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const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Diabetes Mellitus & Systemic Hypertension – Latest Updates";
pres.author = "Orris Health";

// ─── COLOUR PALETTE ───────────────────────────────────────────────────────────
const BG_DARK   = "0D1F3C";   // deep navy  (dominant)
const BG_LIGHT  = "F0F4FA";   // pale blue-white (content slides)
const ACCENT1   = "1DB8A4";   // teal-green (diabetes)
const ACCENT2   = "E84F4F";   // coral-red  (hypertension)
const GOLD      = "F5A623";   // amber (highlights / stats)
const WHITE     = "FFFFFF";
const DARK_TEXT = "1A2B45";
const MID_GREY  = "8795A8";

// ─── HELPERS ──────────────────────────────────────────────────────────────────
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// ══════════════════════════════════════════════════════════════════════════════
//  SLIDES
// ══════════════════════════════════════════════════════════════════════════════

// 1. Title
titleSlide("Diabetes Mellitus &\nSystemic Hypertension", "Latest Updates 2025–2026");

// 2. Agenda
contentSlide("What We Will Cover Today", [
  "Understanding Diabetes Mellitus – what it is & types",
  "Causes, risk factors & who is at risk",
  "How doctors diagnose diabetes",
  "Latest treatment advances (ADA Standards of Care 2026)",
  "Understanding Systemic Hypertension – what it is",
  "Causes, risks & complications",
  "New blood pressure targets (ACC/AHA 2025 Guideline)",
  "How diabetes & high BP are connected",
  "Lifestyle changes – the most powerful medicine",
  "Key takeaways & questions",
], BG_DARK);

// ─── SECTION 1: DIABETES ─────────────────────────────────────────────────────
// 3. Divider
sectionDivider("PART 1", "Diabetes Mellitus", ACCENT1);

// 4. What is Diabetes?
contentSlide("What Is Diabetes Mellitus?", [
  "A chronic condition where the body cannot properly use glucose (sugar) from food",
  "Insulin, a hormone made by the pancreas, is needed to move glucose into cells",
  "In diabetes: either not enough insulin is made, or the body ignores it",
  "Result: blood sugar stays too high → damages organs over time",
  "",
  { text: "3 Main Types:", options: { bold: true, fontSize: 17, color: ACCENT1, breakLine: true, bullet: false } },
  { text: "  Type 1 – immune system destroys insulin-making cells (autoimmune)", options: { bullet: { type: "bullet" }, fontSize: 16, color: DARK_TEXT, breakLine: true } },
  { text: "  Type 2 – body resists insulin; most common (90–95% of cases)", options: { bullet: { type: "bullet" }, fontSize: 16, color: DARK_TEXT, breakLine: true } },
  { text: "  Gestational – develops during pregnancy; often resolves after birth", options: { bullet: { type: "bullet" }, fontSize: 16, color: DARK_TEXT, breakLine: false } },
], ACCENT1);

// 5. Global Burden – stats
statSlide("Diabetes by the Numbers (2025)", [
  { value: "589M", label: "People with diabetes worldwide (IDF 2025)" },
  { value: "1 in 9", label: "Adults globally affected" },
  { value: "90%", label: "Cases are Type 2 diabetes" },
  { value: "3.3M", label: "Deaths linked to diabetes each year" },
], ACCENT1);

// 6. Risk Factors
contentSlide("Who Is at Risk for Type 2 Diabetes?", [
  "Overweight or obesity (BMI ≥25 kg/m²) – strongest modifiable risk factor",
  "Physical inactivity – sitting too much, little daily exercise",
  "Family history of diabetes – genes play a role",
  "Age 45 or older (risk rises with age)",
  "High blood pressure or high cholesterol",
  "History of gestational diabetes or giving birth to a baby >9 lbs",
  "Prediabetes – blood sugar higher than normal but not yet diabetic",
  "Certain ethnicities: South Asian, African, Hispanic, Indigenous populations are at higher risk",
  "",
  { text: "⚠ Up to 70% of prediabetes cases can be prevented from progressing to Type 2 with lifestyle changes", options: { bold: true, fontSize: 15, color: ACCENT2, breakLine: false, bullet: false } },
], ACCENT1);

// 7. Symptoms
contentSlide("Signs & Symptoms of Diabetes", [
  { text: "Common Symptoms (often subtle in Type 2):", options: { bold: true, fontSize: 17, color: ACCENT1, breakLine: true, bullet: false } },
  "Frequent urination – especially at night",
  "Excessive thirst & dry mouth",
  "Unexplained weight loss (especially Type 1)",
  "Fatigue & lack of energy",
  "Blurred vision",
  "Slow-healing wounds or frequent infections",
  "Numbness or tingling in hands / feet",
  "",
  { text: "⚠ Many people with Type 2 have NO symptoms for years – regular screening is essential!", options: { bold: true, fontSize: 15, color: ACCENT2, breakLine: false, bullet: false } },
], ACCENT1);

// 8. Diagnosis
contentSlide("How Is Diabetes Diagnosed?", [
  { text: "Four accepted tests (ADA 2026):", options: { bold: true, fontSize: 17, color: ACCENT1, breakLine: true, bullet: false } },
  "Fasting plasma glucose (FPG) ≥126 mg/dL (7.0 mmol/L)",
  "2-hour glucose during oral glucose tolerance test (OGTT) ≥200 mg/dL",
  "HbA1c (glycated haemoglobin) ≥6.5% – reflects average blood sugar over 3 months",
  "Random plasma glucose ≥200 mg/dL WITH symptoms",
  "",
  { text: "Prediabetes range:", options: { bold: true, fontSize: 16, color: GOLD, breakLine: true, bullet: false } },
  { text: "  HbA1c 5.7–6.4%  |  FPG 100–125 mg/dL  |  OGTT 140–199 mg/dL", options: { fontSize: 15, color: DARK_TEXT, breakLine: true, bullet: false } },
  "",
  { text: "2026 Update: A1C testing recommended for ALL patients admitted to hospital", options: { bold: true, fontSize: 15, color: ACCENT2, breakLine: false, bullet: false } },
], ACCENT1);

// 9. Treatment overview
contentSlide("Treating Diabetes – The Modern Approach", [
  { text: "Lifestyle is FIRST-LINE therapy:", options: { bold: true, fontSize: 17, color: ACCENT1, breakLine: true, bullet: false } },
  "Healthy eating: reduce refined carbs, added sugars; increase fibre",
  "Physical activity: at least 150 min/week of moderate exercise",
  "Weight management: losing 5–10% body weight significantly improves blood sugar",
  "Stop smoking & e-cigarettes (new 2026 ADA recommendation)",
  "",
  { text: "Medications – when lifestyle alone isn't enough:", options: { bold: true, fontSize: 17, color: ACCENT1, breakLine: true, bullet: false } },
  "Metformin – still the most common first pill for Type 2",
  "GLP-1 receptor agonists (e.g., semaglutide/Ozempic) – also aid weight loss",
  "SGLT2 inhibitors (e.g., empagliflozin) – protect the heart & kidneys too",
  "Insulin – used in Type 1 always; in Type 2 when needed",
], ACCENT1);

// 10. ADA 2026 Updates
contentSlide("ADA 2026 – Key New Updates for Everyone to Know", [
  { text: "Blood Sugar Target (HbA1c):", options: { bold: true, fontSize: 16, color: ACCENT1, breakLine: true, bullet: false } },
  "< 7% for most adults; higher targets acceptable for frail/elderly patients",
  "",
  { text: "New in 2026:", options: { bold: true, fontSize: 16, color: GOLD, breakLine: true, bullet: false } },
  "GLP-1 / GIP dual agonists (tirzepatide) now recommended for Type 2 with obesity or heart failure",
  "Continuous Glucose Monitoring (CGM) now recommended for older adults on insulin",
  "Blood pressure goal updated to <120 mmHg systolic for high CV/kidney risk patients",
  "Hyperglycemia redefined: plasma glucose ≥200 mg/dL OR known history of diabetes",
  "All hospital patients to have A1C checked on admission",
  "Protein intake guidance for older adults: ≥0.8 g/kg body weight/day",
  "Focus on tobacco AND e-cigarette cessation counselling",
], ACCENT1);

// 11. Complications of Diabetes
contentSlide("Long-Term Complications if Diabetes is Uncontrolled", [
  { text: "Heart & Blood Vessels:", options: { bold: true, color: ACCENT2, fontSize: 16, breakLine: true, bullet: false } },
  "2–4× higher risk of heart attack and stroke; #1 cause of death in diabetes",
  { text: "Eyes (Diabetic Retinopathy):", options: { bold: true, color: ACCENT2, fontSize: 16, breakLine: true, bullet: false } },
  "Leading cause of blindness in working-age adults",
  { text: "Kidneys (Diabetic Nephropathy):", options: { bold: true, color: ACCENT2, fontSize: 16, breakLine: true, bullet: false } },
  "Leading cause of kidney failure requiring dialysis",
  { text: "Nerves (Diabetic Neuropathy):", options: { bold: true, color: ACCENT2, fontSize: 16, breakLine: true, bullet: false } },
  "Numbness, pain, foot ulcers → amputations",
  { text: "Other:", options: { bold: true, color: ACCENT2, fontSize: 16, breakLine: true, bullet: false } },
  "Increased infection risk, sexual dysfunction, gum disease, cognitive decline",
], ACCENT1);

// ─── SECTION 2: HYPERTENSION ─────────────────────────────────────────────────
// 12. Divider
sectionDivider("PART 2", "Systemic Hypertension", ACCENT2);

// 13. What is Hypertension?
contentSlide("What Is Systemic Hypertension?", [
  "Blood pressure is the force of blood pushing against artery walls",
  "Measured in two numbers: Systolic (top) / Diastolic (bottom) – in mmHg",
  "",
  { text: "Blood Pressure Categories (2025 ACC/AHA Guideline):", options: { bold: true, fontSize: 17, color: ACCENT2, breakLine: true, bullet: false } },
  { text: "  Normal:          <120 / <80 mmHg", options: { fontSize: 15, color: DARK_TEXT, breakLine: true, bullet: false, fontFace: "Courier New" } },
  { text: "  Elevated:        120–129 / <80 mmHg", options: { fontSize: 15, color: GOLD, breakLine: true, bullet: false, fontFace: "Courier New" } },
  { text: "  Stage 1 HTN:     130–139 / 80–89 mmHg", options: { fontSize: 15, color: "E07020", breakLine: true, bullet: false, fontFace: "Courier New" } },
  { text: "  Stage 2 HTN:     ≥140 / ≥90 mmHg", options: { fontSize: 15, color: ACCENT2, breakLine: true, bullet: false, fontFace: "Courier New" } },
  { text: "  Crisis:          >180 / >120 mmHg (emergency!)", options: { fontSize: 15, color: ACCENT2, bold: true, breakLine: false, bullet: false, fontFace: "Courier New" } },
], ACCENT2);

// 14. Hypertension stats
statSlide("Hypertension by the Numbers (2025)", [
  { value: "1.3B", label: "People with hypertension globally" },
  { value: "50%", label: "US adults will develop HTN in lifetime" },
  { value: "#1", label: "Most modifiable cardiovascular risk factor" },
  { value: "<50%", label: "Of those diagnosed actually have it controlled" },
], ACCENT2);

// 15. Causes & Risk Factors
contentSlide("Causes & Risk Factors for Hypertension", [
  { text: "Primary (Essential) Hypertension – 90–95% of cases:", options: { bold: true, color: ACCENT2, fontSize: 16, breakLine: true, bullet: false } },
  "No single cause identified; combination of genetics + lifestyle",
  { text: "Secondary Hypertension – 5–10% of cases:", options: { bold: true, color: ACCENT2, fontSize: 16, breakLine: true, bullet: false } },
  "Kidney disease, sleep apnoea, thyroid disorders, certain medications",
  "",
  { text: "Key Risk Factors:", options: { bold: true, color: GOLD, fontSize: 16, breakLine: true, bullet: false } },
  "High salt (sodium) diet",
  "Excess weight & obesity",
  "Physical inactivity",
  "Heavy alcohol consumption",
  "Stress & poor sleep",
  "Family history of high BP",
  "Older age (arteries stiffen with age)",
], ACCENT2);

// 16. Why it matters
contentSlide("Why Hypertension Is Called the 'Silent Killer'", [
  { text: "Most people have NO symptoms until serious damage occurs", options: { bold: true, fontSize: 17, color: ACCENT2, breakLine: true, bullet: false } },
  "",
  { text: "For every 10 mmHg reduction in systolic blood pressure:", options: { bold: true, fontSize: 16, color: DARK_TEXT, breakLine: true, bullet: false } },
  "↓ 17% risk of coronary heart disease",
  "↓ 27% risk of stroke",
  "↓ 28% risk of heart failure",
  "↓ 20% risk of major cardiovascular events",
  "↓ 13% risk of death from any cause",
  "",
  { text: "Source: 2025 ACC/AHA High Blood Pressure Guideline (Jones DW et al., Circulation 2025;152:1-105)", options: { fontSize: 13, color: MID_GREY, italic: true, breakLine: false, bullet: false } },
], ACCENT2);

// 17. ACC/AHA 2025 Guideline Updates
contentSlide("2025 ACC/AHA Hypertension Guideline – What's New?", [
  "Replaces the 2017 guideline – most comprehensive update in 8 years",
  { text: "Key target remains: <130/80 mmHg for ALL adults with hypertension", options: { bold: true, color: ACCENT2, fontSize: 16, breakLine: true, bullet: false } },
  "",
  { text: "Major changes in 2025:", options: { bold: true, color: GOLD, fontSize: 16, breakLine: true, bullet: false } },
  "New PREVENT™ Equation replaces old Pooled Cohort Equations for 10-year CVD risk",
  "Medication now recommended after 3–6 months of lifestyle changes if BP stays ≥130/80 mmHg (even in lower-risk Stage 1 patients)",
  "Earlier treatment for cognitive decline & dementia prevention",
  "Improved guidance on BP during & after pregnancy",
  "Greater emphasis on home blood pressure monitoring",
  "More detailed management of hypertensive emergencies (SBP >180/DBP >120)",
  "Screening recommendations for secondary causes of hypertension",
], ACCENT2);

// 18. Treatment of Hypertension
contentSlide("Managing High Blood Pressure – Overview", [
  { text: "Step 1 – Lifestyle Modification (always):", options: { bold: true, color: ACCENT2, fontSize: 16, breakLine: true, bullet: false } },
  "DASH diet: fruits, vegetables, low-fat dairy, reduce sodium to <2,300 mg/day",
  "Aerobic exercise: 150 min/week; resistance training 2–3×/week",
  "Limit alcohol: ≤1 drink/day women, ≤2 drinks/day men",
  "Maintain healthy weight; quit smoking",
  "",
  { text: "Step 2 – Medications (4 main classes):", options: { bold: true, color: ACCENT2, fontSize: 16, breakLine: true, bullet: false } },
  "ACE inhibitors / ARBs – especially helpful in diabetes or kidney disease",
  "Calcium channel blockers – good for older adults",
  "Thiazide diuretics – often used as first choice",
  "Beta-blockers – useful when heart disease also present",
], ACCENT2);

// ─── SECTION 3: CONNECTION ────────────────────────────────────────────────────
// 19. Divider
sectionDivider("PART 3", "Diabetes & Hypertension – The Connection", GOLD);

// 20. How they're linked
twoColSlide(
  "How Diabetes & Hypertension Interact",
  "🩺 Diabetes affects BP",
  [
    "High blood sugar damages blood vessel walls",
    "Damaged vessels become stiff & narrow → raises BP",
    "Kidneys affected by diabetes retain more salt → raises BP",
    "Obesity (common in Type 2) independently raises BP",
    "2 out of 3 people with diabetes also have hypertension",
  ],
  "💉 Hypertension worsens Diabetes",
  [
    "High BP accelerates diabetic kidney disease (nephropathy)",
    "Increases risk of diabetic eye damage (retinopathy)",
    "Raises risk of heart attack & stroke dramatically",
    "Both together multiply cardiovascular risk by 4–8×",
    "Treating both is more effective than treating either alone",
  ],
  ACCENT1, ACCENT2
);

// 21. Shared treatments
contentSlide("Shared & Overlapping Treatments", [
  { text: "Medications that treat BOTH:", options: { bold: true, color: GOLD, fontSize: 17, breakLine: true, bullet: false } },
  "SGLT2 inhibitors (gliflozins) – lower blood sugar AND blood pressure AND protect kidneys",
  "GLP-1 receptor agonists – lower blood sugar, reduce weight, modest BP reduction",
  "ACE inhibitors / ARBs – lower BP AND protect kidneys in diabetes",
  "",
  { text: "Shared lifestyle approaches:", options: { bold: true, color: GOLD, fontSize: 17, breakLine: true, bullet: false } },
  "Weight loss reduces both blood sugar and blood pressure",
  "Regular exercise improves insulin sensitivity AND lowers BP",
  "Low-sodium, high-fibre diet benefits both conditions",
  "Stopping smoking reduces cardiovascular risk from both",
  "",
  { text: "ADA 2026: BP target <120 mmHg systolic for diabetic patients with high CV/kidney risk", options: { bold: true, fontSize: 15, color: ACCENT2, breakLine: false, bullet: false } },
], GOLD);

// ─── SECTION 4: LIFESTYLE ─────────────────────────────────────────────────────
// 22. Lifestyle power
contentSlide("The Power of Lifestyle – Your Best Medicine", [
  { text: "Evidence shows lifestyle changes can:", options: { bold: true, color: ACCENT1, fontSize: 17, breakLine: true, bullet: false } },
  "Prevent or delay Type 2 diabetes by up to 58% (Diabetes Prevention Program trial)",
  "Reduce systolic blood pressure by 5–20 mmHg with diet & exercise alone",
  "Reduce the need for multiple medications",
  "",
  { text: "Five key habits:", options: { bold: true, color: GOLD, fontSize: 16, breakLine: true, bullet: false } },
  "1. Move more – 30 minutes of walking most days is enough to start",
  "2. Eat smart – more vegetables, less salt, sugar & processed food",
  "3. Maintain a healthy weight – even modest loss makes a big difference",
  "4. Sleep well – poor sleep raises blood sugar and blood pressure",
  "5. Manage stress – chronic stress raises both cortisol and BP",
], ACCENT1);

// 23. Monitoring
contentSlide("Monitoring – Know Your Numbers", [
  { text: "Diabetes monitoring:", options: { bold: true, color: ACCENT1, fontSize: 17, breakLine: true, bullet: false } },
  "HbA1c test every 3–6 months – target < 7% for most people",
  "Fasting blood glucose daily or as advised",
  "CGM (Continuous Glucose Monitor) – increasingly recommended, especially for older adults on insulin (ADA 2026)",
  "Annual kidney function, eye exam, and foot examination",
  "",
  { text: "Blood pressure monitoring:", options: { bold: true, color: ACCENT2, fontSize: 17, breakLine: true, bullet: false } },
  "Home blood pressure monitoring strongly recommended (2025 ACC/AHA)",
  "Check in both arms at first visit",
  "Target: < 130/80 mmHg for most; <120 mmHg systolic for high-risk patients",
  "Keep a log and share with your doctor",
], GOLD);

// 24. When to seek help
contentSlide("When to See a Doctor Urgently", [
  { text: "🚨 Diabetes – Seek emergency care if:", options: { bold: true, color: ACCENT2, fontSize: 17, breakLine: true, bullet: false } },
  "Blood sugar >300 mg/dL or below 70 mg/dL with symptoms",
  "Severe nausea, vomiting, fruity-smelling breath (possible DKA)",
  "Sudden confusion, extreme weakness, or loss of consciousness",
  "",
  { text: "🚨 Hypertension – Seek emergency care if:", options: { bold: true, color: ACCENT2, fontSize: 17, breakLine: true, bullet: false } },
  "Blood pressure reading >180/120 mmHg – this is a hypertensive crisis",
  "Severe headache, vision changes, chest pain, or shortness of breath with high BP",
  "Sudden weakness or numbness (possible stroke)",
  "",
  { text: "Regular check-ups every 3–6 months even without symptoms are essential", options: { bold: true, fontSize: 15, color: ACCENT1, breakLine: false, bullet: false } },
], ACCENT2);

// 25. Key Takeaways / Closing
const sl25 = pres.addSlide();
sl25.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: BG_DARK } });
sl25.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.08, fill: { color: ACCENT1 } });
sl25.addShape(pres.ShapeType.rect, { x: 0, y: 5.54, w: 10, h: 0.085, fill: { color: ACCENT2 } });
sl25.addText("Key Takeaways", { x: 0.5, y: 0.18, w: 9, h: 0.6, fontSize: 26, bold: true, color: WHITE, align: "center", fontFace: "Calibri" });
const takeaways = [
  { text: "✅ Both diabetes and hypertension are common, serious, but largely preventable & manageable", options: { bullet: false, fontSize: 15, color: ACCENT1, breakLine: true } },
  { text: "✅ ADA 2026: HbA1c <7%, BP <130/80 mmHg (or <120 in high-risk); newer drugs (GLP-1, SGLT2) recommended", options: { bullet: false, fontSize: 15, color: ACCENT1, breakLine: true } },
  { text: "✅ ACC/AHA 2025: New PREVENT™ risk calculator; earlier medication if lifestyle alone doesn't control BP", options: { bullet: false, fontSize: 15, color: ACCENT2, breakLine: true } },
  { text: "✅ The two conditions are strongly linked and worsen each other – manage both together", options: { bullet: false, fontSize: 15, color: GOLD, breakLine: true } },
  { text: "✅ Lifestyle change (diet, exercise, weight loss) is the single most powerful intervention", options: { bullet: false, fontSize: 15, color: WHITE, breakLine: true } },
  { text: "✅ Know your numbers: blood sugar (HbA1c) and blood pressure – monitor regularly at home", options: { bullet: false, fontSize: 15, color: WHITE, breakLine: false } },
];
sl25.addText(takeaways, { x: 0.5, y: 0.95, w: 9, h: 4.3, fontFace: "Calibri", valign: "top", lineSpacingMultiple: 1.4 });

// ══════════════════════════════════════════════════════════════════════════════
pres.writeFile({ fileName: "/home/daytona/workspace/diabetes-htn-ppt/Diabetes_Hypertension_Latest_Updates.pptx" })
  .then(() => console.log("✅ PPTX written successfully"))
  .catch(err => { console.error("❌ Error:", err); process.exit(1); });