Create a PowerPoint presentation for Section 1: Essential Physiology (Slides 2-5) Slide 2: Normal Glucose Homeostasis • Blood glucose maintained ~4-6 mmol/L (70-110 mg/dL) fasting • Sources: Dietary carbohydrates, hepatic gluconeogenesis/glycogenolysis • Key hormones: Insulin (lowers), Glucagon (raises) • Other: Cortisol, catecholamines, growth hormone (counter-regulatory) Slide 3: Role of Insulin • Produced by pancreatic beta cells • Actions: o Promotes glucose uptake (GLUT4 in muscle/adipose) o Glycogen synthesis (liver/muscle) o Inhibits lipolysis and gluconeogenesis • Anabolic hormone Slide 4: Role of Glucagon • Produced by pancreatic alpha cells • Actions: o Stimulates glycogenolysis and gluconeogenesis in liver o Promotes ketogenesis in prolonged fasting • Released in response to low blood glucose Slide 5: Pancreatic Islets and Regulation • Diagram of islets of Langerhans (beta, alpha cells) • Feedback loop: High glucose → insulin release; Low glucose → glucagon release • Postprandial vs. fasting states Section 2: Definitions and Classification (Slides 6-8) Slide 6: Definition of Diabetes Mellitus • Group of metabolic disorders characterized by chronic hyperglycemia due to defects in insulin secretion, insulin action, or both • Leads to disturbances in carbohydrate, fat, and protein metabolism Slide 7: Main Types of Diabetes • Type 1 DM (5-10%): Autoimmune beta-cell destruction → absolute insulin deficiency • Type 2 DM (90-95%): Insulin resistance + relative insulin deficiency • Gestational DM • Other: MODY, secondary (steroids, pancreatitis, etc.), prediabetes Slide 8: Diagnostic Criteria • Fasting plasma glucose ≥7.0 mmol/L (126 mg/dL) • 2h OGTT ≥11.1 mmol/L (200 mg/dL) • HbA1c ≥6.5% (48 mmol/mol) • Random glucose ≥11.1 mmol/L + symptoms • (Note: Confirm with repeat test unless symptomatic) Section 3: Pathophysiology (Slides 9-13) Slide 9: Pathophysiology of Type 1 DM • Autoimmune destruction of beta cells (T-cell mediated) • Genetic predisposition (HLA) + environmental triggers (viruses?) • Absolute insulin deficiency → hyperglycemia, lipolysis, ketogenesis Slide 10: Pathophysiology of Type 2 DM • Insulin resistance (muscle, liver, adipose) • Compensatory hyperinsulinemia initially • Progressive beta-cell dysfunction/failure • Contributing factors: Obesity, visceral fat, inflammation, genetics Slide 11: Hyperglycemia Consequences • Osmotic diuresis (polyuria, polydipsia, dehydration) • Glycosuria • Long-term: Advanced glycation end-products (AGEs), oxidative stress, vascular damage Slide 12-13: Flowcharts • One for T1DM, one for T2DM progression Section 4: Clinical Features and Natural History (Slides 14-18) Slide 14: Classic Symptoms of Hyperglycemia • Polyuria, polydipsia, polyphagia • Weight loss (especially T1) • Fatigue, blurred vision, recurrent infections • Slow-healing wounds Slide 15: Natural History of Type 1 DM • Rapid onset (weeks) • Often presents with DKA in children/young adults • Lifelong insulin dependence Slide 16: Natural History of Type 2 DM • Insidious onset (years) • Often diagnosed incidentally • Prediabetes phase → overt diabetes → complications • Strongly associated with obesity/metabolic syndrome Slide 17-18: Chronic Complications • Microvascular: Retinopathy, nephropathy, neuropathy • Macrovascular: CAD, stroke, peripheral artery disease • Others: Diabetic foot, infections, skin changes • Timeline graphic showing progression with poor control Section 5: Investigations (Slides 19-21) Slide 19: Diagnostic & Monitoring Tests • Blood glucose (fasting/random) • HbA1c (glycated hemoglobin) – reflects 2-3 months • OGTT • C-peptide/insulin levels (to differentiate T1 vs T2) • Autoantibodies (GAD, islet cell) for T1 Slide 20: Screening for Complications • Eye exam (fundoscopy/retinopathy screening) • Urine ACR (albumin-creatinine ratio) • eGFR/renal function • Lipid profile, ECG/foot exam • Neuropathy assessment Slide 21: Other Labs • Electrolytes, ketones (in illness), arterial blood gas Section 6: Management (Slides 22-28) Slide 22: General Principles • Patient education, lifestyle modification (diet, exercise, weight loss) • Glycemic targets (individualized, e.g., HbA1c <7%) • Multidisciplinary care: Dietitian, educator, podiatrist, etc. • Cardiovascular risk reduction (BP, lipids, smoking) Slide 23: Type 1 DM Management • Insulin therapy (basal-bolus, pump) • Carbohydrate counting, self-monitoring/CGM • Sick day rules Slide 24: Type 2 DM Management • Lifestyle first • Metformin (first-line) • Other orals: SGLT2i, GLP-1RA, sulfonylureas, DPP4i • Insulin if needed • Note benefits of SGLT2i/GLP-1 for CV/renal protection Slide 25: Monitoring and Follow-up • Regular HbA1c, self-monitoring • Annual complication screening Section 7: Diabetic Emergencies (Slides 26-34) Slide 26: Overview of Emergencies • Hyperglycemic: DKA, HHS • Hypoglycemia • Others: Hyperosmolar hyperglycemic state, lactic acidosis Slide 27: Diabetic Ketoacidosis (DKA) • Triad: Hyperglycemia (>11-13.9 mmol/L), ketonemia/acidosis (pH<7.3, bicarb<15), anion gap • Mostly T1DM (can occur in T2) • Precipitants: Infection, insulin omission, illness Slide 28: DKA Clinical Features • Polyuria/polydipsia, nausea/vomiting, abdominal pain • Kussmaul breathing, fruity breath (acetone) • Dehydration, altered mental status/coma Slide 29: HHS (Hyperosmolar Hyperglycemic State) • Severe hyperglycemia (>33 mmol/L), hyperosmolality (>320 mOsm), profound dehydration • Minimal/no ketoacidosis • Mostly elderly T2DM, insidious onset (days-weeks) • Higher mortality than DKA Slide 30: Hypoglycemia • Blood glucose <4 mmol/L (or <3.9 with symptoms) • Causes: Excess insulin/meds, missed meals, exercise • Symptoms: Adrenergic (sweating, tremor) + neuroglycopenic (confusion, seizure) Slide 31-32: Management of DKA/HHS • ABC, fluids (normal saline initially), insulin (after K+ check), electrolytes (esp. potassium), treat precipitant • Monitoring: Hourly glucose, electrolytes, gap closure • Key differences table (DKA vs HHS) Slide 33: Hypoglycemia Management • Conscious: Oral carbs (15g) • Unconscious: IV dextrose or IM glucagon • Prevent recurrence Slide 34: Prevention of Emergencies • Education, sick day rules, access to supplies, regular follow-up Conclusion & References (Slides 35-36) • Summary key points • Importance of early diagnosis, tight control, and education • References (ADA, NICE, or key sources) • Q&A slide Additional Tips for Creation: • Use simple diagrams (glucose regulation loop, DKA pathway). • Include tables for comparisons (DKA vs HHS, T1 vs T2). • Add high-yield images: Fundus photo of retinopathy, foot ulcer (with sensitivity). • Total timing: 30-45 minutes presentation. • Sources: Base on guidelines (e.g., ADA, WHO) for accuracy.
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Give me the script
Here is the complete PptxGenJS script for the full 36-slide Diabetes Mellitus presentation:
// Diabetes Mellitus Presentation
// Run: node diabetes.js
// Requires: npm install pptxgenjs (or use pre-installed version)
const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Diabetes Mellitus: Physiology, Pathophysiology & Management";
pres.author = "Medical Education";
// ─── THEME COLORS ───────────────────────────────────────────────────────────
const C = {
navy: "0A2342", // dominant background
teal: "00848E", // accent headers
cyan: "00C9D7", // highlight / bullets
white: "FFFFFF",
light: "E8F6F7", // light card bg
gray: "B0BEC5",
red: "E53935",
amber: "FFB300",
green: "2E7D32",
darkTeal:"006670",
muted: "CFD8DC",
charcoal:"1C3A4A",
};
// ─── MASTER HELPERS ──────────────────────────────────────────────────────────
/** Full-bleed navy background */
function navyBg(slide) {
slide.addShape(pres.shapes.RECTANGLE, {
x: 0, y: 0, w: 10, h: 5.625,
fill: { color: C.navy }, line: { color: C.navy },
});
}
/** Teal accent bar at top (under a header area) */
function topBar(slide, color = C.teal) {
slide.addShape(pres.shapes.RECTANGLE, {
x: 0, y: 0, w: 10, h: 0.08,
fill: { color: color }, line: { color: color },
});
}
/** Bottom footer strip */
function footer(slide, label = "") {
slide.addShape(pres.shapes.RECTANGLE, {
x: 0, y: 5.35, w: 10, h: 0.27,
fill: { color: C.teal }, line: { color: C.teal },
});
if (label) {
slide.addText(label, {
x: 0.2, y: 5.35, w: 9.6, h: 0.27,
fontSize: 9, color: C.white, valign: "middle", align: "left",
bold: false, margin: 0,
});
}
}
/** Standard content slide shell: navy bg + teal accent + title */
function contentShell(slide, title, footerLabel = "Diabetes Mellitus | Medical Education") {
navyBg(slide);
// left accent bar
slide.addShape(pres.shapes.RECTANGLE, {
x: 0, y: 0, w: 0.07, h: 5.625,
fill: { color: C.cyan }, line: { color: C.cyan },
});
// Title band
slide.addShape(pres.shapes.RECTANGLE, {
x: 0.07, y: 0, w: 9.93, h: 0.82,
fill: { color: C.charcoal }, line: { color: C.charcoal },
});
slide.addText(title, {
x: 0.25, y: 0, w: 9.5, h: 0.82,
fontSize: 22, bold: true, color: C.cyan,
valign: "middle", align: "left", margin: 0,
});
footer(slide, footerLabel);
}
/** Bullet list helper — returns pptxgen text array */
function bullets(items, fontSize = 14, color = C.white, indent = false) {
return items.map((item, i) => ({
text: item,
options: {
bullet: { code: indent ? "2013" : "25CF", color: C.cyan },
fontSize,
color,
breakLine: i < items.length - 1,
indentLevel: indent ? 1 : 0,
},
}));
}
/** Section divider slide */
function sectionDivider(title, subtitle, sectionNum) {
const slide = pres.addSlide();
navyBg(slide);
// Large teal rectangle left panel
slide.addShape(pres.shapes.RECTANGLE, {
x: 0, y: 0, w: 3.5, h: 5.625,
fill: { color: C.teal }, line: { color: C.teal },
});
slide.addText(`SECTION\n${sectionNum}`, {
x: 0, y: 1.5, w: 3.5, h: 2,
fontSize: 38, bold: true, color: C.white,
align: "center", valign: "middle", margin: 0,
});
slide.addText(title, {
x: 3.8, y: 1.5, w: 5.8, h: 1.2,
fontSize: 28, bold: true, color: C.cyan,
align: "left", valign: "bottom", margin: 0,
});
slide.addText(subtitle, {
x: 3.8, y: 2.75, w: 5.8, h: 1.5,
fontSize: 14, color: C.muted,
align: "left", valign: "top", margin: 0,
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE SLIDE
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
navyBg(slide);
// Cyan diagonal accent shape (top-right)
slide.addShape(pres.shapes.RIGHT_TRIANGLE, {
x: 7, y: 0, w: 3, h: 2.5,
fill: { color: C.teal }, line: { color: C.teal },
flipH: true,
});
// Bottom teal bar
slide.addShape(pres.shapes.RECTANGLE, {
x: 0, y: 4.9, w: 10, h: 0.725,
fill: { color: C.teal }, line: { color: C.teal },
});
slide.addText("DIABETES MELLITUS", {
x: 0.5, y: 0.9, w: 9, h: 1.0,
fontSize: 40, bold: true, color: C.cyan,
align: "center", charSpacing: 4, margin: 0,
});
slide.addText("Physiology, Pathophysiology, Classification\nClinical Features & Management", {
x: 0.5, y: 2.0, w: 9, h: 1.1,
fontSize: 18, color: C.white, align: "center",
italic: false, margin: 0,
});
slide.addText("Based on ADA, WHO & NICE Guidelines", {
x: 0.5, y: 3.2, w: 9, h: 0.5,
fontSize: 12, color: C.gray, align: "center", italic: true, margin: 0,
});
slide.addText("Medical Education | 2026", {
x: 0, y: 4.9, w: 10, h: 0.725,
fontSize: 13, color: C.white, align: "center", valign: "middle", bold: true, margin: 0,
});
}
// ════════════════════════════════════════════════════════════════════════════
// SECTION 1 DIVIDER — Essential Physiology
// ════════════════════════════════════════════════════════════════════════════
sectionDivider("Essential Physiology", "Normal glucose homeostasis, insulin, glucagon\nand pancreatic regulation", "1");
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 2 — Normal Glucose Homeostasis
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Normal Glucose Homeostasis");
// Two columns
// Left column — bullets
slide.addText([
...bullets(["Blood glucose maintained ~4–6 mmol/L (70–110 mg/dL) fasting"], 14),
], { x: 0.25, y: 0.95, w: 4.7, h: 0.55, margin: 0 });
// Sources card
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 1.6, w: 4.5, h: 1.1,
fill: { color: C.charcoal }, line: { color: C.teal }, rectRadius: 0.08,
});
slide.addText("GLUCOSE SOURCES", {
x: 0.35, y: 1.65, w: 4.1, h: 0.3,
fontSize: 10, bold: true, color: C.cyan, margin: 0,
});
slide.addText([
...bullets(["Dietary carbohydrates", "Hepatic gluconeogenesis", "Hepatic glycogenolysis"], 13),
], { x: 0.35, y: 1.93, w: 4.1, h: 0.7, margin: 0 });
// Key hormones card
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 2.8, w: 4.5, h: 1.25,
fill: { color: C.charcoal }, line: { color: C.amber }, rectRadius: 0.08,
});
slide.addText("KEY HORMONES", {
x: 0.35, y: 2.85, w: 4.1, h: 0.3,
fontSize: 10, bold: true, color: C.amber, margin: 0,
});
slide.addText([
{ text: "Insulin", options: { bold: true, color: C.cyan, fontSize: 13, breakLine: false } },
{ text: " — lowers blood glucose", options: { color: C.white, fontSize: 13, breakLine: true } },
{ text: "Glucagon", options: { bold: true, color: C.amber, fontSize: 13, breakLine: false } },
{ text: " — raises blood glucose", options: { color: C.white, fontSize: 13, breakLine: true } },
{ text: "Counter-regulatory: ", options: { bold: true, color: C.gray, fontSize: 12, breakLine: false } },
{ text: "Cortisol, catecholamines, GH", options: { color: C.muted, fontSize: 12 } },
], { x: 0.35, y: 3.13, w: 4.1, h: 0.85, margin: 0 });
// Right — Glucose loop diagram (drawn shapes)
// Circle: hyperglycemia
slide.addShape(pres.shapes.OVAL, {
x: 5.5, y: 1.0, w: 1.9, h: 0.7,
fill: { color: C.red }, line: { color: C.red },
});
slide.addText("High Glucose", { x: 5.5, y: 1.0, w: 1.9, h: 0.7, fontSize: 10, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
// Arrow down → insulin released
slide.addShape(pres.shapes.RECTANGLE, { x: 6.3, y: 1.72, w: 0.08, h: 0.5, fill: { color: C.cyan }, line: { color: C.cyan } });
slide.addText("▼ Insulin released", { x: 5.5, y: 2.15, w: 1.9, h: 0.35, fontSize: 9, color: C.cyan, align: "center", margin: 0 });
// Circle: normoglycemia
slide.addShape(pres.shapes.OVAL, {
x: 5.5, y: 2.55, w: 1.9, h: 0.7,
fill: { color: C.green }, line: { color: C.green },
});
slide.addText("Normoglycemia\n4–6 mmol/L", { x: 5.5, y: 2.55, w: 1.9, h: 0.7, fontSize: 9, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
// Arrow down → glucagon released
slide.addShape(pres.shapes.RECTANGLE, { x: 6.3, y: 3.27, w: 0.08, h: 0.5, fill: { color: C.amber }, line: { color: C.amber } });
slide.addText("▼ Glucagon released", { x: 5.5, y: 3.7, w: 1.9, h: 0.35, fontSize: 9, color: C.amber, align: "center", margin: 0 });
// Circle: hypoglycemia
slide.addShape(pres.shapes.OVAL, {
x: 5.5, y: 4.1, w: 1.9, h: 0.7,
fill: { color: C.darkTeal }, line: { color: C.darkTeal },
});
slide.addText("Low Glucose", { x: 5.5, y: 4.1, w: 1.9, h: 0.7, fontSize: 10, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
// Connecting label
slide.addText("Feedback Loop", { x: 7.6, y: 2.6, w: 2, h: 0.4, fontSize: 11, bold: true, color: C.teal, align: "center", margin: 0 });
slide.addShape(pres.shapes.RECTANGLE, { x: 7.55, y: 3.0, w: 0.08, h: 0.08, fill: { color: C.teal }, line: { color: C.teal } });
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 3 — Role of Insulin
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Role of Insulin");
// Source pill
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 0.92, w: 3.2, h: 0.42,
fill: { color: C.teal }, line: { color: C.teal }, rectRadius: 0.15,
});
slide.addText("Produced by Pancreatic β-cells", {
x: 0.2, y: 0.92, w: 3.2, h: 0.42,
fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 0,
});
// Actions header
slide.addText("ACTIONS OF INSULIN", {
x: 0.25, y: 1.5, w: 9, h: 0.35,
fontSize: 13, bold: true, color: C.cyan, margin: 0,
});
// Three action cards
const actions = [
{ title: "Glucose Uptake", body: "Promotes glucose uptake via\nGLUT4 transporters in muscle\nand adipose tissue", color: C.teal },
{ title: "Glycogen Synthesis", body: "Stimulates glycogen storage\nin liver and muscle;\nsuppresses gluconeogenesis", color: C.darkTeal },
{ title: "Anti-Lipolytic", body: "Inhibits lipolysis in adipose;\nprevents free fatty acid\nrelease and ketogenesis", color: C.charcoal },
];
actions.forEach((a, i) => {
const x = 0.2 + i * 3.2;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 1.95, w: 3.0, h: 2.3,
fill: { color: a.color }, line: { color: C.cyan }, rectRadius: 0.1,
});
slide.addText(a.title, {
x, y: 2.0, w: 3.0, h: 0.45,
fontSize: 13, bold: true, color: C.cyan, align: "center", valign: "middle", margin: 0,
});
slide.addShape(pres.shapes.RECTANGLE, {
x: x + 0.5, y: 2.46, w: 2.0, h: 0.04,
fill: { color: C.cyan }, line: { color: C.cyan },
});
slide.addText(a.body, {
x, y: 2.55, w: 3.0, h: 1.55,
fontSize: 12, color: C.white, align: "center", valign: "top", margin: 0,
});
});
// Anabolic banner
slide.addShape(pres.shapes.RECTANGLE, {
x: 0.2, y: 4.45, w: 9.5, h: 0.55,
fill: { color: C.green }, line: { color: C.green },
});
slide.addText("★ ANABOLIC HORMONE — promotes energy storage; major driver of nutrient metabolism", {
x: 0.2, y: 4.45, w: 9.5, h: 0.55,
fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0,
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 4 — Role of Glucagon
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Role of Glucagon");
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 0.92, w: 3.2, h: 0.42,
fill: { color: C.amber }, line: { color: C.amber }, rectRadius: 0.15,
});
slide.addText("Produced by Pancreatic α-cells", {
x: 0.2, y: 0.92, w: 3.2, h: 0.42,
fontSize: 11, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0,
});
slide.addText("ACTIONS OF GLUCAGON", {
x: 0.25, y: 1.5, w: 9, h: 0.35,
fontSize: 13, bold: true, color: C.amber, margin: 0,
});
const gActions = [
{ title: "Glycogenolysis", body: "Breaks down hepatic glycogen\nto release glucose into\nthe bloodstream", color: C.charcoal },
{ title: "Gluconeogenesis", body: "Stimulates new glucose\nsynthesis from amino acids\nand lactate in liver", color: C.darkTeal },
{ title: "Ketogenesis", body: "Promotes ketone body\nproduction during\nprolonged fasting", color: C.charcoal },
];
gActions.forEach((a, i) => {
const x = 0.2 + i * 3.2;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 1.95, w: 3.0, h: 2.2,
fill: { color: a.color }, line: { color: C.amber }, rectRadius: 0.1,
});
slide.addText(a.title, {
x, y: 2.0, w: 3.0, h: 0.45,
fontSize: 13, bold: true, color: C.amber, align: "center", valign: "middle", margin: 0,
});
slide.addShape(pres.shapes.RECTANGLE, {
x: x + 0.5, y: 2.46, w: 2.0, h: 0.04,
fill: { color: C.amber }, line: { color: C.amber },
});
slide.addText(a.body, {
x, y: 2.55, w: 3.0, h: 1.5,
fontSize: 12, color: C.white, align: "center", valign: "top", margin: 0,
});
});
// Trigger banner
slide.addShape(pres.shapes.RECTANGLE, {
x: 0.2, y: 4.4, w: 9.5, h: 0.55,
fill: { color: C.amber }, line: { color: C.amber },
});
slide.addText("Released in response to LOW blood glucose | Opposes insulin action | Catabolic hormone", {
x: 0.2, y: 4.4, w: 9.5, h: 0.55,
fontSize: 12, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0,
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 5 — Pancreatic Islets & Regulation
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Pancreatic Islets & Regulation");
// Left: islet diagram (drawn)
slide.addShape(pres.shapes.OVAL, {
x: 0.3, y: 0.95, w: 4.2, h: 3.0,
fill: { color: C.charcoal }, line: { color: C.cyan, pt: 2 },
});
slide.addText("Islet of\nLangerhans", { x: 0.3, y: 1.05, w: 4.2, h: 0.6, fontSize: 11, bold: true, color: C.cyan, align: "center", margin: 0 });
// β-cell circles
[{ x: 1.0, y: 1.75 }, { x: 1.9, y: 1.7 }, { x: 2.8, y: 1.75 }, { x: 1.45, y: 2.4 }, { x: 2.35, y: 2.4 }].forEach(p => {
slide.addShape(pres.shapes.OVAL, { x: p.x, y: p.y, w: 0.6, h: 0.6, fill: { color: C.teal }, line: { color: C.white } });
slide.addText("β", { x: p.x, y: p.y, w: 0.6, h: 0.6, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
});
// α-cell circles (peripheral)
[{ x: 0.55, y: 2.55 }, { x: 3.35, y: 2.55 }, { x: 1.0, y: 3.15 }, { x: 2.75, y: 3.15 }].forEach(p => {
slide.addShape(pres.shapes.OVAL, { x: p.x, y: p.y, w: 0.6, h: 0.6, fill: { color: C.amber }, line: { color: C.white } });
slide.addText("α", { x: p.x, y: p.y, w: 0.6, h: 0.6, fontSize: 11, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0 });
});
// Legend
slide.addShape(pres.shapes.OVAL, { x: 0.4, y: 4.1, w: 0.3, h: 0.3, fill: { color: C.teal }, line: { color: C.white } });
slide.addText("β-cells: Insulin", { x: 0.75, y: 4.1, w: 1.8, h: 0.3, fontSize: 11, color: C.teal, margin: 0 });
slide.addShape(pres.shapes.OVAL, { x: 2.7, y: 4.1, w: 0.3, h: 0.3, fill: { color: C.amber }, line: { color: C.white } });
slide.addText("α-cells: Glucagon", { x: 3.05, y: 4.1, w: 1.8, h: 0.3, fontSize: 11, color: C.amber, margin: 0 });
// Right: feedback table
const rows = [
["State", "Glucose", "Dominant Hormone", "Effect"],
["Postprandial", "High ↑", "Insulin (β-cells)", "Uptake, storage"],
["Fasting", "Low ↓", "Glucagon (α-cells)", "Release, synthesis"],
["Exercise/Stress", "Variable", "Catecholamines, GH", "Counter-regulatory"],
];
slide.addTable(rows, {
x: 4.7, y: 0.92, w: 5.0, h: 2.8,
fontSize: 10,
color: C.white,
fill: { color: C.navy },
border: { type: "solid", color: C.teal, pt: 1 },
rowH: 0.55,
fontFace: "Calibri",
align: "center",
valign: "middle",
colW: [1.2, 0.9, 1.6, 1.3],
});
// Feedback note
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 4.7, y: 3.85, w: 5.0, h: 1.15,
fill: { color: C.charcoal }, line: { color: C.cyan }, rectRadius: 0.08,
});
slide.addText([
{ text: "Feedback Principle: ", options: { bold: true, color: C.cyan, fontSize: 12, breakLine: false } },
{ text: "Glucose sensors in pancreatic islets detect blood glucose changes and adjust hormone secretion in a tight negative feedback loop to maintain euglycemia.", options: { color: C.white, fontSize: 11 } },
], { x: 4.85, y: 3.9, w: 4.7, h: 1.05, margin: 0, valign: "middle" });
}
// ════════════════════════════════════════════════════════════════════════════
// SECTION 2 DIVIDER — Definitions & Classification
// ════════════════════════════════════════════════════════════════════════════
sectionDivider("Definitions & Classification", "Definition of diabetes, types, and diagnostic criteria", "2");
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 6 — Definition of Diabetes Mellitus
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Definition of Diabetes Mellitus");
// Large definition card
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.3, y: 0.95, w: 9.3, h: 1.7,
fill: { color: C.charcoal }, line: { color: C.cyan, pt: 2 }, rectRadius: 0.1,
});
slide.addText([
{ text: "Diabetes Mellitus", options: { bold: true, color: C.cyan, fontSize: 17, breakLine: true } },
{ text: "A group of metabolic disorders characterised by ", options: { color: C.white, fontSize: 14, breakLine: false } },
{ text: "chronic hyperglycaemia", options: { bold: true, color: C.amber, fontSize: 14, breakLine: false } },
{ text: " due to defects in insulin secretion, insulin action, or both.", options: { color: C.white, fontSize: 14 } },
], { x: 0.5, y: 0.98, w: 9.0, h: 1.6, valign: "middle", margin: 0 });
// Consequences row
slide.addText("METABOLIC CONSEQUENCES", {
x: 0.3, y: 2.8, w: 9, h: 0.35,
fontSize: 12, bold: true, color: C.teal, margin: 0,
});
const consequences = [
{ icon: "🍬", title: "Carbohydrate", body: "Impaired glucose uptake\nand utilisation" },
{ icon: "🧈", title: "Fat", body: "Increased lipolysis,\nketogenesis, dyslipidaemia" },
{ icon: "🥩", title: "Protein", body: "Catabolism, impaired\nwound healing, muscle loss" },
];
consequences.forEach((c, i) => {
const x = 0.3 + i * 3.15;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 3.2, w: 3.0, h: 1.75,
fill: { color: C.charcoal }, line: { color: C.teal }, rectRadius: 0.1,
});
slide.addText(c.icon + " " + c.title + " Metabolism", {
x, y: 3.25, w: 3.0, h: 0.45,
fontSize: 12, bold: true, color: C.cyan, align: "center", margin: 0,
});
slide.addText(c.body, {
x, y: 3.72, w: 3.0, h: 1.1,
fontSize: 12, color: C.white, align: "center", valign: "top", margin: 0,
});
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 7 — Main Types of Diabetes
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Main Types of Diabetes");
const types = [
{ label: "Type 1 DM", pct: "5–10%", desc: "Autoimmune β-cell\ndestruction → absolute\ninsulin deficiency", color: C.red },
{ label: "Type 2 DM", pct: "90–95%", desc: "Insulin resistance +\nrelative insulin deficiency;\nstrongly linked to obesity", color: C.teal },
{ label: "Gestational\nDM", pct: "~7–10%*", desc: "Glucose intolerance first\ndetected during pregnancy;\nresolves postpartum", color: C.amber },
{ label: "Other Types", pct: "Rare", desc: "MODY, steroid-induced,\npancreatitis, secondary\ncauses, prediabetes", color: C.darkTeal },
];
types.forEach((t, i) => {
const x = 0.2 + i * 2.4;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 0.9, w: 2.25, h: 4.1,
fill: { color: C.charcoal }, line: { color: t.color, pt: 2 }, rectRadius: 0.1,
});
// Color header
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 0.9, w: 2.25, h: 0.8,
fill: { color: t.color }, line: { color: t.color }, rectRadius: 0.1,
});
slide.addText(t.label, {
x, y: 0.9, w: 2.25, h: 0.8,
fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0,
});
// Percentage badge
slide.addShape(pres.shapes.OVAL, {
x: x + 0.6, y: 1.77, w: 1.05, h: 0.55,
fill: { color: C.navy }, line: { color: t.color },
});
slide.addText(t.pct, {
x: x + 0.6, y: 1.77, w: 1.05, h: 0.55,
fontSize: 10, bold: true, color: t.color, align: "center", valign: "middle", margin: 0,
});
slide.addText(t.desc, {
x, y: 2.42, w: 2.25, h: 2.3,
fontSize: 11, color: C.white, align: "center", valign: "top", margin: 4,
});
});
slide.addText("* Gestational DM prevalence varies by population and diagnostic criteria", {
x: 0.2, y: 5.05, w: 9.5, h: 0.25,
fontSize: 9, color: C.gray, italic: true, margin: 0,
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 8 — Diagnostic Criteria
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Diagnostic Criteria for Diabetes");
const criteria = [
{ test: "Fasting Plasma Glucose", threshold: "≥7.0 mmol/L", alt: "(≥126 mg/dL)", note: "No caloric intake ≥8h" },
{ test: "2h OGTT Glucose", threshold: "≥11.1 mmol/L", alt: "(≥200 mg/dL)", note: "75g glucose load" },
{ test: "HbA1c", threshold: "≥6.5%", alt: "(≥48 mmol/mol)", note: "Reflects 2–3 month avg" },
{ test: "Random Glucose + Symptoms", threshold: "≥11.1 mmol/L", alt: "(≥200 mg/dL)", note: "Classic symptoms required" },
];
criteria.forEach((c, i) => {
const y = 0.95 + i * 0.98;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y, w: 9.4, h: 0.85,
fill: { color: C.charcoal }, line: { color: C.teal }, rectRadius: 0.07,
});
// Number badge
slide.addShape(pres.shapes.OVAL, {
x: 0.28, y: y + 0.13, w: 0.58, h: 0.58,
fill: { color: C.teal }, line: { color: C.teal },
});
slide.addText(`${i + 1}`, {
x: 0.28, y: y + 0.13, w: 0.58, h: 0.58,
fontSize: 14, bold: true, color: C.white, align: "center", valign: "middle", margin: 0,
});
slide.addText(c.test, {
x: 1.0, y: y + 0.03, w: 3.8, h: 0.43,
fontSize: 13, bold: true, color: C.white, valign: "bottom", margin: 0,
});
slide.addText(c.note, {
x: 1.0, y: y + 0.47, w: 3.8, h: 0.33,
fontSize: 10, color: C.gray, valign: "top", italic: true, margin: 0,
});
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 5.2, y: y + 0.1, w: 2.5, h: 0.62,
fill: { color: C.red }, line: { color: C.red }, rectRadius: 0.08,
});
slide.addText(c.threshold, {
x: 5.2, y: y + 0.1, w: 2.5, h: 0.62,
fontSize: 14, bold: true, color: C.white, align: "center", valign: "middle", margin: 0,
});
slide.addText(c.alt, {
x: 7.8, y: y + 0.2, w: 1.7, h: 0.4,
fontSize: 11, color: C.muted, align: "left", valign: "middle", margin: 0,
});
});
slide.addShape(pres.shapes.RECTANGLE, {
x: 0.2, y: 4.9, w: 9.4, h: 0.35,
fill: { color: C.amber }, line: { color: C.amber },
});
slide.addText("⚠ Confirm with a repeat test on a separate day unless the patient is symptomatic with unequivocal hyperglycaemia", {
x: 0.2, y: 4.9, w: 9.4, h: 0.35,
fontSize: 10, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0,
});
}
// ════════════════════════════════════════════════════════════════════════════
// SECTION 3 DIVIDER — Pathophysiology
// ════════════════════════════════════════════════════════════════════════════
sectionDivider("Pathophysiology", "Type 1, Type 2, consequences of hyperglycaemia\nand disease progression flowcharts", "3");
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 9 — Pathophysiology of Type 1 DM
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Pathophysiology of Type 1 DM");
// T1 pathway — horizontal flowchart
const steps = [
{ label: "Genetic\nPredisposition", sub: "HLA-DR3/DR4", color: C.charcoal },
{ label: "Environmental\nTrigger", sub: "Viral infection?", color: C.charcoal },
{ label: "Autoimmune\nActivation", sub: "T-cell mediated", color: C.red },
{ label: "β-Cell\nDestruction", sub: ">80% lost", color: C.red },
{ label: "Absolute Insulin\nDeficiency", sub: "Zero endogenous", color: C.darkTeal },
];
const bw = 1.55, bh = 1.3, by = 1.15;
steps.forEach((s, i) => {
const x = 0.2 + i * 1.92;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: by, w: bw, h: bh,
fill: { color: s.color }, line: { color: C.cyan }, rectRadius: 0.08,
});
slide.addText(s.label, { x, y: by + 0.05, w: bw, h: 0.7, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText(s.sub, { x, y: by + 0.8, w: bw, h: 0.4, fontSize: 10, color: C.cyan, align: "center", margin: 0, italic: true });
if (i < steps.length - 1) {
slide.addText("▶", { x: x + bw - 0.05, y: by + 0.45, w: 0.45, h: 0.45, fontSize: 16, color: C.cyan, align: "center", valign: "middle", margin: 0 });
}
});
// Consequences
slide.addText("CONSEQUENCES", { x: 0.2, y: 2.65, w: 9, h: 0.35, fontSize: 12, bold: true, color: C.teal, margin: 0 });
const cons = [
{ t: "Hyperglycaemia", d: "Osmotic symptoms\n(polyuria, polydipsia)", c: C.red },
{ t: "Lipolysis", d: "Free fatty acid\nrelease, weight loss", c: C.amber },
{ t: "Ketogenesis", d: "DKA risk;\nketonuria, acidosis", c: C.red },
{ t: "Catabolism", d: "Muscle wasting,\nfatigue, weakness", c: C.darkTeal },
];
cons.forEach((c, i) => {
const x = 0.2 + i * 2.38;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 3.07, w: 2.2, h: 1.95,
fill: { color: C.charcoal }, line: { color: c.c }, rectRadius: 0.08,
});
slide.addText(c.t, { x, y: 3.12, w: 2.2, h: 0.45, fontSize: 12, bold: true, color: c.c, align: "center", valign: "middle", margin: 0 });
slide.addText(c.d, { x, y: 3.6, w: 2.2, h: 1.3, fontSize: 11, color: C.white, align: "center", valign: "top", margin: 0 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 10 — Pathophysiology of Type 2 DM
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Pathophysiology of Type 2 DM");
// Left: text
slide.addText([
...bullets(["Peripheral insulin resistance (muscle, liver, adipose)"], 13),
], { x: 0.2, y: 1.0, w: 5.5, h: 0.45, margin: 0 });
slide.addText([
...bullets(["Compensatory hyperinsulinaemia — β-cells work harder"], 13),
], { x: 0.2, y: 1.48, w: 5.5, h: 0.45, margin: 0 });
slide.addText([
...bullets(["Progressive β-cell dysfunction and eventual failure"], 13),
], { x: 0.2, y: 1.96, w: 5.5, h: 0.45, margin: 0 });
// Contributing factors
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 2.55, w: 5.2, h: 2.5,
fill: { color: C.charcoal }, line: { color: C.teal }, rectRadius: 0.08,
});
slide.addText("CONTRIBUTING FACTORS", { x: 0.3, y: 2.6, w: 5.0, h: 0.35, fontSize: 11, bold: true, color: C.teal, margin: 0 });
slide.addText([
...bullets(["Obesity and visceral adiposity", "Chronic low-grade inflammation (TNF-α, IL-6)", "Ectopic lipid deposition in liver/muscle", "Genetic susceptibility (polygenic)", "Sedentary lifestyle, high caloric diet", "Ageing"], 12),
], { x: 0.3, y: 3.0, w: 4.9, h: 1.9, margin: 0 });
// Right: Staircase progression diagram
slide.addText("Disease Progression", { x: 5.7, y: 0.9, w: 4.0, h: 0.35, fontSize: 12, bold: true, color: C.cyan, margin: 0 });
const stages = [
{ label: "Normal\nGlucose", color: C.green },
{ label: "Insulin\nResistance", color: C.amber },
{ label: "Pre-\nDiabetes", color: C.amber },
{ label: "Type 2\nDiabetes", color: C.red },
{ label: "Complications", color: C.red },
];
stages.forEach((s, i) => {
const x = 5.7 + i * 0.82;
const y = 4.8 - i * 0.65;
slide.addShape(pres.shapes.RECTANGLE, {
x, y, w: 0.75, h: 0.65 * (i + 1),
fill: { color: s.color }, line: { color: s.color },
});
slide.addText(s.label, {
x, y: y - 0.45, w: 0.75, h: 0.42,
fontSize: 8, bold: true, color: s.color, align: "center", margin: 0,
});
});
slide.addText("Time →", { x: 5.7, y: 5.05, w: 4.0, h: 0.25, fontSize: 10, color: C.gray, align: "right", margin: 0 });
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 11 — Consequences of Hyperglycaemia
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Consequences of Hyperglycaemia");
// Acute consequences
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 0.92, w: 4.4, h: 3.85,
fill: { color: C.charcoal }, line: { color: C.amber, pt: 2 }, rectRadius: 0.08,
});
slide.addText("ACUTE", { x: 0.2, y: 0.92, w: 4.4, h: 0.45, fontSize: 14, bold: true, color: C.amber, align: "center", valign: "middle", margin: 0 });
slide.addText([
...bullets(["Osmotic diuresis → polyuria", "Polydipsia (compensatory thirst)", "Dehydration and electrolyte loss", "Glycosuria (glucose in urine)", "Fatigue, blurred vision", "DKA / HHS in extremes"], 12),
], { x: 0.35, y: 1.42, w: 4.1, h: 3.2, margin: 0 });
// Chronic consequences
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 5.1, y: 0.92, w: 4.65, h: 3.85,
fill: { color: C.charcoal }, line: { color: C.red, pt: 2 }, rectRadius: 0.08,
});
slide.addText("CHRONIC", { x: 5.1, y: 0.92, w: 4.65, h: 0.45, fontSize: 14, bold: true, color: C.red, align: "center", valign: "middle", margin: 0 });
slide.addText([
...bullets([
"Advanced Glycation End-Products (AGEs)",
"Oxidative stress & ROS production",
"Protein kinase C activation",
"Polyol pathway activation",
"Endothelial dysfunction",
"Vascular damage → micro & macrovascular disease",
], 12),
], { x: 5.25, y: 1.42, w: 4.35, h: 3.2, margin: 0 });
slide.addShape(pres.shapes.RECTANGLE, {
x: 4.73, y: 0.92, w: 0.08, h: 3.85,
fill: { color: C.cyan }, line: { color: C.cyan },
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 12 — T1DM Flowchart
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "T1DM — Pathophysiology Flowchart");
const nodes = [
{ x: 3.8, y: 0.95, w: 2.4, h: 0.55, label: "Genetic Susceptibility\n(HLA-DR3/DR4)", color: C.charcoal, border: C.cyan },
{ x: 3.8, y: 1.75, w: 2.4, h: 0.55, label: "Environmental Trigger\n(Viral / Unknown)", color: C.charcoal, border: C.teal },
{ x: 3.8, y: 2.55, w: 2.4, h: 0.55, label: "T-Cell Activation\n(Autoimmune response)", color: C.charcoal, border: C.amber },
{ x: 3.8, y: 3.35, w: 2.4, h: 0.55, label: "β-Cell Destruction\n(Insulitis)", color: C.red, border: C.red },
{ x: 3.8, y: 4.15, w: 2.4, h: 0.55, label: "Absolute Insulin\nDeficiency", color: C.red, border: C.red },
];
nodes.forEach((n, i) => {
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: n.x, y: n.y, w: n.w, h: n.h,
fill: { color: n.color }, line: { color: n.border, pt: 1.5 }, rectRadius: 0.07,
});
slide.addText(n.label, {
x: n.x, y: n.y, w: n.w, h: n.h,
fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 2,
});
if (i < nodes.length - 1) {
slide.addText("▼", { x: n.x + n.w / 2 - 0.15, y: n.y + n.h - 0.02, w: 0.3, h: 0.25, fontSize: 14, color: C.cyan, align: "center", margin: 0 });
}
});
// Side consequences from "Absolute Insulin Deficiency"
const cons2 = [
{ x: 0.3, y: 3.8, w: 1.9, h: 0.55, label: "Hyperglycaemia", color: C.amber },
{ x: 0.3, y: 4.55, w: 1.9, h: 0.55, label: "DKA", color: C.red },
{ x: 7.6, y: 3.8, w: 1.9, h: 0.55, label: "Lipolysis", color: C.amber },
{ x: 7.6, y: 4.55, w: 1.9, h: 0.55, label: "Ketogenesis", color: C.red },
];
cons2.forEach(c => {
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: c.x, y: c.y, w: c.w, h: c.h,
fill: { color: c.color }, line: { color: c.color }, rectRadius: 0.07,
});
slide.addText(c.label, {
x: c.x, y: c.y, w: c.w, h: c.h,
fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0,
});
});
// arrows to side
slide.addText("◀", { x: 2.2, y: 4.35, w: 0.3, h: 0.3, fontSize: 14, color: C.amber, align: "center", margin: 0 });
slide.addText("▶", { x: 7.3, y: 4.35, w: 0.3, h: 0.3, fontSize: 14, color: C.amber, align: "center", margin: 0 });
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 13 — T2DM Flowchart
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "T2DM — Progression Flowchart");
const t2nodes = [
{ x: 3.8, y: 0.92, w: 2.4, h: 0.55, label: "Obesity / Sedentary\nLifestyle + Genetics", color: C.charcoal, border: C.cyan },
{ x: 3.8, y: 1.7, w: 2.4, h: 0.55, label: "Insulin Resistance\n(Muscle, Liver, Adipose)", color: C.charcoal, border: C.teal },
{ x: 3.8, y: 2.48, w: 2.4, h: 0.55, label: "Compensatory\nHyperinsulinaemia", color: C.charcoal, border: C.amber },
{ x: 3.8, y: 3.26, w: 2.4, h: 0.55, label: "β-Cell Exhaustion\n& Dysfunction", color: C.amber, border: C.amber },
{ x: 3.8, y: 4.04, w: 2.4, h: 0.55, label: "Overt Type 2 DM\n(Relative Insulin Deficiency)", color: C.red, border: C.red },
];
t2nodes.forEach((n, i) => {
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: n.x, y: n.y, w: n.w, h: n.h,
fill: { color: n.color }, line: { color: n.border, pt: 1.5 }, rectRadius: 0.07,
});
slide.addText(n.label, {
x: n.x, y: n.y, w: n.w, h: n.h,
fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 2,
});
if (i < t2nodes.length - 1) {
slide.addText("▼", { x: n.x + n.w / 2 - 0.15, y: n.y + n.h - 0.02, w: 0.3, h: 0.25, fontSize: 14, color: C.cyan, align: "center", margin: 0 });
}
});
const t2side = [
{ x: 0.2, y: 1.7, w: 2.1, h: 0.55, label: "Visceral Fat\nInflammation", color: C.darkTeal },
{ x: 0.2, y: 2.48, w: 2.1, h: 0.55, label: "Ectopic Lipid\nDeposition", color: C.darkTeal },
{ x: 7.7, y: 3.26, w: 2.1, h: 0.55, label: "Chronic\nHyperglycaemia", color: C.amber },
{ x: 7.7, y: 4.04, w: 2.1, h: 0.55, label: "Long-term\nComplications", color: C.red },
];
t2side.forEach(c => {
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: c.x, y: c.y, w: c.w, h: c.h,
fill: { color: c.color }, line: { color: c.color }, rectRadius: 0.07,
});
slide.addText(c.label, {
x: c.x, y: c.y, w: c.w, h: c.h,
fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 0,
});
});
slide.addText("▶", { x: 2.3, y: 1.87, w: 0.3, h: 0.3, fontSize: 14, color: C.teal, align: "center", margin: 0 });
slide.addText("▶", { x: 2.3, y: 2.65, w: 0.3, h: 0.3, fontSize: 14, color: C.teal, align: "center", margin: 0 });
slide.addText("◀", { x: 7.4, y: 3.43, w: 0.3, h: 0.3, fontSize: 14, color: C.amber, align: "center", margin: 0 });
slide.addText("◀", { x: 7.4, y: 4.21, w: 0.3, h: 0.3, fontSize: 14, color: C.red, align: "center", margin: 0 });
}
// ════════════════════════════════════════════════════════════════════════════
// SECTION 4 DIVIDER — Clinical Features & Natural History
// ════════════════════════════════════════════════════════════════════════════
sectionDivider("Clinical Features\n& Natural History", "Symptoms, disease course, and chronic complications", "4");
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 14 — Classic Symptoms
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Classic Symptoms of Hyperglycaemia");
const symptoms = [
{ icon: "💧", title: "Polyuria", desc: "Osmotic diuresis from\nglycosuria; frequent\nlarge-volume urination" },
{ icon: "🥤", title: "Polydipsia", desc: "Compensatory thirst\nfrom dehydration and\nosmotic shifts" },
{ icon: "🍽", title: "Polyphagia", desc: "Increased hunger despite\neating; cells starved of\nglucose (T1 especially)" },
{ icon: "⚖️", title: "Weight Loss", desc: "Prominent in T1DM;\ncatabolism of fat\nand muscle stores" },
{ icon: "😴", title: "Fatigue", desc: "Cellular energy deficit;\ndehydration and\nelectrolyte imbalance" },
{ icon: "👁", title: "Blurred Vision", desc: "Osmotic changes to\nlens shape from\nhyperglycaemia" },
];
symptoms.forEach((s, i) => {
const col = i % 3;
const row = Math.floor(i / 3);
const x = 0.2 + col * 3.2;
const y = 0.92 + row * 2.05;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y, w: 3.05, h: 1.9,
fill: { color: C.charcoal }, line: { color: C.teal }, rectRadius: 0.1,
});
slide.addText(s.icon + " " + s.title, {
x, y: y + 0.05, w: 3.05, h: 0.5,
fontSize: 13, bold: true, color: C.cyan, align: "center", valign: "middle", margin: 0,
});
slide.addText(s.desc, {
x, y: y + 0.56, w: 3.05, h: 1.25,
fontSize: 11, color: C.white, align: "center", valign: "top", margin: 0,
});
});
slide.addShape(pres.shapes.RECTANGLE, {
x: 0.2, y: 5.04, w: 9.5, h: 0.25,
fill: { color: C.charcoal }, line: { color: C.charcoal },
});
slide.addText("Also: slow-healing wounds, recurrent infections (skin/UTI/candida), peripheral tingling", {
x: 0.2, y: 5.04, w: 9.5, h: 0.25,
fontSize: 9.5, color: C.muted, align: "center", valign: "middle", italic: true, margin: 0,
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 15 — Natural History of T1DM
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Natural History of Type 1 DM");
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 0.95, w: 9.4, h: 1.45,
fill: { color: C.charcoal }, line: { color: C.red, pt: 2 }, rectRadius: 0.08,
});
slide.addText([
{ text: "Onset: ", options: { bold: true, color: C.red, fontSize: 13, breakLine: false } },
{ text: "Rapid — days to weeks. ", options: { color: C.white, fontSize: 13, breakLine: false } },
{ text: "Most common: ", options: { bold: true, color: C.cyan, fontSize: 13, breakLine: false } },
{ text: "Children, adolescents, young adults", options: { color: C.white, fontSize: 13, breakLine: true } },
{ text: "Classic presentation: DKA — polyuria, vomiting, Kussmaul breathing, altered consciousness", options: { color: C.muted, fontSize: 12 } },
], { x: 0.4, y: 0.98, w: 9.0, h: 1.35, valign: "middle", margin: 0 });
const phases = [
{ label: "Pre-clinical\nPhase", sub: "Autoimmunity, GAD antibodies\nNo symptoms; β-cells declining", color: C.darkTeal },
{ label: "Clinical\nOnset", sub: "Rapid symptom onset;\nosmotic symptoms prominent", color: C.amber },
{ label: "Honeymoon\nPeriod", sub: "Partial β-cell recovery;\ntemporary reduced insulin needs", color: C.teal },
{ label: "Established\nT1DM", sub: "Complete β-cell loss;\nlifelong insulin dependence", color: C.red },
];
phases.forEach((p, i) => {
const x = 0.2 + i * 2.38;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 2.6, w: 2.22, h: 2.4,
fill: { color: p.color }, line: { color: C.white }, rectRadius: 0.08,
});
slide.addText(p.label, { x, y: 2.65, w: 2.22, h: 0.65, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addShape(pres.shapes.RECTANGLE, { x: x + 0.35, y: 3.32, w: 1.52, h: 0.04, fill: { color: C.white }, line: { color: C.white } });
slide.addText(p.sub, { x, y: 3.4, w: 2.22, h: 1.4, fontSize: 10, color: C.white, align: "center", valign: "top", margin: 0 });
if (i < phases.length - 1) {
slide.addText("▶", { x: x + 2.22 - 0.05, y: 3.55, w: 0.3, h: 0.3, fontSize: 16, color: C.cyan, align: "center", margin: 0 });
}
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 16 — Natural History of T2DM
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Natural History of Type 2 DM");
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 0.95, w: 9.4, h: 1.1,
fill: { color: C.charcoal }, line: { color: C.teal, pt: 2 }, rectRadius: 0.08,
});
slide.addText("Insidious onset over months to years. Often diagnosed incidentally on routine blood tests. Strongly associated with obesity, metabolic syndrome, and physical inactivity.", {
x: 0.4, y: 0.95, w: 9.0, h: 1.1,
fontSize: 12, color: C.white, valign: "middle", margin: 0,
});
const phases2 = [
{ label: "Normal\nGlucose", sub: "Insulin sensitivity\nnormal", color: C.green },
{ label: "Insulin\nResistance", sub: "Hyperinsulinaemia\ncompensates", color: C.teal },
{ label: "Pre-\nDiabetes", sub: "IFG/IGT; HbA1c\n5.7–6.4%", color: C.amber },
{ label: "Type 2\nDiabetes", sub: "Diagnostic thresholds\nexceeded", color: C.red },
{ label: "Micro/Macro\nComplications", sub: "Retinopathy,\nnephropathy, CVD", color: C.red },
];
phases2.forEach((p, i) => {
const x = 0.15 + i * 1.93;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 2.2, w: 1.8, h: 2.8,
fill: { color: p.color }, line: { color: C.white }, rectRadius: 0.08,
});
slide.addText(p.label, { x, y: 2.25, w: 1.8, h: 0.6, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addShape(pres.shapes.RECTANGLE, { x: x + 0.25, y: 2.87, w: 1.3, h: 0.04, fill: { color: C.white }, line: { color: C.white } });
slide.addText(p.sub, { x, y: 2.96, w: 1.8, h: 1.9, fontSize: 10, color: C.white, align: "center", valign: "top", margin: 0 });
if (i < phases2.length - 1) {
slide.addText("▶", { x: x + 1.8, y: 3.42, w: 0.2, h: 0.3, fontSize: 14, color: C.cyan, align: "center", margin: 0 });
}
});
slide.addText("Time — years to decades →", { x: 0.15, y: 5.1, w: 9.5, h: 0.2, fontSize: 9, color: C.gray, italic: true, margin: 0 });
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 17 — Chronic Complications (Microvascular)
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Chronic Complications — Microvascular");
const compls = [
{
organ: "👁 Retinopathy",
points: ["Commonest cause of blindness in working-age adults", "Background → proliferative retinopathy", "Screen annually with fundoscopy / retinal photography"],
color: C.red,
},
{
organ: "🫘 Nephropathy",
points: ["Thickening of glomerular basement membrane", "Microalbuminuria → proteinuria → CKD", "Diabetic nephropathy = leading cause of ESKD"],
color: C.amber,
},
{
organ: "⚡ Neuropathy",
points: ["Peripheral: glove-and-stocking sensory loss", "Autonomic: gastroparesis, postural hypotension", "Mononeuropathy (e.g., foot drop, CN III palsy)"],
color: C.teal,
},
];
compls.forEach((c, i) => {
const x = 0.2 + i * 3.25;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 0.92, w: 3.1, h: 4.1,
fill: { color: C.charcoal }, line: { color: c.color, pt: 2 }, rectRadius: 0.1,
});
slide.addShape(pres.shapes.RECTANGLE, {
x, y: 0.92, w: 3.1, h: 0.55,
fill: { color: c.color }, line: { color: c.color },
});
slide.addText(c.organ, { x, y: 0.92, w: 3.1, h: 0.55, fontSize: 13, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText([
...bullets(c.points, 12),
], { x: x + 0.1, y: 1.55, w: 2.9, h: 3.3, margin: 0 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 18 — Chronic Complications (Macrovascular + Others)
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Chronic Complications — Macrovascular & Others");
// Macrovascular
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 0.92, w: 5.5, h: 3.55,
fill: { color: C.charcoal }, line: { color: C.red, pt: 2 }, rectRadius: 0.08,
});
slide.addText("MACROVASCULAR", { x: 0.2, y: 0.92, w: 5.5, h: 0.45, fontSize: 13, bold: true, color: C.red, align: "center", margin: 0 });
slide.addText([
...bullets([
"Coronary artery disease (CAD) — 2–4× increased risk",
"Ischaemic stroke and TIA",
"Peripheral arterial disease (PAD)",
"Heart failure (partly HFpEF)",
"Driven by dyslipidaemia, hypertension, smoking, inflammation",
], 12),
], { x: 0.35, y: 1.42, w: 5.2, h: 3.0, margin: 0 });
// Others
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 5.9, y: 0.92, w: 3.85, h: 3.55,
fill: { color: C.charcoal }, line: { color: C.amber, pt: 2 }, rectRadius: 0.08,
});
slide.addText("OTHERS", { x: 5.9, y: 0.92, w: 3.85, h: 0.45, fontSize: 13, bold: true, color: C.amber, align: "center", margin: 0 });
slide.addText([
...bullets([
"Diabetic foot (ulcers, Charcot)",
"Recurrent infections",
"Skin: NLD, acanthosis nigricans",
"Sexual dysfunction (ED)",
"Depression / anxiety",
], 12),
], { x: 6.05, y: 1.42, w: 3.55, h: 3.0, margin: 0 });
// Timeline note
slide.addShape(pres.shapes.RECTANGLE, {
x: 0.2, y: 4.6, w: 9.5, h: 0.48,
fill: { color: C.teal }, line: { color: C.teal },
});
slide.addText("Risk is strongly related to duration of disease and degree of glycaemic control | HbA1c reduction of 1% → ~37% less microvascular events (UKPDS)", {
x: 0.2, y: 4.6, w: 9.5, h: 0.48,
fontSize: 10, bold: true, color: C.white, align: "center", valign: "middle", margin: 0,
});
}
// ════════════════════════════════════════════════════════════════════════════
// SECTION 5 DIVIDER — Investigations
// ════════════════════════════════════════════════════════════════════════════
sectionDivider("Investigations", "Diagnostic tests, monitoring, and complication screening", "5");
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 19 — Diagnostic & Monitoring Tests
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Diagnostic & Monitoring Tests");
const tests = [
{ name: "Fasting Plasma Glucose", detail: "≥7.0 mmol/L diagnostic\nSimple, widely available", use: "Diagnosis", color: C.red },
{ name: "HbA1c", detail: "≥6.5% diagnostic\nReflects 2–3 month avg glucose\nUnaffected by acute changes", use: "Diagnosis + Monitoring", color: C.teal },
{ name: "OGTT (75g)", detail: "2h ≥11.1 mmol/L diagnostic\nGold standard in GDM", use: "Diagnosis", color: C.amber },
{ name: "C-Peptide / Insulin", detail: "Low → T1DM\nNormal/High → T2DM/early\nHelps differentiate types", use: "Differentiation", color: C.darkTeal },
{ name: "Autoantibodies", detail: "GAD65, islet cell, IA-2\nZnT8 antibodies\n+ve → confirms T1DM", use: "T1DM Confirmation", color: C.red },
{ name: "Random Glucose", detail: "≥11.1 + symptoms → diagnostic\nQuick point-of-care test", use: "Diagnosis", color: C.charcoal },
];
tests.forEach((t, i) => {
const col = i % 3;
const row = Math.floor(i / 3);
const x = 0.2 + col * 3.2;
const y = 0.95 + row * 2.05;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y, w: 3.05, h: 1.9,
fill: { color: C.charcoal }, line: { color: t.color }, rectRadius: 0.08,
});
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y, w: 3.05, h: 0.45,
fill: { color: t.color }, line: { color: t.color }, rectRadius: 0.08,
});
slide.addText(t.name, { x, y, w: 3.05, h: 0.45, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText(t.detail, { x, y: y + 0.5, w: 3.05, h: 1.1, fontSize: 10.5, color: C.white, align: "center", valign: "top", margin: 2 });
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, { x: x + 0.3, y: y + 1.63, w: 2.45, h: 0.22, fill: { color: t.color }, line: { color: t.color }, rectRadius: 0.05 });
slide.addText(t.use, { x: x + 0.3, y: y + 1.63, w: 2.45, h: 0.22, fontSize: 9, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 20 — Complication Screening
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Screening for Complications");
const screenings = [
{ name: "Eyes", test: "Fundoscopy / Retinal photography", freq: "Annual", target: "Retinopathy screening", color: C.red },
{ name: "Kidneys", test: "Urine ACR + eGFR / Creatinine", freq: "Annual", target: "Early nephropathy detection", color: C.amber },
{ name: "Feet", test: "10g monofilament + pulses + inspection", freq: "Annual", target: "Neuropathy & PAD", color: C.teal },
{ name: "Cardiovascular", test: "Lipid profile, BP, ECG, BMI, smoking", freq: "Annual", target: "CV risk stratification", color: C.red },
{ name: "HbA1c", test: "Glycated haemoglobin", freq: "Every 3–6 months", target: "Glycaemic control monitoring", color: C.cyan },
{ name: "Neuropathy", test: "Vibration sense, ankle reflexes, 10g filament", freq: "Annual", target: "Peripheral neuropathy", color: C.darkTeal },
];
const rows2 = [
[{ text: "System", options: { bold: true, color: C.cyan } }, { text: "Test", options: { bold: true, color: C.cyan } }, { text: "Frequency", options: { bold: true, color: C.cyan } }, { text: "Targets", options: { bold: true, color: C.cyan } }],
...screenings.map(s => [s.name, s.test, s.freq, s.target]),
];
slide.addTable(rows2, {
x: 0.2, y: 0.92, w: 9.5, h: 4.15,
fontSize: 11,
color: C.white,
fill: { color: C.charcoal },
border: { type: "solid", color: C.teal, pt: 1 },
rowH: 0.55,
fontFace: "Calibri",
align: "left",
valign: "middle",
colW: [1.4, 3.1, 1.9, 3.1],
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 21 — Other Labs
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Other Investigations");
const labGroups = [
{
title: "Acute / Sick Day",
labs: ["Blood ketones (β-hydroxybutyrate >3 mmol/L = severe)", "Arterial blood gas — pH, bicarbonate, pCO₂", "Electrolytes — Na, K (critical in DKA)", "Serum osmolality (HHS >320 mOsm/kg)", "Lactate — lactic acidosis check"],
color: C.red,
},
{
title: "Routine Monitoring",
labs: ["Full blood count — anaemia in CKD", "LFTs — NAFLD common in T2DM", "Thyroid function — associated autoimmunity (T1)", "Micronutrients — Vit B12 (metformin use)", "Coeliac screen — associated with T1DM"],
color: C.teal,
},
];
labGroups.forEach((g, i) => {
const x = 0.2 + i * 4.9;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 0.92, w: 4.6, h: 4.1,
fill: { color: C.charcoal }, line: { color: g.color, pt: 2 }, rectRadius: 0.08,
});
slide.addShape(pres.shapes.RECTANGLE, {
x, y: 0.92, w: 4.6, h: 0.5,
fill: { color: g.color }, line: { color: g.color },
});
slide.addText(g.title, { x, y: 0.92, w: 4.6, h: 0.5, fontSize: 13, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText([
...bullets(g.labs, 12),
], { x: x + 0.1, y: 1.48, w: 4.4, h: 3.45, margin: 0 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SECTION 6 DIVIDER — Management
// ════════════════════════════════════════════════════════════════════════════
sectionDivider("Management", "General principles, T1 and T2 treatment,\nmonitoring and follow-up", "6");
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 22 — General Principles of Management
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "General Principles of Management");
const pillars = [
{ title: "Patient\nEducation", points: ["Disease understanding", "Self-monitoring skills", "Sick day rules"], color: C.teal },
{ title: "Lifestyle\nModification", points: ["Mediterranean-style diet", "≥150 min/week exercise", "Weight loss ≥5–10%"], color: C.green },
{ title: "Glycaemic\nTargets", points: ["HbA1c <7% (53 mmol/mol)", "Individualised goals", "Avoid hypoglycaemia"], color: C.amber },
{ title: "CV Risk\nReduction", points: ["BP <130/80 mmHg", "Statin therapy", "No smoking"], color: C.red },
{ title: "MDT\nCare", points: ["Diabetologist, dietitian", "Diabetes educator", "Podiatrist, ophthalmologist"], color: C.darkTeal },
];
pillars.forEach((p, i) => {
const x = 0.15 + i * 1.93;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 0.92, w: 1.8, h: 4.1,
fill: { color: C.charcoal }, line: { color: p.color, pt: 2 }, rectRadius: 0.08,
});
slide.addShape(pres.shapes.RECTANGLE, {
x, y: 0.92, w: 1.8, h: 0.7,
fill: { color: p.color }, line: { color: p.color },
});
slide.addText(p.title, { x, y: 0.92, w: 1.8, h: 0.7, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText([
...bullets(p.points, 10.5),
], { x: x + 0.05, y: 1.68, w: 1.7, h: 3.2, margin: 0 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 23 — T1DM Management
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Type 1 DM — Management");
// Insulin types table
slide.addText("INSULIN REGIMENS", { x: 0.2, y: 0.92, w: 9, h: 0.35, fontSize: 13, bold: true, color: C.cyan, margin: 0 });
const insulinRows = [
[{ text: "Regimen", options: { bold: true, color: C.cyan } }, { text: "Components", options: { bold: true, color: C.cyan } }, { text: "Notes", options: { bold: true, color: C.cyan } }],
["Basal-Bolus (MDI)", "Long-acting + rapid-acting at meals", "Gold standard; most physiological"],
["CSII (Insulin Pump)", "Continuous subcutaneous infusion", "Better control; preferred in some"],
["Basal-only (bridging)", "Long-acting once/twice daily", "Not ideal; used temporarily"],
];
slide.addTable(insulinRows, {
x: 0.2, y: 1.32, w: 9.5, h: 1.65,
fontSize: 11, color: C.white, fill: { color: C.charcoal },
border: { type: "solid", color: C.teal, pt: 1 },
rowH: 0.44, fontFace: "Calibri", align: "left", valign: "middle",
colW: [2.8, 3.8, 2.9],
});
// Additional management
slide.addText("ADDITIONAL STRATEGIES", { x: 0.2, y: 3.1, w: 9, h: 0.35, fontSize: 13, bold: true, color: C.cyan, margin: 0 });
const addl = [
{ t: "Carbohydrate Counting", d: "Match rapid insulin dose to carb intake; 1 unit per 10–15g CHO (varies)", c: C.teal },
{ t: "CGM", d: "Continuous glucose monitoring — reduces HbA1c & hypoglycaemia events", c: C.darkTeal },
{ t: "Sick Day Rules", d: "Never stop insulin; monitor ketones; increase frequency, seek help if ketones >3", c: C.red },
];
addl.forEach((a, i) => {
const x = 0.2 + i * 3.2;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 3.5, w: 3.05, h: 1.6,
fill: { color: a.c }, line: { color: a.c }, rectRadius: 0.08,
});
slide.addText(a.t, { x, y: 3.53, w: 3.05, h: 0.45, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText(a.d, { x, y: 4.0, w: 3.05, h: 1.0, fontSize: 10.5, color: C.white, align: "center", valign: "top", margin: 2 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 24 — T2DM Management
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Type 2 DM — Pharmacological Management");
const drugs = [
{ name: "Metformin", class: "Biguanide", moa: "↓ hepatic glucose output; improves insulin sensitivity", notes: "First-line; weight neutral; cheap; hold in eGFR<30", color: C.teal },
{ name: "SGLT2 Inhibitors", class: "e.g. Empagliflozin, Dapagliflozin", moa: "Block renal glucose reabsorption → glucosuria", notes: "CV & renal protection ✓; weight loss; risk: DKA, UTI", color: C.green },
{ name: "GLP-1 Receptor Agonists", class: "e.g. Semaglutide, Liraglutide", moa: "Mimic incretin; ↑ insulin, ↓ glucagon, ↓ appetite", notes: "CV protection ✓; weight loss; injectable (or oral)", color: C.green },
{ name: "Sulfonylureas", class: "e.g. Gliclazide, Glibenclamide", moa: "Stimulate β-cell insulin release (KATP channel)", notes: "Hypoglycaemia risk; weight gain; low cost", color: C.amber },
{ name: "DPP-4 Inhibitors", class: "e.g. Sitagliptin, Saxagliptin", moa: "Prolong incretin action (GLP-1/GIP)", notes: "Well tolerated; weight neutral; modest efficacy", color: C.darkTeal },
{ name: "Insulin", class: "Basal ± bolus", moa: "Exogenous insulin replacement", notes: "When oral agents fail; requires BG monitoring", color: C.red },
];
drugs.forEach((d, i) => {
const col = i % 3;
const row = Math.floor(i / 3);
const x = 0.15 + col * 3.22;
const y = 0.92 + row * 2.1;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y, w: 3.08, h: 1.95,
fill: { color: C.charcoal }, line: { color: d.color }, rectRadius: 0.08,
});
slide.addShape(pres.shapes.RECTANGLE, { x, y, w: 3.08, h: 0.42, fill: { color: d.color }, line: { color: d.color } });
slide.addText(d.name, { x, y, w: 3.08, h: 0.42, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText(d.class, { x, y: y + 0.44, w: 3.08, h: 0.28, fontSize: 9, color: C.muted, align: "center", italic: true, margin: 0 });
slide.addText(d.moa, { x, y: y + 0.73, w: 3.08, h: 0.55, fontSize: 9.5, color: C.white, align: "center", margin: 2 });
slide.addText(d.notes, { x, y: y + 1.3, w: 3.08, h: 0.6, fontSize: 9, color: C.cyan, align: "center", margin: 2 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 25 — Monitoring & Follow-up
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Monitoring & Follow-up");
const items = [
{ freq: "Every Visit", tasks: ["Blood pressure measurement", "Weight / BMI", "Foot inspection", "Medication review", "Hypoglycaemia enquiry"], color: C.cyan },
{ freq: "Every 3–6 Months", tasks: ["HbA1c", "Self-monitoring log review", "Hypoglycaemia episodes", "Insulin/medication adjustment"], color: C.teal },
{ freq: "Annual Review", tasks: ["Retinal screening", "Urine ACR + eGFR", "Full foot exam (monofilament)", "Lipids + ECG", "Neuropathy assessment", "Dietitian + educator review"], color: C.amber },
];
items.forEach((it, i) => {
const x = 0.15 + i * 3.25;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 0.92, w: 3.1, h: 4.1,
fill: { color: C.charcoal }, line: { color: it.color, pt: 2 }, rectRadius: 0.08,
});
slide.addShape(pres.shapes.RECTANGLE, { x, y: 0.92, w: 3.1, h: 0.5, fill: { color: it.color }, line: { color: it.color } });
slide.addText(it.freq, { x, y: 0.92, w: 3.1, h: 0.5, fontSize: 13, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText([...bullets(it.tasks, 12)], { x: x + 0.1, y: 1.48, w: 2.9, h: 3.45, margin: 0 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SECTION 7 DIVIDER — Diabetic Emergencies
// ════════════════════════════════════════════════════════════════════════════
sectionDivider("Diabetic Emergencies", "DKA, HHS, hypoglycaemia — recognition,\nmanagement and prevention", "7");
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 26 — Overview of Emergencies
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Diabetic Emergencies — Overview");
const emgs = [
{ title: "DKA", sub: "Diabetic Ketoacidosis", type: "Hyperglycaemic", desc: "Mostly T1DM\nHyperglycaemia + Ketoacidosis\nAcid-base imbalance", color: C.red },
{ title: "HHS", sub: "Hyperosmolar Hyperglycaemic State", type: "Hyperglycaemic", desc: "Mostly elderly T2DM\nExtreme hyperglycaemia\nNo significant ketosis", color: C.amber },
{ title: "Hypoglycaemia", sub: "BG <4 mmol/L", type: "Hypoglycaemic", desc: "Any DM on insulin/sulfonyl\nAdrenergic + neuroglycopenic Sx\nTreat immediately", color: C.teal },
{ title: "Lactic Acidosis", sub: "Rare, high mortality", type: "Metabolic", desc: "Tissue hypoperfusion\nAssociated with metformin\nManage in ICU", color: C.darkTeal },
];
emgs.forEach((e, i) => {
const x = 0.15 + i * 2.42;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 0.92, w: 2.28, h: 4.1,
fill: { color: C.charcoal }, line: { color: e.color, pt: 2 }, rectRadius: 0.1,
});
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, { x, y: 0.92, w: 2.28, h: 0.55, fill: { color: e.color }, line: { color: e.color }, rectRadius: 0.1 });
slide.addText(e.title, { x, y: 0.92, w: 2.28, h: 0.55, fontSize: 14, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText(e.sub, { x, y: 1.52, w: 2.28, h: 0.45, fontSize: 9.5, color: e.color, align: "center", italic: true, margin: 0 });
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, { x: x + 0.35, y: 2.02, w: 1.58, h: 0.28, fill: { color: e.color }, line: { color: e.color }, rectRadius: 0.06 });
slide.addText(e.type, { x: x + 0.35, y: 2.02, w: 1.58, h: 0.28, fontSize: 9, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText(e.desc, { x, y: 2.38, w: 2.28, h: 2.5, fontSize: 11, color: C.white, align: "center", valign: "top", margin: 2 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 27 — DKA Criteria
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Diabetic Ketoacidosis (DKA)");
// DKA triad
slide.addText("THE DIAGNOSTIC TRIAD", { x: 0.2, y: 0.92, w: 9, h: 0.35, fontSize: 12, bold: true, color: C.red, margin: 0 });
const triad = [
{ label: "Hyperglycaemia", val: ">11–13.9 mmol/L\n(>200 mg/dL)", color: C.red },
{ label: "Ketonaemia /\nKetonuria", val: ">3 mmol/L ketones\nor urine ketones 2+", color: C.red },
{ label: "Metabolic\nAcidosis", val: "pH <7.3\nBicarb <15 mEq/L\nAnion gap >12", color: C.red },
];
triad.forEach((t, i) => {
const x = 0.2 + i * 3.22;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 1.35, w: 3.08, h: 1.75,
fill: { color: t.color }, line: { color: t.color }, rectRadius: 0.1,
});
slide.addText(t.label, { x, y: 1.38, w: 3.08, h: 0.6, fontSize: 14, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addShape(pres.shapes.RECTANGLE, { x: x + 0.5, y: 1.97, w: 2.08, h: 0.04, fill: { color: C.white }, line: { color: C.white } });
slide.addText(t.val, { x, y: 2.04, w: 3.08, h: 0.98, fontSize: 12, color: C.white, align: "center", valign: "top", margin: 0 });
});
// Precipitants & info
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 3.25, w: 4.55, h: 1.8,
fill: { color: C.charcoal }, line: { color: C.amber }, rectRadius: 0.08,
});
slide.addText("PRECIPITANTS", { x: 0.2, y: 3.27, w: 4.55, h: 0.35, fontSize: 11, bold: true, color: C.amber, margin: 2 });
slide.addText([
...bullets(["Infection (most common — 30–40%)", "Insulin omission / non-compliance", "New T1DM presentation", "MI, stroke, surgery, drugs (steroids, SGLT2i)", "Unknown in ~25%"], 11),
], { x: 0.35, y: 3.63, w: 4.25, h: 1.35, margin: 0 });
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 5.0, y: 3.25, w: 4.75, h: 1.8,
fill: { color: C.charcoal }, line: { color: C.cyan }, rectRadius: 0.08,
});
slide.addText("KEY FACTS", { x: 5.0, y: 3.27, w: 4.75, h: 0.35, fontSize: 11, bold: true, color: C.cyan, margin: 2 });
slide.addText([
...bullets(["Primarily Type 1 DM but can occur in T2", "Can present with near-normal glucose (euglycaemic DKA — SGLT2i)", "Mortality <1% with prompt treatment", "Most common cause of DM death in <20yr"], 11),
], { x: 5.15, y: 3.63, w: 4.45, h: 1.35, margin: 0 });
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 28 — DKA Clinical Features
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "DKA — Clinical Features");
const features = [
{ system: "Osmotic", items: ["Polyuria, polydipsia", "Dehydration", "Dry mucous membranes, tachycardia"] },
{ system: "GI", items: ["Nausea and vomiting", "Diffuse abdominal pain", "Anorexia"] },
{ system: "Respiratory", items: ["Kussmaul breathing\n(deep, rapid, laboured)", "Fruity/acetone breath"] },
{ system: "Neurological", items: ["Fatigue, lethargy", "Confusion, drowsiness", "Coma (severe cases)"] },
];
features.forEach((f, i) => {
const x = 0.2 + i * 2.4;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 0.92, w: 2.25, h: 4.1,
fill: { color: C.charcoal }, line: { color: C.red }, rectRadius: 0.08,
});
slide.addShape(pres.shapes.RECTANGLE, { x, y: 0.92, w: 2.25, h: 0.5, fill: { color: C.red }, line: { color: C.red } });
slide.addText(f.system, { x, y: 0.92, w: 2.25, h: 0.5, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText([...bullets(f.items, 11.5)], { x: x + 0.05, y: 1.47, w: 2.15, h: 3.45, margin: 0 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 29 — HHS
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Hyperosmolar Hyperglycaemic State (HHS)");
// Diagnostic criteria
slide.addText("DIAGNOSTIC CRITERIA", { x: 0.2, y: 0.92, w: 9, h: 0.35, fontSize: 12, bold: true, color: C.amber, margin: 0 });
const hhsCrit = [
{ label: "Glucose", val: ">33 mmol/L\n(>600 mg/dL)" },
{ label: "Osmolality", val: ">320 mOsm/kg\n(effective)" },
{ label: "pH", val: ">7.3\n(minimal acidosis)" },
{ label: "Ketones", val: "Absent or\ntrace only" },
];
hhsCrit.forEach((c, i) => {
const x = 0.2 + i * 2.4;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 1.35, w: 2.25, h: 1.55,
fill: { color: C.amber }, line: { color: C.amber }, rectRadius: 0.08,
});
slide.addText(c.label, { x, y: 1.38, w: 2.25, h: 0.42, fontSize: 13, bold: true, color: C.navy, align: "center", margin: 0 });
slide.addText(c.val, { x, y: 1.82, w: 2.25, h: 1.0, fontSize: 12, bold: true, color: C.navy, align: "center", valign: "top", margin: 0 });
});
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 3.05, w: 4.55, h: 2.0,
fill: { color: C.charcoal }, line: { color: C.amber }, rectRadius: 0.08,
});
slide.addText("FEATURES", { x: 0.2, y: 3.07, w: 4.55, h: 0.35, fontSize: 11, bold: true, color: C.amber, margin: 2 });
slide.addText([
...bullets(["Mostly elderly Type 2 DM", "Insidious onset over days–weeks", "Profound dehydration (8–10L deficit)", "Neurological signs common: confusion, seizures", "No significant ketoacidosis"], 11),
], { x: 0.35, y: 3.44, w: 4.25, h: 1.55, margin: 0 });
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 5.0, y: 3.05, w: 4.75, h: 2.0,
fill: { color: C.charcoal }, line: { color: C.red }, rectRadius: 0.08,
});
slide.addText("vs DKA", { x: 5.0, y: 3.07, w: 4.75, h: 0.35, fontSize: 11, bold: true, color: C.red, margin: 2 });
slide.addText([
...bullets(["HHS: older patient, T2DM", "HHS: gradual onset vs DKA acute", "HHS: higher glucose, higher osmolality", "HHS: no/minimal ketosis vs DKA significant", "HHS: higher mortality (15–20%) vs DKA (<1%)"], 11),
], { x: 5.15, y: 3.44, w: 4.45, h: 1.55, margin: 0 });
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 30 — Hypoglycaemia
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Hypoglycaemia");
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 0.92, w: 9.4, h: 0.6,
fill: { color: C.teal }, line: { color: C.teal }, rectRadius: 0.07,
});
slide.addText("Definition: Blood glucose <4.0 mmol/L | Symptoms may occur below 3.9 mmol/L", {
x: 0.2, y: 0.92, w: 9.4, h: 0.6,
fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0,
});
// Symptoms
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.2, y: 1.62, w: 4.55, h: 3.2,
fill: { color: C.charcoal }, line: { color: C.cyan }, rectRadius: 0.08,
});
slide.addText("SYMPTOMS", { x: 0.2, y: 1.64, w: 4.55, h: 0.4, fontSize: 12, bold: true, color: C.cyan, margin: 2 });
slide.addText("Adrenergic (autonomic):", { x: 0.35, y: 2.1, w: 4.25, h: 0.3, fontSize: 11, bold: true, color: C.amber, margin: 0 });
slide.addText([...bullets(["Sweating, tremor, palpitations", "Anxiety, hunger"], 11)], { x: 0.35, y: 2.42, w: 4.25, h: 0.75, margin: 0 });
slide.addText("Neuroglycopenic:", { x: 0.35, y: 3.2, w: 4.25, h: 0.3, fontSize: 11, bold: true, color: C.red, margin: 0 });
slide.addText([...bullets(["Confusion, slurred speech", "Seizure, coma", "Focal neurological signs"], 11)], { x: 0.35, y: 3.52, w: 4.25, h: 1.2, margin: 0 });
// Causes
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 5.0, y: 1.62, w: 4.75, h: 3.2,
fill: { color: C.charcoal }, line: { color: C.amber }, rectRadius: 0.08,
});
slide.addText("CAUSES", { x: 5.0, y: 1.64, w: 4.75, h: 0.4, fontSize: 12, bold: true, color: C.amber, margin: 2 });
slide.addText([
...bullets([
"Excess insulin dose",
"Sulfonylurea (prolonged hypoglycaemia)",
"Missed or delayed meals",
"Unaccustomed exercise",
"Alcohol (inhibits gluconeogenesis)",
"Renal / hepatic impairment",
"Hypoglycaemia unawareness (autonomic neuropathy)",
], 11),
], { x: 5.15, y: 2.1, w: 4.45, h: 2.65, margin: 0 });
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 31 — DKA Management
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "DKA Management");
const steps31 = [
{ n: "1", title: "Airway / Assess", body: "ABC, GCS; IV access; continuous monitoring; urine output catheterisation if comatose", color: C.teal },
{ n: "2", title: "IV Fluids", body: "0.9% NaCl — 1L over 1h, then 500mL/h×2h, then adjust. Cautious in cardiac/renal disease", color: C.teal },
{ n: "3", title: "Insulin", body: "Fixed-rate IV insulin 0.1 unit/kg/h\nDo NOT start until K⁺ ≥3.5 mEq/L\nSwitch to SC when gap closed + eating", color: C.amber },
{ n: "4", title: "Potassium", body: "Replace K⁺ if <5.5 mEq/L\nMonitor hourly initially\nHypoK is most dangerous complication", color: C.red },
{ n: "5", title: "Monitor", body: "Hourly glucose & ketones\n2-hourly electrolytes, VBG\nTarget: ketones falling >0.5/h", color: C.darkTeal },
{ n: "6", title: "Treat Cause", body: "Cultures → antibiotics if infected\nReview medications\nAddress precipitant", color: C.charcoal },
];
steps31.forEach((s, i) => {
const col = i % 3;
const row = Math.floor(i / 3);
const x = 0.15 + col * 3.25;
const y = 0.92 + row * 2.1;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y, w: 3.1, h: 1.95,
fill: { color: C.charcoal }, line: { color: s.color }, rectRadius: 0.08,
});
slide.addShape(pres.shapes.OVAL, { x: x + 0.1, y: y + 0.1, w: 0.45, h: 0.45, fill: { color: s.color }, line: { color: s.color } });
slide.addText(s.n, { x: x + 0.1, y: y + 0.1, w: 0.45, h: 0.45, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText(s.title, { x: x + 0.62, y: y + 0.1, w: 2.38, h: 0.45, fontSize: 12, bold: true, color: s.color, valign: "middle", margin: 0 });
slide.addText(s.body, { x: x + 0.1, y: y + 0.6, w: 2.9, h: 1.25, fontSize: 10.5, color: C.white, valign: "top", margin: 2 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 32 — DKA vs HHS Comparison Table
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "DKA vs HHS — Comparison");
const compRows = [
[{ text: "Feature", options: { bold: true, color: C.cyan } }, { text: "DKA", options: { bold: true, color: C.red } }, { text: "HHS", options: { bold: true, color: C.amber } }],
["Diabetes Type", "Primarily T1DM", "Primarily T2DM"],
["Onset", "Acute (hours–days)", "Insidious (days–weeks)"],
["Age", "Young (any age)", "Elderly"],
["Glucose", ">11–13.9 mmol/L", ">33 mmol/L"],
["Osmolality", "Normal/mildly raised", ">320 mOsm/kg"],
["pH", "<7.3", ">7.3"],
["Bicarbonate", "<15 mEq/L", "Normal"],
["Ketones", "Raised (>3 mmol/L)", "Absent/trace"],
["Anion Gap", "High", "Normal"],
["Mortality", "<1% with treatment", "15–20%"],
["Fluid Deficit", "3–5 L", "8–10 L"],
];
slide.addTable(compRows, {
x: 0.2, y: 0.92, w: 9.5, h: 4.3,
fontSize: 11, color: C.white, fill: { color: C.charcoal },
border: { type: "solid", color: C.teal, pt: 1 },
rowH: 0.33, fontFace: "Calibri", align: "left", valign: "middle",
colW: [3.0, 3.25, 3.25],
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 33 — Hypoglycaemia Management
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Hypoglycaemia Management");
// Decision pathway
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 3.5, y: 0.92, w: 3.0, h: 0.6,
fill: { color: C.teal }, line: { color: C.teal }, rectRadius: 0.08,
});
slide.addText("Blood Glucose <4 mmol/L", { x: 3.5, y: 0.92, w: 3.0, h: 0.6, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText("▼", { x: 4.85, y: 1.53, w: 0.3, h: 0.3, fontSize: 18, color: C.cyan, align: "center", margin: 0 });
// Two branches
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.3, y: 1.92, w: 4.2, h: 0.6,
fill: { color: C.green }, line: { color: C.green }, rectRadius: 0.08,
});
slide.addText("CONSCIOUS / Can Swallow", { x: 0.3, y: 1.92, w: 4.2, h: 0.6, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 5.4, y: 1.92, w: 4.1, h: 0.6,
fill: { color: C.red }, line: { color: C.red }, rectRadius: 0.08,
});
slide.addText("UNCONSCIOUS / Cannot Swallow", { x: 5.4, y: 1.92, w: 4.1, h: 0.6, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 0.3, y: 2.65, w: 4.2, h: 1.65,
fill: { color: C.charcoal }, line: { color: C.green }, rectRadius: 0.08,
});
slide.addText([
...bullets(["15g fast-acting carbs: 4 glucose tablets, 150mL fruit juice, or 3 tsp sugar", "Recheck glucose after 15 min", "If still <4: repeat treatment", "When recovered: give longer-acting carb snack"], 11),
], { x: 0.4, y: 2.7, w: 4.0, h: 1.55, margin: 0 });
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 5.4, y: 2.65, w: 4.1, h: 1.65,
fill: { color: C.charcoal }, line: { color: C.red }, rectRadius: 0.08,
});
slide.addText([
...bullets(["IV 10% Dextrose 150–200mL (or 50mL 50% dextrose)", "IM/SC Glucagon 1mg — if no IV access", "Recovery position; do NOT give oral glucose", "Repeat glucose check every 15 min"], 11),
], { x: 5.5, y: 2.7, w: 3.9, h: 1.55, margin: 0 });
slide.addShape(pres.shapes.RECTANGLE, {
x: 0.2, y: 4.45, w: 9.5, h: 0.55,
fill: { color: C.amber }, line: { color: C.amber },
});
slide.addText("Prevention: review doses, education on hypoglycaemia recognition, medical alert ID, always carry glucose", {
x: 0.2, y: 4.45, w: 9.5, h: 0.55,
fontSize: 10.5, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0,
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 34 — Prevention of Emergencies
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
contentShell(slide, "Prevention of Diabetic Emergencies");
const strategies = [
{ title: "Patient\nEducation", points: ["Recognise warning signs", "Know when to seek help", "Understand sick day rules"], color: C.teal },
{ title: "Sick Day\nRules", points: ["Never stop insulin in T1DM", "Monitor glucose/ketones 4-hrly", "Increase fluids, seek advice if vomiting"], color: C.amber },
{ title: "Access to\nSupplies", points: ["Insulin, test strips, glucose", "Glucagon kit at home", "CGM where available"], color: C.green },
{ title: "Regular\nFollow-up", points: ["HbA1c every 3–6 months", "Review hypo patterns", "Adjust regimen proactively"], color: C.darkTeal },
{ title: "Medication\nAdherence", points: ["Address barriers to compliance", "Simplify regimens when possible", "Pharmacy support"], color: C.cyan },
];
strategies.forEach((s, i) => {
const x = 0.15 + i * 1.93;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y: 0.92, w: 1.8, h: 4.1,
fill: { color: C.charcoal }, line: { color: s.color, pt: 2 }, rectRadius: 0.08,
});
slide.addShape(pres.shapes.RECTANGLE, { x, y: 0.92, w: 1.8, h: 0.7, fill: { color: s.color }, line: { color: s.color } });
slide.addText(s.title, { x, y: 0.92, w: 1.8, h: 0.7, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText([...bullets(s.points, 10.5)], { x: x + 0.05, y: 1.68, w: 1.7, h: 3.2, margin: 0 });
});
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 35 — Summary & Conclusion
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
navyBg(slide);
slide.addShape(pres.shapes.RECTANGLE, {
x: 0, y: 0, w: 0.07, h: 5.625,
fill: { color: C.cyan }, line: { color: C.cyan },
});
slide.addShape(pres.shapes.RECTANGLE, {
x: 0.07, y: 0, w: 9.93, h: 0.75,
fill: { color: C.charcoal }, line: { color: C.charcoal },
});
slide.addText("Key Takeaways", {
x: 0.25, y: 0, w: 9.5, h: 0.75,
fontSize: 22, bold: true, color: C.cyan, valign: "middle", margin: 0,
});
const takeaways = [
{ n: "1", t: "Glucose Homeostasis", d: "Tightly regulated by insulin (β-cells) and glucagon (α-cells) within 4–6 mmol/L" },
{ n: "2", t: "Types of DM", d: "T1 = autoimmune absolute deficiency; T2 = resistance + relative deficiency; both lead to chronic hyperglycaemia" },
{ n: "3", t: "Diagnosis", d: "Based on glucose thresholds or HbA1c ≥6.5%; confirm with repeat test unless symptomatic" },
{ n: "4", t: "Complications", d: "Micro (retinopathy, nephropathy, neuropathy) and macro (CAD, stroke, PAD) — prevented by good control" },
{ n: "5", t: "Management", d: "Lifestyle + Metformin for T2; insulin for T1; SGLT2i/GLP-1RA have proven CV & renal benefit" },
{ n: "6", t: "Emergencies", d: "DKA: fluids + insulin + K⁺. HHS: slow rehydration. Hypoglycaemia: 15g glucose or IV dextrose" },
];
takeaways.forEach((t, i) => {
const col = i % 2;
const row = Math.floor(i / 2);
const x = 0.25 + col * 4.88;
const y = 0.88 + row * 1.47;
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x, y, w: 4.65, h: 1.32,
fill: { color: C.charcoal }, line: { color: C.teal }, rectRadius: 0.07,
});
slide.addShape(pres.shapes.OVAL, { x: x + 0.1, y: y + 0.1, w: 0.48, h: 0.48, fill: { color: C.cyan }, line: { color: C.cyan } });
slide.addText(t.n, { x: x + 0.1, y: y + 0.1, w: 0.48, h: 0.48, fontSize: 13, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0 });
slide.addText(t.t, { x: x + 0.65, y: y + 0.1, w: 3.9, h: 0.42, fontSize: 12, bold: true, color: C.cyan, valign: "middle", margin: 0 });
slide.addText(t.d, { x: x + 0.1, y: y + 0.57, w: 4.45, h: 0.68, fontSize: 10.5, color: C.white, valign: "top", margin: 2 });
});
footer(slide, "Early diagnosis + tight control + patient education = prevention of complications");
}
// ════════════════════════════════════════════════════════════════════════════
// SLIDE 36 — References & Q&A
// ════════════════════════════════════════════════════════════════════════════
{
const slide = pres.addSlide();
navyBg(slide);
slide.addShape(pres.shapes.RECTANGLE, {
x: 0, y: 0, w: 0.07, h: 5.625,
fill: { color: C.cyan }, line: { color: C.cyan },
});
slide.addShape(pres.shapes.RECTANGLE, {
x: 0.07, y: 0, w: 9.93, h: 0.75,
fill: { color: C.charcoal }, line: { color: C.charcoal },
});
slide.addText("References & Q&A", {
x: 0.25, y: 0, w: 9.5, h: 0.75,
fontSize: 22, bold: true, color: C.cyan, valign: "middle", margin: 0,
});
const refs = [
"American Diabetes Association. Standards of Medical Care in Diabetes — 2024. Diabetes Care 2024;47(Suppl 1).",
"World Health Organization. Classification of Diabetes Mellitus. WHO, 2019.",
"NICE Guideline NG28. Type 2 diabetes in adults: management. NICE, updated 2022.",
"NICE Guideline NG17. Type 1 diabetes in adults: diagnosis and management. NICE, updated 2022.",
"Joint British Diabetes Societies (JBDS). Management of Diabetic Ketoacidosis in Adults. 2023.",
"UKPDS Group. Intensive blood-glucose control with sulphonylureas or insulin. Lancet 1998;352:837–853.",
"Zinman B, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes (EMPA-REG). NEJM 2015.",
];
refs.forEach((r, i) => {
slide.addShape(pres.shapes.RECTANGLE, {
x: 0.15, y: 0.85 + i * 0.55, w: 0.22, h: 0.35,
fill: { color: C.teal }, line: { color: C.teal },
});
slide.addText(`${i + 1}`, { x: 0.15, y: 0.85 + i * 0.55, w: 0.22, h: 0.35, fontSize: 9, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
slide.addText(r, { x: 0.42, y: 0.85 + i * 0.55, w: 9.3, h: 0.48, fontSize: 9.5, color: C.muted, valign: "middle", margin: 0 });
});
// Q&A area
slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
x: 2.5, y: 4.75, w: 5.0, h: 0.65,
fill: { color: C.teal }, line: { color: C.teal }, rectRadius: 0.1,
});
slide.addText("Questions & Discussion", {
x: 2.5, y: 4.75, w: 5.0, h: 0.65,
fontSize: 16, bold: true, color: C.white, align: "center", valign: "middle", margin: 0,
});
}
// ════════════════════════════════════════════════════════════════════════════
// WRITE FILE
// ════════════════════════════════════════════════════════════════════════════
pres.writeFile({ fileName: "/home/daytona/workspace/diabetes-pptx/Diabetes_Mellitus.pptx" })
.then(() => console.log("✅ Saved: /home/daytona/workspace/diabetes-pptx/Diabetes_Mellitus.pptx"))
.catch(err => { console.error("❌ Error:", err); process.exit(1); });
To run it:
node /home/daytona/workspace/diabetes-pptx/diabetes.js
The script will produce
Diabetes_Mellitus.pptx with:- 36 slides covering all 7 sections
- Navy/teal/cyan color theme with color-coded section cards
- Tables (DKA vs HHS comparison, diagnostic criteria, complication screening)
- Flowcharts (T1DM & T2DM progression using drawn shapes + arrows)
- Step-by-step DKA management numbered cards
- Hypoglycaemia decision pathway (conscious vs unconscious branches)
- 7 numbered references (ADA 2024, WHO, NICE, JBDS, UKPDS, EMPA-REG)
Save the script as
diabetes.js in /home/daytona/workspace/diabetes-pptx/, then run it. Want me to execute it now and give you the download link?Execute the script to generate the PPTX file
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