / NEONATAL COMPLICATIONS", { x:7.0, y:2.2, w:6.0, h:0.38,
    fontSize:14, bold:true, color:C.teal, fontFace:"Calibri", margin:0 });
  const fetalComps = [
    "Macrosomia (birth weight >4 kg / LGA)",
    "Shoulder dystocia and birth trauma",
    "Neonatal hypoglycemia (fetal hyperinsulinism)",
    "Neonatal hyperbilirubinemia (jaundice)",
    "Respiratory distress syndrome",
    "Congenital malformations (with overt DM)",
    "Intrauterine fetal demise (stillbirth)",
    "Long-term: ↑ risk of childhood obesity & T2DM",
  ];
  bulletBlock(s, fetalComps, 7.0, 2.6, 6.0, 4.6, 13);

  // Divider
  s.addShape(pres.ShapeType.line, { x:6.65, y:2.15, w:0, h:5.0,
    line:{color:C.light, pt:1.5, dashType:"dash"} });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 8 — SCREENING
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  headerBand(s, "Screening for GDM", "Who, When & How");

  // When box
  s.addShape(pres.ShapeType.roundRect, { x:0.35, y:1.6, w:12.6, h:0.75,
    fill:{color:C.teal}, line:{color:C.teal}, rectRadius:0.12 });
  s.addText("WHEN:  All pregnant women should be screened at 24–28 weeks of gestation  |  High-risk women: screen earlier in the 1st trimester", {
    x:0.5, y:1.65, w:12.3, h:0.65,
    fontSize:13.5, color:C.white, fontFace:"Calibri", bold:true, valign:"middle", margin:0
  });

  // Two-Step
  s.addShape(pres.ShapeType.roundRect, { x:0.35, y:2.5, w:6.2, h:4.65,
    fill:{color:C.white}, line:{color:C.teal, pt:1.5}, rectRadius:0.12 });
  s.addShape(pres.ShapeType.roundRect, { x:0.35, y:2.5, w:6.2, h:0.5,
    fill:{color:C.teal}, line:{color:C.teal}, rectRadius:0.12 });
  s.addShape(pres.ShapeType.rect, { x:0.35, y:2.78, w:6.2, h:0.22, fill:{color:C.teal}, line:{color:C.teal} });
  s.addText("TWO-STEP APPROACH (USA / ACOG)", { x:0.45, y:2.54, w:6.0, h:0.42,
    fontSize:13, bold:true, color:C.white, fontFace:"Calibri", margin:0 });

  const step1 = [
    "STEP 1 — Glucose Challenge Test (GCT):",
    "  • Non-fasting 50-g oral glucose load",
    "  • Measure plasma glucose at 1 hour",
    "  • Threshold: ≥130–140 mg/dL = abnormal",
    "  • If abnormal → proceed to Step 2",
    "",
    "STEP 2 — 100-g OGTT (3-hour, fasting):",
    "  • 3 days adequate carbohydrate intake pre-test",
    "  • Overnight fast (8–14 hours)",
    "  • Seated, non-smoking during test",
    "  • Carpenter-Coustan Criteria:",
    "    – Fasting:  ≥95 mg/dL",
    "    – 1 hr:     ≥180 mg/dL",
    "    – 2 hr:     ≥155 mg/dL",
    "    – 3 hr:     ≥140 mg/dL",
    "  • ≥2 abnormal values = GDM diagnosis",
    "  • (2018 ACOG: 1 abnormal value may warrant treatment)",
  ];
  s.addText(step1.join("\n"), { x:0.5, y:3.1, w:5.9, h:3.9,
    fontSize:11.5, color:C.textDark, fontFace:"Calibri", valign:"top",
    lineSpacingMultiple:1.25, margin:0 });

  // One-Step
  s.addShape(pres.ShapeType.roundRect, { x:6.8, y:2.5, w:6.15, h:4.65,
    fill:{color:C.white}, line:{color:"1A6A7A", pt:1.5}, rectRadius:0.12 });
  s.addShape(pres.ShapeType.roundRect, { x:6.8, y:2.5, w:6.15, h:0.5,
    fill:{color:"1A6A7A"}, line:{color:"1A6A7A"}, rectRadius:0.12 });
  s.addShape(pres.ShapeType.rect, { x:6.8, y:2.78, w:6.15, h:0.22, fill:{color:"1A6A7A"}, line:{color:"1A6A7A"} });
  s.addText("ONE-STEP APPROACH (IADPSG / WHO / ADA)", { x:6.9, y:2.54, w:5.9, h:0.42,
    fontSize:13, bold:true, color:C.white, fontFace:"Calibri", margin:0 });

  const step1b = [
    "75-g OGTT, fasting, at 24–28 weeks:",
    "  • Overnight fast required",
    "  • Plasma glucose at fasting, 1 hr, 2 hr",
    "  • ANY single abnormal value = GDM",
    "",
    "IADPSG Diagnostic Thresholds:",
    "  • Fasting:  ≥92 mg/dL  (5.1 mmol/L)",
    "  • 1 hour:   ≥180 mg/dL (10.0 mmol/L)",
    "  • 2 hour:   ≥153 mg/dL (8.5 mmol/L)",
    "",
    "Overt Diabetes During Pregnancy:",
    "  • Fasting ≥126 mg/dL",
    "  • HbA1c ≥6.5%",
    "  • Random glucose ≥200 mg/dL",
    "",
    "Note: One-step detects more cases but has\n  higher false-positive rates and cost.",
  ];
  s.addText(step1b.join("\n"), { x:6.9, y:3.1, w:5.9, h:3.9,
    fontSize:11.5, color:C.textDark, fontFace:"Calibri", valign:"top",
    lineSpacingMultiple:1.25, margin:0 });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 9 — DIAGNOSTIC CRITERIA TABLE
// ═══════════════════════════════════════════════════════════════════════════
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  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.white}, line:{color:C.white} });
  headerBand(s, "Diagnostic Criteria", "IADPSG / ADA / ACOG / NDDG Comparison");

  // Main table
  const tableData = [
    [
      { text:"Criteria / Organization", options:{ bold:true, color:C.white } },
      { text:"Test", options:{ bold:true, color:C.white } },
      { text:"Fasting", options:{ bold:true, color:C.white } },
      { text:"1 hour", options:{ bold:true, color:C.white } },
      { text:"2 hour", options:{ bold:true, color:C.white } },
      { text:"3 hour", options:{ bold:true, color:C.white } },
      { text:"Cutoff", options:{ bold:true, color:C.white } },
    ],
    ["IADPSG / WHO 2013", "75-g OGTT", "≥92 mg/dL", "≥180 mg/dL", "≥153 mg/dL", "N/A", "Any 1 value"],
    ["ADA (2024)", "75-g or 100-g", "≥92 mg/dL", "≥180 mg/dL", "≥153 mg/dL", "—", "Any 1 (75g)"],
    ["ACOG (100g)", "100-g OGTT", "≥95 mg/dL", "≥180 mg/dL", "≥155 mg/dL", "≥140 mg/dL", "≥2 values"],
    ["Carpenter-Coustan", "100-g OGTT", "≥95 mg/dL", "≥180 mg/dL", "≥155 mg/dL", "≥140 mg/dL", "≥2 values"],
    ["NDDG (older)", "100-g OGTT", "≥105 mg/dL", "≥190 mg/dL", "≥165 mg/dL", "≥145 mg/dL", "≥2 values"],
    ["O'Sullivan (original)", "100-g OGTT", "≥90 mg/dL", "≥165 mg/dL", "≥145 mg/dL", "≥125 mg/dL", "≥2 values"],
  ];

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    return row.map((cell, ci) => {
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      return {
        text: typeof cell === "string" ? cell : cell,
        options: {
          bold: isHeader || ci === 0,
          color: isHeader ? C.white : (ci===0 ? C.teal : C.textDark),
          fontSize: 12,
          fontFace: "Calibri",
          fill: isHeader ? { color: C.navy } : (ri%2===0 ? { color:C.offWhite } : { color:C.white }),
          align: ci===0 ? "left" : "center",
          valign: "middle",
          margin: [4,4,4,6]
        }
      };
    });
  });

  s.addTable(tRows, {
    x:0.3, y:1.65, w:12.7, h:3.8,
    border: { pt:0.8, color:C.light },
    rowH: 0.52,
    colW: [2.5, 1.6, 1.6, 1.6, 1.6, 1.6, 1.7]
  });

  // Notes
  s.addText("KEY NOTES", { x:0.3, y:5.65, w:2.8, h:0.35,
    fontSize:13, bold:true, color:C.teal, fontFace:"Calibri", margin:0 });
  const notes = [
    "IADPSG one-step approach diagnoses ~18% of pregnant women vs ~7% with ACOG two-step — significant policy implications",
    "Two-step has false-negative rate of ~4% and ~15% non-compliance with follow-up 100-g OGTT",
    "Overt diabetes in pregnancy: fasting ≥126 mg/dL, HbA1c ≥6.5%, or random ≥200 mg/dL with symptoms",
    "Early screening (<24 wk) recommended for high-risk women using non-pregnant diagnostic criteria"
  ];
  bulletBlock(s, notes, 0.3, 6.02, 12.7, 1.35, 12);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 10 — GLYCEMIC TARGETS & MONITORING
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  headerBand(s, "Glycemic Targets & Monitoring", "Treatment Goals During Pregnancy");

  // Target boxes
  const targets = [
    { label:"Fasting", value:"< 95 mg/dL\n(5.3 mmol/L)", color:C.teal },
    { label:"1-hr Postprandial", value:"< 140 mg/dL\n(7.8 mmol/L)", color:"1A6A7A" },
    { label:"2-hr Postprandial", value:"< 120 mg/dL\n(6.7 mmol/L)", color:C.navy },
    { label:"HbA1c", value:"< 6%\n(if measured)", color:"4A3E8C" },
  ];

  targets.forEach((t, i) => {
    const x = 0.3 + i*3.18;
    s.addShape(pres.ShapeType.roundRect, { x, y:1.6, w:3.0, h:1.8,
      fill:{color:t.color}, line:{color:t.color}, rectRadius:0.12 });
    s.addText(t.label, { x, y:1.7, w:3.0, h:0.45,
      fontSize:13, bold:true, color:C.white, fontFace:"Calibri", align:"center", margin:0 });
    s.addText(t.value, { x, y:2.12, w:3.0, h:1.2,
      fontSize:20, bold:true, color:C.white, fontFace:"Calibri", align:"center", valign:"middle", lineSpacingMultiple:1.3, margin:0 });
  });

  // Monitoring protocols
  s.addText("SELF-MONITORING BLOOD GLUCOSE (SMBG)", { x:0.3, y:3.6, w:6.1, h:0.38,
    fontSize:14, bold:true, color:C.teal, fontFace:"Calibri", margin:0 });
  bulletBlock(s, [
    "Minimum: fasting + 1-hr or 2-hr post each main meal (4–7 tests/day)",
    "HbA1c is of limited utility during pregnancy due to ↑ RBC turnover (falsely low values)",
    "Continuous Glucose Monitoring (CGM): evidence-based for T1DM in pregnancy; role in GDM being studied",
    "Fasting glucose is most predictive of neonatal macrosomia",
    "Post-prandial glucose more closely correlates with LGA birthweight",
  ], 0.3, 4.0, 6.1, 3.15, 12.5);

  s.addText("INSULIN DOSE PROGRESSION", { x:6.7, y:3.6, w:6.2, h:0.38,
    fontSize:14, bold:true, color:C.teal, fontFace:"Calibri", margin:0 });
  bulletBlock(s, [
    "1st trimester: 0.7–0.8 units/kg/day",
    "2nd trimester: 0.8–1.0 units/kg/day",
    "3rd trimester: 0.9–1.2 units/kg/day",
    "Typical regimen: basal insulin + short-acting (prandial) insulin",
    "Insulin pump (CSII) may be used in selected patients",
    "Doses increase as insulin resistance rises with gestation",
  ], 6.7, 4.0, 6.2, 3.15, 12.5);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 11 — MANAGEMENT: LIFESTYLE
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.white}, line:{color:C.white} });
  headerBand(s, "Management – Lifestyle Intervention", "First-Line Treatment for GDM");

  // Banner
  s.addShape(pres.ShapeType.roundRect, { x:0.35, y:1.6, w:12.6, h:0.6,
    fill:{color:C.green}, line:{color:C.green}, rectRadius:0.1 });
  s.addText("Lifestyle intervention alone achieves glycemic targets in 70–85% of women with GDM", {
    x:0.5, y:1.65, w:12.3, h:0.5,
    fontSize:14, bold:true, color:C.white, fontFace:"Calibri", align:"center", margin:0 });

  const domains = [
    {
      icon:"🥗", title:"Medical Nutrition Therapy (MNT)",
      color:C.teal,
      items:[
        "Refer to registered dietitian for individualized plan",
        "Goal: achieve normoglycemia while ensuring adequate nutrition",
        "Carbohydrate: 35–45% of total calories; spread across 3 meals + 2–3 snacks",
        "Low glycaemic index foods preferred",
        "Avoid concentrated sweets, fruit juices, refined carbohydrates",
        "Adequate caloric intake: ~30 kcal/kg/day for normal BMI (↓ for obese)",
        "Weight gain targets per IOM guidelines based on pre-pregnancy BMI",
      ]
    },
    {
      icon:"🏃", title:"Physical Activity",
      color:"1A6A7A",
      items:[
        "Moderate exercise: ≥30 minutes/day on most days",
        "Walking, swimming, stationary cycling (aerobic exercise preferred)",
        "Resistance training also beneficial",
        "Reduces postprandial glucose by increasing peripheral glucose uptake",
        "Contraindications: obstetric (placenta previa, risk of PTL, cervical incompetence)",
        "Post-meal walking (15 min) is particularly effective for postprandial glucose control",
      ]
    },
    {
      icon:"⚖️", title:"Weight Management",
      color:C.navy,
      items:[
        "Excessive gestational weight gain worsens insulin resistance",
        "IOM targets: Normal BMI → 11.5–16 kg; Overweight → 7–11.5 kg; Obese → 5–9 kg",
        "Weight loss not recommended during pregnancy, but weight restriction appropriate",
        "Post-partum weight reduction is critical to reduce T2DM risk",
      ]
    },
  ];

  domains.forEach((d, i) => {
    const x = 0.35 + i*4.32;
    s.addShape(pres.ShapeType.roundRect, { x, y:2.35, w:4.18, h:4.85,
      fill:{color:C.offWhite}, line:{color:d.color, pt:1.5}, rectRadius:0.12 });
    s.addShape(pres.ShapeType.roundRect, { x, y:2.35, w:4.18, h:0.55,
      fill:{color:d.color}, line:{color:d.color}, rectRadius:0.12 });
    s.addShape(pres.ShapeType.rect, { x, y:2.63, w:4.18, h:0.27, fill:{color:d.color}, line:{color:d.color} });
    s.addText(d.title, { x:x+0.08, y:2.39, w:4.02, h:0.47,
      fontSize:13, bold:true, color:C.white, fontFace:"Calibri", margin:0 });
    const rows = d.items.map((item, idx) => ({
      text: item,
      options:{ bullet:true, breakLine: idx<d.items.length-1, fontSize:11.5, color:C.textDark }
    }));
    s.addText(rows, { x:x+0.1, y:2.97, w:3.98, h:4.1,
      fontFace:"Calibri", valign:"top", paraSpaceAfter:3, lineSpacingMultiple:1.2, margin:0 });
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 12 — MANAGEMENT: PHARMACOLOGICAL
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  headerBand(s, "Management – Pharmacological", "When Lifestyle Alone is Insufficient");

  s.addShape(pres.ShapeType.roundRect, { x:0.35, y:1.6, w:12.6, h:0.58,
    fill:{color:C.warn}, line:{color:C.warn}, rectRadius:0.1 });
  s.addText("Add pharmacotherapy when glycemic targets are not met within 1–2 weeks of lifestyle intervention", {
    x:0.5, y:1.65, w:12.3, h:0.48,
    fontSize:13.5, bold:true, color:C.white, fontFace:"Calibri", align:"center", margin:0 });

  // Insulin card
  s.addShape(pres.ShapeType.roundRect, { x:0.35, y:2.35, w:6.1, h:4.85,
    fill:{color:C.white}, line:{color:C.teal, pt:2}, rectRadius:0.12 });
  s.addShape(pres.ShapeType.roundRect, { x:0.35, y:2.35, w:6.1, h:0.55,
    fill:{color:C.teal}, line:{color:C.teal}, rectRadius:0.12 });
  s.addShape(pres.ShapeType.rect, { x:0.35, y:2.63, w:6.1, h:0.27, fill:{color:C.teal}, line:{color:C.teal} });
  s.addText("INSULIN  (Gold Standard — Preferred)", { x:0.45, y:2.39, w:5.9, h:0.47,
    fontSize:14, bold:true, color:C.white, fontFace:"Calibri", margin:0 });
  bulletBlock(s, [
    "Does NOT cross the placenta → safest fetal profile",
    "Preferred medical therapy in pregnancy (ADA / ACOG / WHO)",
    "Types used: NPH (basal), Regular, Aspart, Lispro (rapid-acting)",
    "Glargine & Detemir: limited pregnancy data; used in clinical practice",
    "Dose titration based on fasting and postprandial SMBG values",
    "Escalating doses required as pregnancy progresses (insulin resistance ↑)",
    "IV insulin infusion recommended intrapartum (tight glycemic control at delivery)",
    "Risk: hypoglycaemia — patient education on recognition and management essential",
  ], 0.45, 2.97, 5.9, 4.1, 12.5);

  // Oral agents card
  s.addShape(pres.ShapeType.roundRect, { x:6.85, y:2.35, w:6.1, h:4.85,
    fill:{color:C.white}, line:{color:"1A6A7A", pt:2}, rectRadius:0.12 });
  s.addShape(pres.ShapeType.roundRect, { x:6.85, y:2.35, w:6.1, h:0.55,
    fill:{color:"1A6A7A"}, line:{color:"1A6A7A"}, rectRadius:0.12 });
  s.addShape(pres.ShapeType.rect, { x:6.85, y:2.63, w:6.1, h:0.27, fill:{color:"1A6A7A"}, line:{color:"1A6A7A"} });
  s.addText("ORAL AGENTS  (Selected Cases)", { x:6.95, y:2.39, w:5.9, h:0.47,
    fontSize:14, bold:true, color:C.white, fontFace:"Calibri", margin:0 });

  // Metformin sub-box
  s.addShape(pres.ShapeType.roundRect, { x:7.0, y:3.0, w:5.8, h:2.35,
    fill:{color:"EAF6F9"}, line:{color:C.aqua, pt:1}, rectRadius:0.1 });
  s.addText("Metformin", { x:7.1, y:3.05, w:5.6, h:0.35,
    fontSize:13, bold:true, color:C.teal, fontFace:"Calibri", margin:0 });
  bulletBlock(s, [
    "Crosses the placenta (fetal metformin levels ~50% of maternal)",
    "May appear preferable to insulin in some studies",
    "~46% of women require additional insulin escalation",
    "Acceptable alternative when insulin is declined or unavailable",
    "Long-term offspring metabolic effects under investigation",
    "Not FDA-approved in pregnancy; use is off-label",
  ], 7.1, 3.42, 5.6, 1.85, 11.5);

  // Glibenclamide sub-box
  s.addShape(pres.ShapeType.roundRect, { x:7.0, y:5.45, w:5.8, h:1.55,
    fill:{color:"FFF5F0"}, line:{color:C.warn, pt:1}, rectRadius:0.1 });
  s.addText("Glibenclamide (Glyburide) — Use with Caution", { x:7.1, y:5.5, w:5.6, h:0.35,
    fontSize:12, bold:true, color:C.warn, fontFace:"Calibri", margin:0 });
  bulletBlock(s, [
    "Crosses the placenta → neonatal hypoglycaemia risk",
    "ADA 2024: not recommended as first-line; use only if insulin unavailable",
  ], 7.1, 5.86, 5.6, 1.0, 11.5);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 13 — FETAL SURVEILLANCE & DELIVERY
// ═══════════════════════════════════════════════════════════════════════════
{
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  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.white}, line:{color:C.white} });
  headerBand(s, "Fetal Surveillance & Delivery Planning", "Antepartum & Intrapartum Management");

  const sections = [
    {
      title:"Antenatal Surveillance",
      color:C.teal,
      items:[
        "Detailed anomaly scan at 18–20 weeks (especially if overt DM)",
        "Fetal growth ultrasound every 4 weeks from 28 weeks",
        "LGA / macrosomia (EFW >4000g) on USS suggests suboptimal control",
        "Polyhydramnios: indicator of fetal hyperglycaemia / hyperinsulinism",
        "Non-stress test (NST) / Biophysical profile (BPP) if poorly controlled",
        "Doppler velocimetry if fetal growth restriction (less common)",
      ]
    },
    {
      title:"Timing of Delivery",
      color:"1A6A7A",
      items:[
        "Well-controlled GDM (diet-controlled): delivery at 40–41 weeks",
        "GDM requiring insulin: consider induction at 38–39 weeks",
        "Harrison's 22e: induction may be recommended at early-term (37–39 wk)",
        "Poorly controlled or macrosomic: earlier delivery considered",
        "Preterm delivery reserved for: poor glycemic control, worsening renal disease, active proliferative retinopathy",
      ]
    },
    {
      title:"Mode of Delivery",
      color:C.navy,
      items:[
        "Vaginal delivery preferred unless obstetric indication for CS",
        "Elective CS considered if EFW ≥4500 g (to prevent shoulder dystocia)",
        "Intrapartum glucose: IV dextrose-insulin infusion to keep BG 70–110 mg/dL",
        "Tight glycemic control at delivery → minimizes neonatal hypoglycaemia",
        "Neonatal monitoring: glucose checks at 1–2 hours after birth",
      ]
    },
    {
      title:"Neonatal Care",
      color:"4A3E8C",
      items:[
        "Monitor blood glucose q2–4h for first 12–24 hours",
        "Early feeding (within 30 min of birth) to prevent hypoglycaemia",
        "Watch for: respiratory distress, jaundice, polycythaemia",
        "Paediatrician/neonatologist should be informed pre-delivery",
        "Breastfeeding encouraged — reduces infant obesity risk",
      ]
    },
  ];

  sections.forEach((sec, i) => {
    const x = 0.3 + (i%2)*6.5;
    const y = 1.6 + Math.floor(i/2)*2.85;
    s.addShape(pres.ShapeType.roundRect, { x, y, w:6.2, h:2.65,
      fill:{color:C.offWhite}, line:{color:sec.color, pt:1.5}, rectRadius:0.12 });
    s.addShape(pres.ShapeType.roundRect, { x, y, w:6.2, h:0.45,
      fill:{color:sec.color}, line:{color:sec.color}, rectRadius:0.12 });
    s.addShape(pres.ShapeType.rect, { x, y:y+0.25, w:6.2, h:0.2, fill:{color:sec.color}, line:{color:sec.color} });
    s.addText(sec.title, { x:x+0.1, y:y+0.05, w:6.0, h:0.38,
      fontSize:13, bold:true, color:C.white, fontFace:"Calibri", margin:0 });
    const rows = sec.items.map((item, idx) => ({
      text:item, options:{ bullet:true, breakLine: idx<sec.items.length-1, fontSize:11.5, color:C.textDark }
    }));
    s.addText(rows, { x:x+0.1, y:y+0.52, w:6.0, h:2.05,
      fontFace:"Calibri", valign:"top", paraSpaceAfter:2, lineSpacingMultiple:1.15, margin:0 });
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 14 — POSTPARTUM CARE
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  headerBand(s, "Postpartum Care & Long-term Prognosis", "Beyond Delivery — The Lifelong Risk");

  // Key statistic
  s.addShape(pres.ShapeType.roundRect, { x:0.35, y:1.6, w:12.6, h:0.85,
    fill:{color:C.navy}, line:{color:C.navy}, rectRadius:0.12 });
  s.addText([
    {text:"50% ", options:{bold:true, fontSize:22, color:C.aqua}},
    {text:"of women with GDM will develop T2DM within 10 years  |  ", options:{fontSize:14, color:C.white}},
    {text:"~20x ", options:{bold:true, fontSize:22, color:C.aqua}},
    {text:"higher lifetime risk of T2DM", options:{fontSize:14, color:C.white}},
  ], { x:0.5, y:1.65, w:12.3, h:0.75,
    fontFace:"Calibri", align:"center", valign:"middle", margin:0 });

  const cards = [
    {
      title:"Immediate Postpartum",
      color:C.teal,
      items:[
        "Insulin requirements drop dramatically after placental delivery",
        "Discontinue GDM-specific treatment immediately after delivery",
        "Continue SMBG for 24–48 hours to confirm resolution",
        "Breastfeeding encouraged — reduces infant obesity risk and may reduce maternal T2DM risk",
      ]
    },
    {
      title:"6-Week Postpartum Screen",
      color:"1A6A7A",
      items:[
        "75-g OGTT at 4–12 weeks postpartum (not HbA1c alone — less sensitive)",
        "Reclassify: normal / prediabetes / T2DM using non-pregnant criteria",
        "If normal: screen every 1–3 years for life",
        "Up to 20% will already have glucose abnormality at 6-week screen",
      ]
    },
    {
      title:"Long-term Follow-up",
      color:C.navy,
      items:[
        "Annual fasting glucose or HbA1c",
        "Counsel on T2DM prevention: diet, exercise, weight management",
        "Metformin may be considered in high-risk women",
        "Intensive lifestyle intervention reduces T2DM risk by ~58% (DPP trial)",
        "Cardiovascular risk factor monitoring: lipids, BP, waist circumference",
        "Impaired glucose metabolism in ~50% within 10 years",
      ]
    },
    {
      title:"Offspring Surveillance",
      color:"4A3E8C",
      items:[
        "Intrauterine hyperglycaemia programs metabolic risk in offspring",
        "Children of GDM mothers: ↑ risk of childhood obesity",
        "↑ risk of T2DM and metabolic syndrome in adolescence/adulthood",
        "Promote healthy lifestyle from infancy",
        "Breastfeeding is protective for both mother and child",
      ]
    },
  ];

  cards.forEach((c, i) => {
    const x = 0.3 + (i%2)*6.5;
    const y = 2.65 + Math.floor(i/2)*2.45;
    s.addShape(pres.ShapeType.roundRect, { x, y, w:6.2, h:2.28,
      fill:{color:C.white}, line:{color:c.color, pt:1.5}, rectRadius:0.12 });
    s.addShape(pres.ShapeType.roundRect, { x, y, w:6.2, h:0.42,
      fill:{color:c.color}, line:{color:c.color}, rectRadius:0.12 });
    s.addShape(pres.ShapeType.rect, { x, y:y+0.22, w:6.2, h:0.2, fill:{color:c.color}, line:{color:c.color} });
    s.addText(c.title, { x:x+0.1, y:y+0.04, w:6.0, h:0.38,
      fontSize:13, bold:true, color:C.white, fontFace:"Calibri", margin:0 });
    const rows = c.items.map((item, idx) => ({
      text:item, options:{ bullet:true, breakLine: idx<c.items.length-1, fontSize:11.5, color:C.textDark }
    }));
    s.addText(rows, { x:x+0.1, y:y+0.5, w:6.0, h:1.72,
      fontFace:"Calibri", valign:"top", paraSpaceAfter:2, lineSpacingMultiple:1.15, margin:0 });
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 15 — PREVENTION & FUTURE DIRECTIONS
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.white}, line:{color:C.white} });
  headerBand(s, "Prevention & Future Directions", "Reducing GDM & Its Consequences");

  const preCol = [
    {
      title:"Pre-conception Prevention",
      color:C.teal,
      items:[
        "Achieve healthy BMI before pregnancy",
        "Regular physical activity pre-conception",
        "Balanced diet (Mediterranean diet shows benefit)",
        "Screen and treat prediabetes before pregnancy",
        "Metformin in high-risk women (DPP data)",
      ]
    },
    {
      title:"During Pregnancy",
      color:"1A6A7A",
      items:[
        "Healthy diet from 1st trimester",
        "Regular aerobic exercise (no contraindications)",
        "Limit gestational weight gain per IOM guidelines",
        "Probiotics: emerging evidence — gut microbiome role",
        "myo-Inositol supplementation: under investigation",
      ]
    },
  ];

  const futCol = [
    {
      title:"Research & Emerging Areas",
      color:C.navy,
      items:[
        "Continuous glucose monitoring (CGM) in GDM: ongoing RCTs",
        "Telemedicine & digital health: remote glucose monitoring",
        "Artificial Pancreas (closed-loop insulin delivery): trials in pregnancy",
        "Gut microbiome modifications: probiotic/prebiotic trials",
        "Pharmacogenomics: predicting metformin responders vs non-responders",
        "GLP-1 receptor agonists: not currently recommended in pregnancy",
      ]
    },
    {
      title:"Policy & Public Health",
      color:"4A3E8C",
      items:[
        "Universal screening debate: one-step vs two-step (cost-effectiveness)",
        "HAPO FUS: long-term follow-up data informing future guidelines",
        "ADA updates Standards of Care annually — stay current",
        "WHO 2013 criteria: adopted in most countries outside USA",
        "Community-level obesity prevention as primary GDM prevention",
      ]
    },
  ];

  [...preCol, ...futCol].forEach((c, i) => {
    const x = 0.3 + (i%2)*6.5;
    const y = 1.6 + Math.floor(i/2)*2.85;
    s.addShape(pres.ShapeType.roundRect, { x, y, w:6.2, h:2.68,
      fill:{color:C.offWhite}, line:{color:c.color, pt:1.5}, rectRadius:0.12 });
    s.addShape(pres.ShapeType.roundRect, { x, y, w:6.2, h:0.45,
      fill:{color:c.color}, line:{color:c.color}, rectRadius:0.12 });
    s.addShape(pres.ShapeType.rect, { x, y:y+0.25, w:6.2, h:0.2, fill:{color:c.color}, line:{color:c.color} });
    s.addText(c.title, { x:x+0.1, y:y+0.05, w:6.0, h:0.38,
      fontSize:13, bold:true, color:C.white, fontFace:"Calibri", margin:0 });
    const rows = c.items.map((item, idx) => ({
      text:item, options:{ bullet:true, breakLine: idx<c.items.length-1, fontSize:11.5, color:C.textDark }
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    s.addText(rows, { x:x+0.1, y:y+0.52, w:6.0, h:2.1,
      fontFace:"Calibri", valign:"top", paraSpaceAfter:2, lineSpacingMultiple:1.15, margin:0 });
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 16 — SUMMARY
// ═══════════════════════════════════════════════════════════════════════════
{
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  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  headerBand(s, "Summary & Key Take-Aways", "What Every Medical Student Must Know About GDM");

  const takeaways = [
    { num:"01", text:"GDM = glucose intolerance first diagnosed in pregnancy; affects ~6–8% of pregnancies; usually asymptomatic" },
    { num:"02", text:"Mechanism: physiologic insulin resistance (placental hormones) + insufficient β-cell compensation → hyperglycaemia" },
    { num:"03", text:"Risk factors: obesity, age >30, prior GDM, PCOS, family history of T2DM, high-risk ethnicity" },
    { num:"04", text:"Screen ALL women at 24–28 weeks: two-step (50g GCT → 100g OGTT, USA/ACOG) or one-step (75g OGTT, IADPSG/WHO)" },
    { num:"05", text:"Complications: macrosomia, shoulder dystocia, preeclampsia, neonatal hypoglycaemia, future T2DM in mother & offspring" },
    { num:"06", text:"Treatment: lifestyle first (70–85% success) → insulin if targets not met; metformin as second-line if insulin declined" },
    { num:"07", text:"Glycemic targets: fasting <95, 1-hr PP <140, 2-hr PP <120 mg/dL; monitor with SMBG at minimum 4x/day" },
    { num:"08", text:"Postpartum 75g OGTT at 4–12 weeks; annual screening lifelong; lifestyle intervention reduces future T2DM by ~58%" },
  ];

  takeaways.forEach((t, i) => {
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    s.addShape(pres.ShapeType.roundRect, { x:x+0.08, y:y+0.1, w:0.48, h:0.48,
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    s.addText(t.text, { x:x+0.65, y:y+0.1, w:5.45, h:1.08,
      fontSize:12, color:C.textDark, fontFace:"Calibri", valign:"middle",
      lineSpacingMultiple:1.2, margin:0 });
  });

  s.addText("Sources: Creasy & Resnik MFM 8e  |  Goldman-Cecil Medicine  |  Harrison's Principles 22e  |  Textbook of Family Medicine 9e  |  Barash Clinical Anesthesia 9e", {
    x:0.3, y:7.1, w:12.7, h:0.32,
    fontSize:9.5, color:"6A8BA8", fontFace:"Calibri", align:"center", margin:0 });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 17 — CLOSING / THANK YOU
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x:0, y:0, w:13.3, h:7.5, fill:{color:C.navy}, line:{color:C.navy} });
  s.addShape(pres.ShapeType.rect, { x:0, y:5.8, w:13.3, h:1.7, fill:{color:C.teal}, line:{color:C.teal} });
  s.addShape(pres.ShapeType.rect, { x:0, y:3.6, w:13.3, h:0.07, fill:{color:C.aqua}, line:{color:C.aqua} });

  s.addText("Thank You", { x:0.8, y:0.7, w:11.7, h:1.2,
    fontSize:54, bold:true, color:C.white, fontFace:"Calibri", align:"center", margin:0 });
  s.addText("Gestational Diabetes Mellitus", { x:0.8, y:1.85, w:11.7, h:0.65,
    fontSize:26, color:C.aqua, fontFace:"Calibri", align:"center", margin:0 });
  s.addText("Questions & Discussion", { x:0.8, y:2.55, w:11.7, h:0.5,
    fontSize:18, color:C.light, fontFace:"Calibri", align:"center", margin:0 });

  const refs = [
    "Creasy & Resnik's Maternal-Fetal Medicine: Principles and Practice, 8th Edition",
    "Goldman-Cecil Medicine, International Edition (2-Volume Set)",
    "Harrison's Principles of Internal Medicine, 22nd Edition (2025)",
    "Textbook of Family Medicine, 9th Edition",
    "Barash, Cullen & Stoelting's Clinical Anesthesia, 9th Edition",
    "ADA Standards of Medical Care in Diabetes | ACOG Practice Bulletin No. 190 | IADPSG Consensus 2010",
  ];
  s.addText("References", { x:0.8, y:3.82, w:11.7, h:0.38,
    fontSize:14, bold:true, color:C.aqua, fontFace:"Calibri", align:"center", margin:0 });
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    fontFace:"Calibri", align:"center", lineSpacingMultiple:1.3, margin:0 });

  s.addText("Prepared for Medical Students  |  July 2026", {
    x:0.8, y:6.05, w:11.7, h:0.42,
    fontSize:13, color:C.white, fontFace:"Calibri", align:"center", bold:true, margin:0 });
}

// ─── WRITE FILE ───────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/gdm-ppt/GDM_Presentation.pptx" })
  .then(() => console.log("✅ GDM_Presentation.pptx written successfully"))
  .catch(err => console.error("❌ Error:", err));

Running Command

cd /home/daytona/workspace/gdm-ppt && node gdm.js

Editing File

~/gdm-ppt/gdm.js

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/gdm-ppt/gdm.js'

Running Command

cd /home/daytona/workspace/gdm-ppt && node gdm.js

Running Command

ls -lh /home/daytona/workspace/gdm-ppt/GDM_Presentation.pptx

Your GDM presentation is ready! Here's your download link:

GDM Presentation

Presentation · PPTX

What's Inside (17 Slides)

#	Slide Title
1	Title Slide - with 5 key facts panel
2	Table of Contents - 14 topics listed
3	Definition & Background - WHO/ADA definition, mechanism overview
4	Epidemiology & Prevalence - stats, ethnic variation, rising trends
5	Pathophysiology - flow diagram (placental hormones → insulin resistance → β-cell failure)
6	Risk Factors - maternal, medical history, obstetric, family/ethnic
7	Clinical Features & Complications - maternal + fetal columns
8	Screening - Two-step (ACOG) vs One-step (IADPSG) side-by-side
9	Diagnostic Criteria Table - IADPSG / ADA / ACOG / NDDG / Carpenter-Coustan comparison
10	Glycemic Targets & Monitoring - SMBG targets + insulin dose progression
11	Management - Lifestyle - MNT, exercise, weight management
12	Management - Pharmacological - Insulin (gold standard) vs Metformin vs Glibenclamide
13	Fetal Surveillance & Delivery - antenatal monitoring, timing, mode of delivery, neonatal care
14	Postpartum Care & Long-term Prognosis - 6-week OGTT, T2DM risk, offspring surveillance
15	Prevention & Future Directions - CGM, digital health, gut microbiome, GLP-1 research
16	Summary - 8 key take-aways every student must know
17	Thank You / References

Design: Navy/teal/aqua color palette, dark header bands, card layouts, visual stat boxes, and a comparison table - built for medical students and clinical presentations.

Sources: Creasy & Resnik MFM 8e, Goldman-Cecil Medicine, Harrison's 22e (2025), Textbook of Family Medicine 9e, Barash Clinical Anesthesia 9e.

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