const pptxgen = require("pptxgenjs");
const pres = new pptxgen();

// A0 poster-like layout: use LAYOUT_WIDE (13.3" x 7.5") in landscape
// For a portrait poster feel, we use a custom tall layout
pres.defineLayout({ name: "POSTER", width: 24, height: 36 });
pres.layout = "POSTER";

// ── Color palette ──────────────────────────────────────────────
const DARK_BG    = "0D1B2A";  // deep navy
const PANEL_BG   = "112233";  // slightly lighter navy
const ACCENT     = "E8402A";  // red-orange accent
const GOLD       = "F5A623";  // amber/gold highlight
const GREEN      = "27AE60";  // outcome green
const LIGHT_TXT  = "F0F4F8";  // near-white
const SUBHEAD    = "A8C7E0";  // muted light blue
const CARD_BG    = "1A2E42";  // card surface
const WHITE      = "FFFFFF";
const DIVIDER    = "2A4A6A";

// ── Background ─────────────────────────────────────────────────
const slide = pres.addSlide();
slide.background = { color: DARK_BG };

// ── Top gradient bar ───────────────────────────────────────────
slide.addShape(pres.ShapeType.rect, {
  x: 0, y: 0, w: 24, h: 2.6,
  fill: { color: "1A3A5C" },
  line: { color: "1A3A5C" }
});
// Accent top stripe
slide.addShape(pres.ShapeType.rect, {
  x: 0, y: 0, w: 24, h: 0.22,
  fill: { color: ACCENT },
  line: { color: ACCENT }
});

// ── TITLE BLOCK ────────────────────────────────────────────────
slide.addText("DIABETIC KETOACIDOSIS", {
  x: 0.6, y: 0.3, w: 22.8, h: 1.0,
  fontSize: 64, bold: true, color: WHITE,
  fontFace: "Calibri", charSpacing: 6, align: "center", margin: 0
});
slide.addText("TRIGGERS & OUTCOMES: Non-Compliance · Infection · First Presentation", {
  x: 0.6, y: 1.28, w: 22.8, h: 0.78,
  fontSize: 30, bold: false, color: GOLD,
  fontFace: "Calibri", align: "center", margin: 0, charSpacing: 2
});

// Conference tag
slide.addShape(pres.ShapeType.rect, {
  x: 0, y: 2.6, w: 24, h: 0.18,
  fill: { color: ACCENT }, line: { color: ACCENT }
});

// Presenter line
slide.addText("PG Medicine Resident Conference  |  Department of Internal Medicine  |  May 2026", {
  x: 0.6, y: 2.82, w: 22.8, h: 0.45,
  fontSize: 18, color: SUBHEAD, fontFace: "Calibri", align: "center", margin: 0
});

// ── SECTION HELPERS ────────────────────────────────────────────
function sectionHeader(slide, x, y, w, label, color) {
  slide.addShape(pres.ShapeType.rect, {
    x, y, w, h: 0.52,
    fill: { color: color || ACCENT },
    line: { color: color || ACCENT }, rounding: 0.04
  });
  slide.addText(label, {
    x: x + 0.12, y: y + 0.06, w: w - 0.24, h: 0.42,
    fontSize: 22, bold: true, color: WHITE,
    fontFace: "Calibri", align: "left", margin: 0
  });
}

function card(slide, x, y, w, h) {
  slide.addShape(pres.ShapeType.rect, {
    x, y, w, h,
    fill: { color: CARD_BG },
    line: { color: DIVIDER, pt: 1 },
    shadow: { type: "outer", blur: 6, offset: 3, angle: 45, color: "000000", opacity: 0.3 }
  });
}

// ── ROW 1: Three columns ───────────────────────────────────────
// Col widths: 7.4" each with 0.4" gutters
// Total: 7.4+7.4+7.4 + 0.4+0.4 = 23.2 — starts at x=0.4
const COL1_X = 0.4;
const COL2_X = 8.2;
const COL3_X = 16.0;
const COL_W  = 7.6;
const ROW1_Y = 3.5;

// ────────────────────────────────────
// COL 1: BACKGROUND & PATHOPHYSIOLOGY
// ────────────────────────────────────
card(slide, COL1_X, ROW1_Y, COL_W, 10.2);
sectionHeader(slide, COL1_X, ROW1_Y, COL_W, "⚗  PATHOPHYSIOLOGY", "1A5276");

slide.addText("DKA is a life-threatening triad of:", {
  x: COL1_X + 0.18, y: ROW1_Y + 0.65, w: COL_W - 0.36, h: 0.38,
  fontSize: 19, bold: true, color: GOLD, fontFace: "Calibri", margin: 0
});

// Triad visual: three horizontal badges
const triadItems = [
  { label: "HYPERGLYCEMIA", sub: "Glucose ≥250 mg/dL" },
  { label: "KETOSIS",        sub: "β-OHB ≥3.0 mmol/L" },
  { label: "ACIDOSIS",       sub: "pH < 7.30" }
];
triadItems.forEach((item, i) => {
  const bx = COL1_X + 0.18;
  const by = ROW1_Y + 1.12 + i * 0.82;
  slide.addShape(pres.ShapeType.rect, {
    x: bx, y: by, w: COL_W - 0.36, h: 0.72,
    fill: { color: "1A3A5C" }, line: { color: GOLD, pt: 1.5 }, rounding: 0.06
  });
  slide.addText([
    { text: item.label + "  ", options: { bold: true, color: GOLD, fontSize: 20 } },
    { text: item.sub, options: { bold: false, color: LIGHT_TXT, fontSize: 16 } }
  ], {
    x: bx + 0.15, y: by + 0.12, w: COL_W - 0.66, h: 0.48,
    fontFace: "Calibri", margin: 0
  });
});

slide.addText("Mechanism:", {
  x: COL1_X + 0.18, y: ROW1_Y + 3.68, w: COL_W - 0.36, h: 0.35,
  fontSize: 18, bold: true, color: SUBHEAD, fontFace: "Calibri", margin: 0
});

const mechText = [
  { text: "↑ Glucagon / ↓ Insulin  →  unrestrained lipolysis", options: { bullet: true, color: LIGHT_TXT, fontSize: 17, breakLine: true } },
  { text: "Free fatty acids → hepatic ketogenesis (β-OHB, acetoacetate)", options: { bullet: true, color: LIGHT_TXT, fontSize: 17, breakLine: true } },
  { text: "Osmotic diuresis → dehydration + electrolyte losses", options: { bullet: true, color: LIGHT_TXT, fontSize: 17, breakLine: true } },
  { text: "Kussmaul breathing = respiratory compensation for acidosis", options: { bullet: true, color: LIGHT_TXT, fontSize: 17, breakLine: true } },
  { text: "Average fluid deficit: 70–120 mL/kg body weight", options: { bullet: true, color: LIGHT_TXT, fontSize: 17, breakLine: true } },
  { text: "K⁺, PO₄, Mg²⁺: total-body depleted despite elevated serum levels", options: { bullet: true, color: LIGHT_TXT, fontSize: 17 } },
];
slide.addText(mechText, {
  x: COL1_X + 0.18, y: ROW1_Y + 4.08, w: COL_W - 0.36, h: 5.5,
  fontFace: "Calibri", margin: 0, paraSpaceAfter: 4
});

// ────────────────────────────────────
// COL 2: TRIGGERS
// ────────────────────────────────────
card(slide, COL2_X, ROW1_Y, COL_W, 10.2);
sectionHeader(slide, COL2_X, ROW1_Y, COL_W, "⚡  TRIGGERS / PRECIPITANTS", ACCENT);

// Three main trigger boxes
const triggers = [
  {
    icon: "💊",
    title: "NON-COMPLIANCE",
    color: "C0392B",
    items: [
      "Most common trigger in established T1DM",
      "Deliberate insulin omission (weight control, psychosocial)",
      "Insulin access barriers — cost, supply shortages",
      "Insulin pump failure or site occlusion",
      "Missing doses during illness ('sick-day rules' not followed)",
      "Elderly / low-vision patients: administration errors",
    ]
  },
  {
    icon: "🦠",
    title: "INFECTION",
    color: "873600",
    items: [
      "2nd most common precipitant overall",
      "UTI & pneumonia — most frequent infectious triggers",
      "Stress hormones (cortisol, catecholamines) → counter-regulatory surge",
      "Elevated temperature ≠ DKA itself — always suggests infection",
      "Sepsis / soft-tissue infections in T2DM",
      "COVID-19 associated euglycaemic DKA reported",
    ]
  },
  {
    icon: "🩺",
    title: "FIRST PRESENTATION",
    color: "117A65",
    items: [
      "~25% of all DKA episodes = new-onset diabetes",
      "Common in children & young adults with T1DM",
      "Developing-world setting: higher rate of presentation at DKA",
      "Delayed diagnosis → more severe acidosis at presentation",
      "Classic prodrome: days of polyuria, polydipsia, weight loss",
      "Abdominal pain mimics acute abdomen in 50% of children",
    ]
  }
];

let tyBase = ROW1_Y + 0.62;
triggers.forEach((t, i) => {
  const ty = tyBase + i * 3.12;
  slide.addShape(pres.ShapeType.rect, {
    x: COL2_X + 0.18, y: ty, w: COL_W - 0.36, h: 2.96,
    fill: { color: "1A2E42" }, line: { color: t.color, pt: 2 }, rounding: 0.06
  });
  // Icon + title bar
  slide.addShape(pres.ShapeType.rect, {
    x: COL2_X + 0.18, y: ty, w: COL_W - 0.36, h: 0.5,
    fill: { color: t.color }, line: { color: t.color }, rounding: 0.04
  });
  slide.addText(t.icon + "  " + t.title, {
    x: COL2_X + 0.3, y: ty + 0.05, w: COL_W - 0.6, h: 0.42,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri", margin: 0
  });
  const bulletItems = t.items.map((txt, idx) => ({
    text: txt,
    options: { bullet: true, color: LIGHT_TXT, fontSize: 15.5, breakLine: idx < t.items.length - 1 }
  }));
  slide.addText(bulletItems, {
    x: COL2_X + 0.3, y: ty + 0.56, w: COL_W - 0.48, h: 2.28,
    fontFace: "Calibri", margin: 0, paraSpaceAfter: 3
  });
});

// Additional triggers mini-list
sectionHeader(slide, COL2_X, ROW1_Y + 9.58, COL_W, "OTHER NOTABLE TRIGGERS", "2471AB");
slide.addText([
  { text: "ACS / MI  •  CVA  •  Pancreatitis  •  Pulmonary embolism  •  GI bleeding", options: { color: LIGHT_TXT, fontSize: 14, breakLine: true } },
  { text: "Drugs: corticosteroids, SGLT-2 inhibitors*, clozapine, thiazides, cocaine", options: { color: GOLD, fontSize: 14, breakLine: true } },
  { text: "Endocrinopathy: Cushing's, thyrotoxicosis, acromegaly", options: { color: LIGHT_TXT, fontSize: 14 } },
], {
  x: COL2_X + 0.18, y: ROW1_Y + 10.14, w: COL_W - 0.36, h: 0.68,
  fontFace: "Calibri", margin: 0
});

// ────────────────────────────────────
// COL 3: CLINICAL FEATURES + DIAGNOSIS
// ────────────────────────────────────
card(slide, COL3_X, ROW1_Y, COL_W, 10.2);
sectionHeader(slide, COL3_X, ROW1_Y, COL_W, "🔬  CLINICAL FEATURES & DIAGNOSIS", "6E2FA0");

slide.addText("Symptoms & Signs", {
  x: COL3_X + 0.18, y: ROW1_Y + 0.65, w: COL_W - 0.36, h: 0.35,
  fontSize: 18, bold: true, color: SUBHEAD, fontFace: "Calibri", margin: 0
});
const sx = [
  "Polyuria, polydipsia, polyphagia, weight loss",
  "Nausea, vomiting, anorexia, abdominal pain",
  "Kussmaul breathing (deep, rapid respirations)",
  "Fruity/acetone odour on breath",
  "Tachycardia, hypotension, dry mucous membranes",
  "Altered mental status → coma (severe cases)",
  "Elevated temperature → suggests underlying infection",
];
const sxBullets = sx.map((t, i) => ({
  text: t, options: { bullet: true, color: LIGHT_TXT, fontSize: 16, breakLine: i < sx.length - 1 }
}));
slide.addText(sxBullets, {
  x: COL3_X + 0.18, y: ROW1_Y + 1.06, w: COL_W - 0.36, h: 3.2,
  fontFace: "Calibri", margin: 0, paraSpaceAfter: 3
});

// Diagnostic criteria table
slide.addText("Diagnostic Criteria (ADA / ISPAD)", {
  x: COL3_X + 0.18, y: ROW1_Y + 4.35, w: COL_W - 0.36, h: 0.35,
  fontSize: 18, bold: true, color: SUBHEAD, fontFace: "Calibri", margin: 0
});

const tableRows = [
  [{ text: "Parameter", options: { bold: true, color: GOLD } }, { text: "Mild", options: { bold: true, color: GOLD } }, { text: "Moderate", options: { bold: true, color: GOLD } }, { text: "Severe", options: { bold: true, color: GOLD } }],
  [{ text: "pH" }, { text: "7.25–7.30" }, { text: "7.00–7.24" }, { text: "< 7.00" }],
  [{ text: "HCO₃ (mEq/L)" }, { text: "15–18" }, { text: "10–14" }, { text: "< 10" }],
  [{ text: "Anion Gap" }, { text: "> 10" }, { text: "> 12" }, { text: "> 14" }],
  [{ text: "Sensorium" }, { text: "Alert" }, { text: "Alert/drowsy" }, { text: "Stupor/coma" }],
];

slide.addTable(tableRows, {
  x: COL3_X + 0.18, y: ROW1_Y + 4.76,
  w: COL_W - 0.36,
  colW: [2.2, 1.6, 1.8, 1.6],
  rowH: 0.44,
  fontFace: "Calibri",
  fontSize: 15,
  color: LIGHT_TXT,
  fill: { color: CARD_BG },
  border: { pt: 1, color: DIVIDER },
  align: "center"
});

// Key labs
slide.addText("Key Labs to Order", {
  x: COL3_X + 0.18, y: ROW1_Y + 7.22, w: COL_W - 0.36, h: 0.35,
  fontSize: 18, bold: true, color: SUBHEAD, fontFace: "Calibri", margin: 0
});
const labs = [
  "ABG/VBG — pH, pCO₂, HCO₃",
  "BMP: glucose, electrolytes, BUN, creatinine",
  "Serum ketones (β-OHB) or urine ketones",
  "CBC, blood cultures, urine cultures (if febrile)",
  "ECG — detect ACS trigger; K⁺-related changes",
  "HbA1c — establish prior glycaemic control",
];
const labBullets = labs.map((t, i) => ({
  text: t, options: { bullet: true, color: LIGHT_TXT, fontSize: 15.5, breakLine: i < labs.length - 1 }
}));
slide.addText(labBullets, {
  x: COL3_X + 0.18, y: ROW1_Y + 7.62, w: COL_W - 0.36, h: 2.4,
  fontFace: "Calibri", margin: 0, paraSpaceAfter: 3
});

// ── ROW 2: Management + Outcomes ──────────────────────────────
const ROW2_Y = 14.0;

// ─── MANAGEMENT (spanning col1 + col2 area)
card(slide, COL1_X, ROW2_Y, 15.2, 11.8);
sectionHeader(slide, COL1_X, ROW2_Y, 15.2, "💉  MANAGEMENT OVERVIEW", "1A5276");

// 4 step boxes
const steps = [
  {
    num: "01",
    title: "FLUID RESUSCITATION",
    color: "1565C0",
    content: [
      "0.9% NaCl: 10–20 mL/kg over first 1–2 hrs (bolus)",
      "Then 250–500 mL/hr; switch to 0.45% NaCl once Na corrected",
      "Add dextrose (D5) when glucose reaches 200–250 mg/dL",
      "Goal: correct dehydration, restore perfusion",
    ]
  },
  {
    num: "02",
    title: "INSULIN THERAPY",
    color: "C0392B",
    content: [
      "Regular insulin IV infusion: 0.1 unit/kg/hr",
      "Do NOT start insulin if K⁺ < 3.5 mEq/L — replace K⁺ first",
      "Target glucose fall: 50–75 mg/dL per hour",
      "Transition to SC insulin only when anion gap closed + patient eating",
    ]
  },
  {
    num: "03",
    title: "ELECTROLYTE REPLACEMENT",
    color: "117A65",
    content: [
      "K⁺ replacement: add 20–40 mEq/L to fluids when K⁺ < 5.5",
      "Phosphate: replace if < 1.0 mg/dL or symptomatic",
      "Bicarbonate: consider only if pH < 6.9 (controversial)",
      "Monitor K⁺, glucose every 1–2 hours",
    ]
  },
  {
    num: "04",
    title: "TREAT THE TRIGGER",
    color: "873600",
    content: [
      "Cultures → empiric broad-spectrum antibiotics if infection suspected",
      "Cardiology consult / ECG if ACS triggered event",
      "Insulin access assessment — social work referral",
      "Sick-day management education before discharge",
    ]
  }
];

steps.forEach((step, i) => {
  const row = Math.floor(i / 2);
  const col = i % 2;
  const bx = COL1_X + 0.25 + col * 7.4;
  const by = ROW2_Y + 0.72 + row * 5.5;

  slide.addShape(pres.ShapeType.rect, {
    x: bx, y: by, w: 7.15, h: 5.18,
    fill: { color: "12253A" }, line: { color: step.color, pt: 2 }, rounding: 0.08
  });
  // Number badge
  slide.addShape(pres.ShapeType.rect, {
    x: bx, y: by, w: 1.2, h: 0.72,
    fill: { color: step.color }, line: { color: step.color }, rounding: 0.04
  });
  slide.addText(step.num, {
    x: bx, y: by + 0.06, w: 1.2, h: 0.6,
    fontSize: 28, bold: true, color: WHITE, fontFace: "Calibri", align: "center", margin: 0
  });
  slide.addText(step.title, {
    x: bx + 1.26, y: by + 0.12, w: 5.7, h: 0.52,
    fontSize: 20, bold: true, color: step.color === "1565C0" ? SUBHEAD : step.color === "117A65" ? "#27AE60" : GOLD,
    fontFace: "Calibri", margin: 0
  });
  const contentBullets = step.content.map((t, idx) => ({
    text: t, options: { bullet: true, color: LIGHT_TXT, fontSize: 16.5, breakLine: idx < step.content.length - 1 }
  }));
  slide.addText(contentBullets, {
    x: bx + 0.2, y: by + 0.82, w: 6.8, h: 4.1,
    fontFace: "Calibri", margin: 0, paraSpaceAfter: 5
  });
});

// Monitoring strip at bottom of management card
slide.addShape(pres.ShapeType.rect, {
  x: COL1_X + 0.25, y: ROW2_Y + 11.1, w: 14.7, h: 0.48,
  fill: { color: "1A3A5C" }, line: { color: DIVIDER }
});
slide.addText("⏱  Monitor: Vitals q1h  |  Glucose q1h  |  BMP q2h  |  Reassess AMS hourly  |  Strict I&O", {
  x: COL1_X + 0.35, y: ROW2_Y + 11.14, w: 14.5, h: 0.38,
  fontSize: 16, color: GOLD, fontFace: "Calibri", align: "center", margin: 0
});

// ─── OUTCOMES (col3 area)
card(slide, COL3_X, ROW2_Y, COL_W, 11.8);
sectionHeader(slide, COL3_X, ROW2_Y, COL_W, "📊  OUTCOMES & PROGNOSIS", GREEN);

// Mortality badges
const outcomes = [
  { label: "DKA Mortality", value: "~4%", note: "With aggressive Rx", color: "1A5276" },
  { label: "HHS Mortality", value: "~20%", note: "Elderly comorbidities", color: "8E1A0E" },
];
outcomes.forEach((o, i) => {
  const ox = COL3_X + 0.2 + i * 3.65;
  const oy = ROW2_Y + 0.72;
  slide.addShape(pres.ShapeType.rect, {
    x: ox, y: oy, w: 3.4, h: 2.1,
    fill: { color: o.color }, line: { color: DIVIDER }, rounding: 0.1,
    shadow: { type: "outer", blur: 8, offset: 4, angle: 45, color: "000000", opacity: 0.4 }
  });
  slide.addText(o.value, {
    x: ox, y: oy + 0.15, w: 3.4, h: 1.1,
    fontSize: 56, bold: true, color: WHITE, fontFace: "Calibri", align: "center", margin: 0
  });
  slide.addText(o.label, {
    x: ox, y: oy + 1.18, w: 3.4, h: 0.42,
    fontSize: 18, bold: true, color: GOLD, fontFace: "Calibri", align: "center", margin: 0
  });
  slide.addText(o.note, {
    x: ox, y: oy + 1.6, w: 3.4, h: 0.35,
    fontSize: 14, color: SUBHEAD, fontFace: "Calibri", align: "center", margin: 0
  });
});

// Adverse outcomes
slide.addText("Complications & Adverse Outcomes", {
  x: COL3_X + 0.18, y: ROW2_Y + 3.05, w: COL_W - 0.36, h: 0.38,
  fontSize: 19, bold: true, color: SUBHEAD, fontFace: "Calibri", margin: 0
});
const compItems = [
  { txt: "Cerebral oedema", sub: " — most feared in children; monitor Na⁺ closely" },
  { txt: "Hypokalaemia", sub: " — post-insulin; fatal arrhythmias if untreated" },
  { txt: "Hypoglycaemia", sub: " — over-treatment; switch fluids at glucose 200–250" },
  { txt: "Acute kidney injury", sub: " — from dehydration/haemodynamic compromise" },
  { txt: "Aspiration pneumonia", sub: " — obtunded patients; NGT if needed" },
  { txt: "ARDS / pulmonary oedema", sub: " — overly aggressive fluid resuscitation" },
  { txt: "Thromboembolism", sub: " — hyperviscosity + immobility; prophylaxis" },
];
const compBullets = compItems.map((item, idx) => ({
  text: [
    { text: item.txt, options: { bold: true, color: GOLD } },
    { text: item.sub }
  ],
  options: { bullet: true, color: LIGHT_TXT, fontSize: 15.5, breakLine: idx < compItems.length - 1 }
}));
// Flatten for addText rich text
const compFlat = [];
compItems.forEach((item, idx) => {
  compFlat.push({ text: "• ", options: { color: GOLD, fontSize: 15.5 } });
  compFlat.push({ text: item.txt, options: { bold: true, color: GOLD, fontSize: 15.5 } });
  compFlat.push({ text: item.sub + (idx < compItems.length - 1 ? "\n" : ""), options: { color: LIGHT_TXT, fontSize: 15.5 } });
});
slide.addText(compFlat, {
  x: COL3_X + 0.18, y: ROW2_Y + 3.5, w: COL_W - 0.36, h: 4.2,
  fontFace: "Calibri", margin: 0, paraSpaceAfter: 4
});

// Mortality risk factors
slide.addText("Predictors of Poor Outcome", {
  x: COL3_X + 0.18, y: ROW2_Y + 7.82, w: COL_W - 0.36, h: 0.38,
  fontSize: 19, bold: true, color: SUBHEAD, fontFace: "Calibri", margin: 0
});
const poorOutcome = [
  "Extremes of age (very young / elderly)",
  "Severe comorbidities (CKD, HF, malignancy)",
  "Severity of precipitating illness (sepsis, ACS)",
  "Delayed diagnosis / delayed treatment initiation",
  "Initial pH < 7.0 or bicarbonate < 5 mEq/L",
  "Altered mental status / deep coma on presentation",
];
const poorBullets = poorOutcome.map((t, i) => ({
  text: t, options: { bullet: true, color: LIGHT_TXT, fontSize: 15, breakLine: i < poorOutcome.length - 1 }
}));
slide.addText(poorBullets, {
  x: COL3_X + 0.18, y: ROW2_Y + 8.26, w: COL_W - 0.36, h: 2.9,
  fontFace: "Calibri", margin: 0, paraSpaceAfter: 3
});

// Discharge criteria strip
slide.addShape(pres.ShapeType.rect, {
  x: COL3_X + 0.18, y: ROW2_Y + 11.1, w: COL_W - 0.36, h: 0.48,
  fill: { color: "1A3A5C" }, line: { color: DIVIDER }
});
slide.addText("✅  Discharge: pH > 7.3  |  AG closed  |  Tolerating PO  |  SC insulin established", {
  x: COL3_X + 0.28, y: ROW2_Y + 11.14, w: COL_W - 0.56, h: 0.38,
  fontSize: 15, color: GREEN, fontFace: "Calibri", align: "center", margin: 0
});

// ── ROW 3: Prevention & Key Takeaways ─────────────────────────
const ROW3_Y = 26.1;

card(slide, COL1_X, ROW3_Y, COL_W * 1.5 + 0.4, 4.8);
sectionHeader(slide, COL1_X, ROW3_Y, COL_W * 1.5 + 0.4, "🛡  PREVENTION & EDUCATION", "117A65");

const prevItems = [
  ["Sick-day rules", "Continue insulin even when unable to eat; increase monitoring frequency"],
  ["Insulin access", "Address cost/access barriers proactively; pen devices for adherence"],
  ["Early warning signs", "Educate patients: nausea + polyuria + hyperglycaemia = check ketones"],
  ["Technology", "CGM + insulin pumps reduce DKA rates in T1DM; pump occlusion awareness"],
  ["Mental health", "Screen for eating disorders, depression — major drivers of insulin omission"],
  ["Transition care", "Adolescents transitioning to adult services are highest-risk period"],
];
const prevBullets = [];
prevItems.forEach((item, idx) => {
  prevBullets.push({ text: item[0] + ": ", options: { bold: true, color: GOLD, fontSize: 16 } });
  prevBullets.push({ text: item[1] + (idx < prevItems.length - 1 ? "\n" : ""), options: { color: LIGHT_TXT, fontSize: 15.5 } });
});
slide.addText(prevBullets, {
  x: COL1_X + 0.2, y: ROW3_Y + 0.62, w: (COL_W * 1.5 + 0.4) - 0.4, h: 3.9,
  fontFace: "Calibri", margin: 0, paraSpaceAfter: 4
});

// Key takeaways box
card(slide, COL1_X + COL_W * 1.5 + 0.7, ROW3_Y, COL_W * 1.5 + 0.4 - 0.2, 4.8);
sectionHeader(slide, COL1_X + COL_W * 1.5 + 0.7, ROW3_Y, COL_W * 1.5 + 0.4 - 0.2, "💡  KEY TAKEAWAYS", GOLD.slice(0));

const ktkx = COL1_X + COL_W * 1.5 + 0.7;
const keyTakes = [
  "Non-compliance is the #1 modifiable trigger — address social determinants",
  "Infection raises counter-regulatory hormones → always search for source",
  "25% of DKA = first presentation of diabetes — educate + ensure follow-up",
  "Never delay K⁺ replacement; do NOT start insulin if K⁺ < 3.5",
  "DKA mortality ~4% — worsens with age, comorbidities, severe acidosis",
  "Discharge only when anion gap closed + SC insulin established + eating",
];
const ktBullets = keyTakes.map((t, i) => ({
  text: t, options: { bullet: true, color: LIGHT_TXT, fontSize: 16, breakLine: i < keyTakes.length - 1 }
}));
slide.addText(ktBullets, {
  x: ktkx + 0.2, y: ROW3_Y + 0.62, w: (COL_W * 1.5 + 0.4 - 0.2) - 0.4, h: 3.9,
  fontFace: "Calibri", margin: 0, paraSpaceAfter: 4
});

// ── BOTTOM FOOTER ──────────────────────────────────────────────
slide.addShape(pres.ShapeType.rect, {
  x: 0, y: 35.4, w: 24, h: 0.6,
  fill: { color: "0A1628" }, line: { color: "0A1628" }
});
slide.addShape(pres.ShapeType.rect, {
  x: 0, y: 35.78, w: 24, h: 0.22,
  fill: { color: ACCENT }, line: { color: ACCENT }
});
slide.addText(
  "Sources: Goldman-Cecil Medicine 26e (Table 210-11, pp.2483-2485)  |  Rosen's Emergency Medicine 10e (pp.2542-2548)  |  ADA DKA Guidelines  |  ISPAD Clinical Practice Consensus Guidelines",
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    x: 0.4, y: 35.42, w: 23.2, h: 0.34,
    fontSize: 12, color: SUBHEAD, fontFace: "Calibri", align: "center", margin: 0
  }
);

// ── Save ───────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/eposter/DKA_Triggers_Outcomes_Poster.pptx" })
  .then(() => console.log("Poster saved."))
  .catch(e => console.error(e));