const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Diabetes Mellitus";
pres.author = "Orris Medical AI";

// ─── THEME ───────────────────────────────────────────────────────────────────
const C = {
  navy:      "0A2342",   // dominant dark
  teal:      "1A7A6E",   // supporting accent
  tealLight: "2ABFAA",   // highlights
  amber:     "E8A838",   // sharp accent
  white:     "FFFFFF",
  offWhite:  "F0F4F8",
  lightGray: "D4DCE6",
  midGray:   "6B7D8F",
  darkText:  "1A2B3C",
};

const FONT = "Calibri";

// ─── HELPERS ─────────────────────────────────────────────────────────────────
function darkBg(slide) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.navy } });
}
function lightBg(slide) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.offWhite } });
}
function accentBar(slide, label, y = 0) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y, w: 10, h: 0.08, fill: { color: C.tealLight } });
}
function sectionLabel(slide, text) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.42, fill: { color: C.teal } });
  slide.addText(text.toUpperCase(), {
    x: 0.3, y: 0.04, w: 9.4, h: 0.34, fontSize: 10, bold: true,
    color: C.white, fontFace: FONT, charSpacing: 3, valign: "middle", margin: 0
  });
}
function slideTitle(slide, title, x = 0.45, y = 0.55, w = 9.1) {
  slide.addText(title, {
    x, y, w, h: 0.65, fontSize: 26, bold: true,
    color: C.navy, fontFace: FONT, valign: "middle"
  });
  slide.addShape(pres.ShapeType.rect, { x, y: y + 0.68, w: 1.2, h: 0.05, fill: { color: C.amber } });
}
function footerLine(slide, pageNum) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 5.45, w: 10, h: 0.02, fill: { color: C.lightGray } });
  slide.addText("Diabetes Mellitus  |  Medical Education", {
    x: 0.3, y: 5.46, w: 7, h: 0.16, fontSize: 8, color: C.midGray, fontFace: FONT
  });
  slide.addText(String(pageNum), {
    x: 9.5, y: 5.46, w: 0.4, h: 0.16, fontSize: 8, color: C.midGray, fontFace: FONT, align: "right"
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 1: TITLE
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  // Left accent stripe
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.12, h: 5.625, fill: { color: C.tealLight } });
  // Decorative circle
  s.addShape(pres.ShapeType.ellipse, { x: 6.5, y: -1.2, w: 5.5, h: 5.5, fill: { color: "122A4A" }, line: { color: "122A4A" } });
  s.addShape(pres.ShapeType.ellipse, { x: 7.2, y: -0.5, w: 4.0, h: 4.0, fill: { color: "0D3A60" }, line: { color: "0D3A60" } });

  s.addText("DIABETES", {
    x: 0.6, y: 1.2, w: 8.5, h: 1.1, fontSize: 58, bold: true,
    color: C.white, fontFace: FONT, charSpacing: 8
  });
  s.addText("MELLITUS", {
    x: 0.6, y: 2.15, w: 8.5, h: 1.0, fontSize: 58, bold: true,
    color: C.tealLight, fontFace: FONT, charSpacing: 8
  });
  s.addShape(pres.ShapeType.rect, { x: 0.6, y: 3.2, w: 3.5, h: 0.06, fill: { color: C.amber } });
  s.addText("A Comprehensive Clinical Overview", {
    x: 0.6, y: 3.35, w: 7, h: 0.4, fontSize: 16,
    color: C.lightGray, fontFace: FONT, italic: true
  });
  s.addText("Harrison's Principles of Internal Medicine · Miller's Anesthesia · Rosen's Emergency Medicine", {
    x: 0.6, y: 4.8, w: 9, h: 0.3, fontSize: 8.5,
    color: C.midGray, fontFace: FONT, italic: true
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 2: AGENDA / OUTLINE
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  lightBg(s);
  sectionLabel(s, "Overview");
  slideTitle(s, "Topics Covered");

  const topics = [
    ["01", "Definition & Epidemiology"],
    ["02", "Classification"],
    ["03", "Pathophysiology"],
    ["04", "Clinical Features & Diagnosis"],
    ["05", "Acute Complications"],
    ["06", "Chronic Complications"],
    ["07", "Management & Treatment"],
    ["08", "Prevention & Key Takeaways"],
  ];

  // Two columns
  const col1 = topics.slice(0, 4);
  const col2 = topics.slice(4);
  const startY = 1.5;
  const rowH = 0.72;

  [col1, col2].forEach((col, ci) => {
    col.forEach((item, ri) => {
      const x = ci === 0 ? 0.45 : 5.25;
      const y = startY + ri * rowH;
      // Number badge
      s.addShape(pres.ShapeType.rect, { x, y, w: 0.5, h: 0.45, fill: { color: C.teal }, rectRadius: 0.06 });
      s.addText(item[0], { x, y: y + 0.02, w: 0.5, h: 0.4, fontSize: 13, bold: true, color: C.white, fontFace: FONT, align: "center", valign: "middle" });
      // Topic text
      s.addText(item[1], { x: x + 0.6, y: y + 0.04, w: 4.0, h: 0.38, fontSize: 14, color: C.darkText, fontFace: FONT, valign: "middle" });
    });
  });

  footerLine(s, 2);
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 3: DEFINITION & EPIDEMIOLOGY
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  lightBg(s);
  sectionLabel(s, "Definition & Epidemiology");
  slideTitle(s, "What Is Diabetes Mellitus?");

  // Definition box
  s.addShape(pres.ShapeType.rect, { x: 0.45, y: 1.45, w: 9.1, h: 0.85, fill: { color: C.navy }, rectRadius: 0.1 });
  s.addText("Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Chronic hyperglycemia leads to long-term damage and dysfunction of multiple organs.", {
    x: 0.6, y: 1.5, w: 8.8, h: 0.75, fontSize: 12, color: C.white, fontFace: FONT, valign: "middle"
  });

  // Stats cards
  const cards = [
    { val: "537M+", label: "Adults with Diabetes\nWorldwide (2021)" },
    { val: "5–10%", label: "of cases are\nType 1 DM" },
    { val: "90–95%", label: "of cases are\nType 2 DM" },
    { val: "2040", label: "Projected major\nglobal rise" },
  ];
  cards.forEach((c, i) => {
    const x = 0.45 + i * 2.3;
    s.addShape(pres.ShapeType.rect, { x, y: 2.55, w: 2.1, h: 1.3, fill: { color: C.teal }, rectRadius: 0.1 });
    s.addText(c.val, { x, y: 2.65, w: 2.1, h: 0.5, fontSize: 22, bold: true, color: C.amber, fontFace: FONT, align: "center" });
    s.addText(c.label, { x, y: 3.1, w: 2.1, h: 0.65, fontSize: 11, color: C.white, fontFace: FONT, align: "center", valign: "top" });
  });

  s.addText("Source: IDF Diabetes Atlas; Harrison's Principles of Internal Medicine 22E", {
    x: 0.45, y: 4.95, w: 9.1, h: 0.25, fontSize: 8, color: C.midGray, fontFace: FONT, italic: true
  });
  footerLine(s, 3);
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 4: CLASSIFICATION
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  lightBg(s);
  sectionLabel(s, "Classification");
  slideTitle(s, "Types of Diabetes Mellitus");

  const types = [
    {
      title: "Type 1 DM",
      color: C.navy,
      points: [
        "Autoimmune destruction of beta cells",
        "Absolute insulin deficiency",
        "5–10% of all cases",
        "Onset: childhood / early adulthood",
        "Prone to DKA",
      ]
    },
    {
      title: "Type 2 DM",
      color: C.teal,
      points: [
        "Progressive beta cell dysfunction",
        "Background of insulin resistance",
        "90–95% of all cases",
        "Associated with obesity & metabolic syndrome",
        "Prone to HHS",
      ]
    },
    {
      title: "Gestational DM",
      color: "2E6B9B",
      points: [
        "Diagnosed during pregnancy",
        "Not overt DM prior to gestation",
        "2nd or 3rd trimester",
        "Risk of future T2DM for mother",
        "Managed with diet ± insulin",
      ]
    },
    {
      title: "Other Specific Types",
      color: "4A7B5E",
      points: [
        "Monogenic: MODY, neonatal DM",
        "Exocrine pancreas disease",
        "Drug-induced (glucocorticoids, HIV Rx)",
        "Post-transplant",
        "Endocrinopathies (Cushing's, acromegaly)",
      ]
    },
  ];

  types.forEach((t, i) => {
    const x = 0.45 + i * 2.38;
    s.addShape(pres.ShapeType.rect, { x, y: 1.45, w: 2.2, h: 0.4, fill: { color: t.color }, rectRadius: 0.07 });
    s.addText(t.title, { x, y: 1.5, w: 2.2, h: 0.3, fontSize: 11, bold: true, color: C.white, fontFace: FONT, align: "center", valign: "middle" });
    s.addShape(pres.ShapeType.rect, { x, y: 1.88, w: 2.2, h: 3.2, fill: { color: C.white }, line: { color: C.lightGray, pt: 1 }, rectRadius: 0.07 });
    s.addText(t.points.map(p => ({ text: p, options: { bullet: { indent: 10 }, breakLine: true, fontSize: 10, color: C.darkText, fontFace: FONT } })),
      { x: x + 0.08, y: 1.95, w: 2.05, h: 3.05 });
  });

  footerLine(s, 4);
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 5: PATHOPHYSIOLOGY
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  // Split dark/light background
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 4.8, h: 5.625, fill: { color: C.navy } });
  s.addShape(pres.ShapeType.rect, { x: 4.8, y: 0, w: 5.2, h: 5.625, fill: { color: C.offWhite } });
  sectionLabel(s, "Pathophysiology");

  // Left: T1DM
  s.addText("TYPE 1 DM", {
    x: 0.3, y: 0.55, w: 4.2, h: 0.5, fontSize: 18, bold: true, color: C.tealLight, fontFace: FONT, charSpacing: 2
  });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.0, w: 1.5, h: 0.05, fill: { color: C.amber } });

  const t1Steps = [
    "Genetic susceptibility (HLA loci)",
    "Environmental trigger (enterovirus?)",
    "Autoantibodies form (anti-GAD65, anti-IA2, anti-insulin)",
    "T-cell mediated destruction of beta cells",
    "Progressive loss of insulin secretion",
    "Absolute insulin deficiency → hyperglycemia",
  ];
  s.addText(t1Steps.map((p, i) => ({
    text: `${i + 1}.  ${p}`,
    options: { breakLine: true, fontSize: 11, color: i < 3 ? C.lightGray : C.white, fontFace: FONT, bold: i >= 4 }
  })), { x: 0.3, y: 1.15, w: 4.3, h: 4.0 });

  // Right: T2DM
  s.addText("TYPE 2 DM", {
    x: 5.1, y: 0.55, w: 4.6, h: 0.5, fontSize: 18, bold: true, color: C.navy, fontFace: FONT, charSpacing: 2
  });
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.0, w: 1.5, h: 0.05, fill: { color: C.teal } });

  const t2Steps = [
    "Genetic predisposition + obesity",
    "Peripheral insulin resistance (muscle, liver, fat)",
    "Beta cells compensate with excess insulin",
    "Beta cell exhaustion over time",
    "Relative insulin deficiency",
    "Hyperglycemia + metabolic syndrome",
  ];
  s.addText(t2Steps.map((p, i) => ({
    text: `${i + 1}.  ${p}`,
    options: { breakLine: true, fontSize: 11, color: i < 3 ? C.midGray : C.darkText, fontFace: FONT, bold: i >= 4 }
  })), { x: 5.1, y: 1.15, w: 4.6, h: 4.0 });

  footerLine(s, 5);
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 6: CLINICAL FEATURES & DIAGNOSIS
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  lightBg(s);
  sectionLabel(s, "Clinical Features & Diagnosis");
  slideTitle(s, "Recognizing & Diagnosing Diabetes");

  // Symptoms section
  s.addShape(pres.ShapeType.rect, { x: 0.45, y: 1.5, w: 4.2, h: 0.32, fill: { color: C.teal }, rectRadius: 0.06 });
  s.addText("CLASSIC SYMPTOMS (4 Polys + Weight Loss)", {
    x: 0.55, y: 1.54, w: 4.0, h: 0.24, fontSize: 9.5, bold: true, color: C.white, fontFace: FONT, valign: "middle"
  });

  const symptoms = ["Polyuria (excessive urination)", "Polydipsia (excessive thirst)", "Polyphagia (excessive hunger)", "Polyneuropathy (tingling / numbness)", "Unexplained weight loss", "Blurred vision, fatigue, poor wound healing"];
  s.addText(symptoms.map(p => ({ text: p, options: { bullet: true, breakLine: true, fontSize: 11, color: C.darkText, fontFace: FONT } })),
    { x: 0.55, y: 1.88, w: 4.0, h: 2.5 });

  // Diagnostic Criteria box
  s.addShape(pres.ShapeType.rect, { x: 4.95, y: 1.45, w: 4.6, h: 3.7, fill: { color: C.navy }, rectRadius: 0.12 });
  s.addText("DIAGNOSTIC CRITERIA (ADA)", {
    x: 5.05, y: 1.55, w: 4.4, h: 0.35, fontSize: 11, bold: true, color: C.amber, fontFace: FONT, align: "center", charSpacing: 1
  });

  const criteria = [
    { label: "Random Glucose", val: "> 200 mg/dL + symptoms" },
    { label: "HbA1c", val: "≥ 6.5%" },
    { label: "Fasting Glucose", val: "> 126 mg/dL (8 hr fast)*" },
    { label: "2-hr OGTT", val: "> 200 mg/dL (75 g load)" },
    { label: "Pre-diabetes HbA1c", val: "5.7 – 6.4%" },
    { label: "Impaired Fasting", val: "100 – 125 mg/dL" },
  ];
  criteria.forEach((c, i) => {
    const y = 2.02 + i * 0.51;
    s.addShape(pres.ShapeType.rect, { x: 5.05, y, w: 2.0, h: 0.38, fill: { color: C.teal }, rectRadius: 0.05 });
    s.addText(c.label, { x: 5.1, y: y + 0.04, w: 1.9, h: 0.3, fontSize: 10, bold: true, color: C.white, fontFace: FONT, valign: "middle" });
    s.addText(c.val, { x: 7.1, y: y + 0.04, w: 2.35, h: 0.3, fontSize: 10, color: C.lightGray, fontFace: FONT, valign: "middle" });
  });
  s.addText("* Confirmed by repeat testing", {
    x: 5.05, y: 5.1, w: 4.4, h: 0.2, fontSize: 8, color: C.midGray, fontFace: FONT, italic: true
  });

  footerLine(s, 6);
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 7: ACUTE COMPLICATIONS
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  sectionLabel(s, "Acute Complications");
  s.addText("Acute Complications", {
    x: 0.5, y: 0.55, w: 9, h: 0.7, fontSize: 26, bold: true, color: C.white, fontFace: FONT
  });
  s.addShape(pres.ShapeType.rect, { x: 0.5, y: 1.22, w: 1.2, h: 0.05, fill: { color: C.amber } });

  const comps = [
    {
      title: "Diabetic Ketoacidosis (DKA)",
      badge: "T1DM",
      color: "B23A2E",
      points: [
        "Absolute insulin deficiency",
        "Glucose > 250 mg/dL, ketones ↑, pH < 7.3",
        "Nausea, vomiting, abdominal pain",
        "Kussmaul breathing, fruity breath",
        "Precipitants: infection, missed insulin, MI",
        "Rx: IV fluids, insulin infusion, K⁺ replacement",
      ]
    },
    {
      title: "Hyperosmolar Hyperglycemic State (HHS)",
      badge: "T2DM",
      color: "B27A2E",
      points: [
        "Severe hyperglycemia (> 600 mg/dL)",
        "Hyperosmolarity, no significant ketosis",
        "Altered consciousness, seizures",
        "Associated with acute illness",
        "High mortality rate (~15%)",
        "Rx: Aggressive IV fluids, gradual insulin",
      ]
    },
    {
      title: "Hypoglycemia",
      badge: "Any DM",
      color: "1A7A6E",
      points: [
        "Glucose < 70 mg/dL",
        "Sweating, dizziness, palpitations",
        "Severe: < 54 mg/dL → neuroglycopenia",
        "Headache, confusion, seizure",
        "Hypoglycemic unawareness with recurrence",
        "Rx: 15 g fast carbs or IV dextrose",
      ]
    },
  ];

  comps.forEach((c, i) => {
    const x = 0.3 + i * 3.2;
    s.addShape(pres.ShapeType.rect, { x, y: 1.4, w: 3.05, h: 3.9, fill: { color: "11294A" }, rectRadius: 0.12 });
    s.addShape(pres.ShapeType.rect, { x, y: 1.4, w: 3.05, h: 0.5, fill: { color: c.color }, rectRadius: 0.12 });
    s.addShape(pres.ShapeType.rect, { x, y: 1.7, w: 3.05, h: 0.2, fill: { color: c.color } });
    s.addText(c.title, { x: x + 0.1, y: 1.43, w: 2.4, h: 0.44, fontSize: 10.5, bold: true, color: C.white, fontFace: FONT, valign: "middle" });
    // Badge
    s.addShape(pres.ShapeType.rect, { x: x + 2.35, y: 1.47, w: 0.62, h: 0.28, fill: { color: C.amber }, rectRadius: 0.05 });
    s.addText(c.badge, { x: x + 2.33, y: 1.48, w: 0.66, h: 0.26, fontSize: 8, bold: true, color: C.navy, fontFace: FONT, align: "center", valign: "middle" });
    s.addText(c.points.map(p => ({ text: p, options: { bullet: true, breakLine: true, fontSize: 10, color: C.lightGray, fontFace: FONT } })),
      { x: x + 0.12, y: 2.0, w: 2.8, h: 3.1 });
  });

  footerLine(s, 7);
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 8: CHRONIC COMPLICATIONS
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  lightBg(s);
  sectionLabel(s, "Chronic Complications");
  slideTitle(s, "Long-Term Complications of Diabetes");

  // Microvascular
  s.addShape(pres.ShapeType.rect, { x: 0.45, y: 1.45, w: 4.3, h: 0.35, fill: { color: C.teal }, rectRadius: 0.07 });
  s.addText("MICROVASCULAR (Diabetes-specific)", {
    x: 0.55, y: 1.5, w: 4.1, h: 0.25, fontSize: 10, bold: true, color: C.white, fontFace: FONT, valign: "middle"
  });
  const micro = [
    ["Retinopathy", "Leading cause of blindness in working-age adults; proliferative & non-proliferative forms"],
    ["Nephropathy", "Diabetic kidney disease; leading cause of ESRD; presents as proteinuria → CKD"],
    ["Neuropathy", "Peripheral (glove-stocking), autonomic (gastroparesis, orthostatic hypotension), mononeuropathy"],
  ];
  micro.forEach(([title, desc], i) => {
    const y = 1.92 + i * 0.9;
    s.addShape(pres.ShapeType.rect, { x: 0.45, y, w: 0.08, h: 0.68, fill: { color: C.tealLight } });
    s.addText(title, { x: 0.65, y, w: 4.0, h: 0.3, fontSize: 12, bold: true, color: C.navy, fontFace: FONT });
    s.addText(desc, { x: 0.65, y: y + 0.3, w: 4.0, h: 0.38, fontSize: 10, color: C.midGray, fontFace: FONT });
  });

  // Macrovascular
  s.addShape(pres.ShapeType.rect, { x: 5.0, y: 1.45, w: 4.55, h: 0.35, fill: { color: C.navy }, rectRadius: 0.07 });
  s.addText("MACROVASCULAR (Shared pathophysiology)", {
    x: 5.1, y: 1.5, w: 4.35, h: 0.25, fontSize: 10, bold: true, color: C.white, fontFace: FONT, valign: "middle"
  });
  const macro = [
    ["Atherosclerotic CVD", "2-4x higher ASCVD risk; MI, stroke; correlates with HbA1c and postprandial glucose"],
    ["Peripheral Arterial Disease", "Claudication → critical limb ischemia; major driver of diabetic foot complications"],
    ["Heart Failure", "Both HFrEF and HFpEF; SGLT2 inhibitors have shown benefit in outcome trials"],
  ];
  macro.forEach(([title, desc], i) => {
    const y = 1.92 + i * 0.9;
    s.addShape(pres.ShapeType.rect, { x: 5.0, y, w: 0.08, h: 0.68, fill: { color: C.amber } });
    s.addText(title, { x: 5.2, y, w: 4.2, h: 0.3, fontSize: 12, bold: true, color: C.navy, fontFace: FONT });
    s.addText(desc, { x: 5.2, y: y + 0.3, w: 4.2, h: 0.38, fontSize: 10, color: C.midGray, fontFace: FONT });
  });

  // Non-vascular footer
  s.addShape(pres.ShapeType.rect, { x: 0.45, y: 4.78, w: 9.1, h: 0.38, fill: { color: C.lightGray }, rectRadius: 0.07 });
  s.addText("Non-vascular complications also include: infections, skin changes (necrobiosis lipoidica), cheiroarthropathy, hearing loss, fractures, dementia, cognitive impairment", {
    x: 0.6, y: 4.82, w: 8.8, h: 0.3, fontSize: 9.5, color: C.darkText, fontFace: FONT, valign: "middle"
  });

  footerLine(s, 8);
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 9: MANAGEMENT — NON-PHARMACOLOGICAL
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  lightBg(s);
  sectionLabel(s, "Management");
  slideTitle(s, "Non-Pharmacological Management");

  const pillars = [
    { icon: "🥗", title: "Medical Nutrition Therapy", points: ["Individualized meal planning", "Low glycemic index foods", "Reduce simple sugars & saturated fat", "Mediterranean or DASH diet patterns"] },
    { icon: "🏃", title: "Physical Activity", points: ["150 min/wk moderate aerobic exercise", "Resistance training 2–3x/week", "Reduces HbA1c by ~0.6–1.0%", "Improves insulin sensitivity"] },
    { icon: "⚖️", title: "Weight Management", points: ["5–10% weight loss significantly improves glycemia", "T2DM remission possible with >15 kg loss", "Bariatric surgery for BMI ≥ 35", "Goal: prevent further beta cell decline"] },
    { icon: "📋", title: "Self-Monitoring & Education", points: ["SMBG or continuous glucose monitoring (CGM)", "HbA1c target: < 7.0% for most adults", "Foot care, eye exams, BP control", "Diabetes self-management education (DSME)"] },
  ];

  pillars.forEach((p, i) => {
    const x = 0.45 + i * 2.35;
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    s.addText(p.icon, { x, y: 1.6, w: 2.2, h: 0.55, fontSize: 26, align: "center" });
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// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 10: MANAGEMENT — PHARMACOLOGICAL
// ─────────────────────────────────────────────────────────────────────────────
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  lightBg(s);
  sectionLabel(s, "Pharmacological Management");
  slideTitle(s, "Pharmacotherapy for Type 2 Diabetes");

  const drugs = [
    { name: "Metformin (Biguanide)", color: C.navy, badge: "1st Line", details: "↓ hepatic gluconeogenesis; no weight gain; HbA1c ↓ ~1.5%; avoid if GFR < 30" },
    { name: "Sulfonylureas", color: C.teal, badge: "Add-on", details: "Stimulate pancreatic insulin release (glipizide, glimepiride); risk of hypoglycemia" },
    { name: "DPP-4 Inhibitors", color: "2E6B9B", badge: "Add-on", details: "↓ insulin degradation (sitagliptin); once daily; weight neutral; low hypoglycemia risk" },
    { name: "SGLT2 Inhibitors", color: "4A7B5E", badge: "CV Benefit", details: "Block renal glucose reabsorption (empagliflozin); ↓ HF hospitalization, CKD progression" },
    { name: "GLP-1 Receptor Agonists", color: "7B4A2E", badge: "CV + Weight", details: "Incretin mimetics (semaglutide, liraglutide); significant weight loss; CV & renal benefits" },
    { name: "Insulin", color: "5E2E7B", badge: "T1DM / T2DM", details: "Basal-bolus regimens for T1DM; added to T2DM when oral agents fail; various formulations" },
  ];

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// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 11: INSULIN THERAPY (T1DM focus)
// ─────────────────────────────────────────────────────────────────────────────
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  sectionLabel(s, "Insulin Therapy");
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    ["Intermediate\n(NPH)", "1–3 hr", "4–8 hr", "12–18 hr", "Basal (twice daily)"],
    ["Long-acting\n(Glargine, Detemir)", "1–2 hr", "Flat", "20–24 hr", "Once-daily basal"],
    ["Ultra-long\n(Degludec)", "1 hr", "Peakless", "> 42 hr", "Flexible basal"],
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// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 12: GLYCEMIC TARGETS
// ─────────────────────────────────────────────────────────────────────────────
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  sectionLabel(s, "Glycemic Targets");
  slideTitle(s, "Monitoring & Target Goals (ADA Guidelines)");

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    { metric: "HbA1c", goal: "< 7.0%", note: "Most non-pregnant adults; < 8% for elderly / complex" },
    { metric: "Fasting Blood\nGlucose", goal: "80–130 mg/dL", note: "Pre-meal capillary glucose target" },
    { metric: "Post-prandial\nGlucose (2-hr)", goal: "< 180 mg/dL", note: "Peak postprandial capillary glucose" },
    { metric: "Blood Pressure", goal: "< 130/80 mmHg", note: "ACE inhibitors / ARBs preferred if proteinuria" },
    { metric: "LDL Cholesterol", goal: "< 70 mg/dL", note: "Statin therapy for all T2DM patients > 40 yrs" },
    { metric: "BMI / Weight", goal: "< 25 kg/m²", note: "5–10% weight reduction significantly improves control" },
  ];

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// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 13: PREVENTION
// ─────────────────────────────────────────────────────────────────────────────
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    { num: "01", title: "Lifestyle Modification", body: "The Diabetes Prevention Program (DPP) showed 58% reduction in T2DM incidence with 7% weight loss + 150 min/wk exercise in high-risk individuals." },
    { num: "02", title: "Metformin Prophylaxis", body: "In the DPP trial, metformin reduced T2DM incidence by 31% in adults with pre-diabetes, particularly those with BMI > 35 or history of gestational DM." },
    { num: "03", title: "Screen High-Risk Groups", body: "Screen all adults ≥ 35 yrs; overweight/obese adults; those with hypertension, dyslipidemia, family history, GDM, or PCOS. Repeat every 3 years if normal." },
    { num: "04", title: "Cardiovascular Risk Reduction", body: "Statins, BP control, smoking cessation, and antiplatelet therapy (selected patients) significantly reduce ASCVD events in people with DM." },
  ];

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// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 14: KEY TAKEAWAYS
// ─────────────────────────────────────────────────────────────────────────────
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  sectionLabel(s, "Summary");
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  const takeaways = [
    "Diabetes mellitus is defined by chronic hyperglycemia from defects in insulin secretion, action, or both — affecting over 537 million adults worldwide.",
    "T1DM is autoimmune (absolute insulin deficiency); T2DM involves insulin resistance with progressive beta cell failure; both share similar long-term complications.",
    "Diagnosis requires meeting one ADA criterion: HbA1c ≥ 6.5%, fasting glucose > 126, 2-hr OGTT > 200, or random glucose > 200 with symptoms.",
    "Microvascular complications (retinopathy, nephropathy, neuropathy) are diabetes-specific; macrovascular complications (ASCVD, PAD, HF) carry higher mortality.",
    "Glycemic targets: HbA1c < 7% for most adults; achieved through lifestyle, metformin as first-line, and add-on agents (SGLT2i/GLP-1 RA for CV/renal benefit).",
    "Prevention works: 7% weight loss + 150 min/wk exercise reduces T2DM incidence by 58% in high-risk individuals (DPP Trial).",
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// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 15: REFERENCES
// ─────────────────────────────────────────────────────────────────────────────
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  lightBg(s);
  sectionLabel(s, "References");
  slideTitle(s, "Sources & Further Reading");

  const refs = [
    "Harrison's Principles of Internal Medicine, 22nd Edition (2025) — Chapter 417: Diabetes Mellitus",
    "Miller's Anesthesia, 10th Edition (2022) — Chapter on Perioperative Diabetes Management",
    "Rosen's Emergency Medicine, 9th Edition — Chapter 115: Diabetes Mellitus & Hypoglycemic Emergencies",
    "Creasy & Resnik's Maternal-Fetal Medicine — Classification of Diabetes in Pregnancy",
    "Goodman & Gilman's Pharmacological Basis of Therapeutics — Chapter on Antidiabetic Drugs",
    "American Diabetes Association: Standards of Medical Care in Diabetes — Diabetes Care (Annual Supplement)",
    "DCCT Research Group: Effect of Intensive Therapy on Diabetic Complications. NEJM 1993.",
    "DPP Research Group: Reduction in the Incidence of T2DM with Lifestyle Intervention or Metformin. NEJM 2002.",
  ];

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// ─────────────────────────────────────────────────────────────────────────────
// WRITE FILE
// ─────────────────────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/diabetes-ppt/Diabetes_Mellitus.pptx" })
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  .catch(e => { console.error("❌ Error:", e); process.exit(1); });