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fix(glucose): state band edges in the reader's glucose unit
The time-in-range labels in the doctor report, the target caption on the glucose panel, the glucose page description and the fasting explainer printed fixed mg/dL figures, so a reader on mmol/L saw "Low (< 70 mg/dL)" beside values in mmol/L. The cut-points now live in one place (`GLUCOSE_TIR_CUT_POINTS`, `GLUCOSE_FASTING_CUT_POINTS`) with the SI figure each guideline prints, the analytics engine counts its bands from the same constants, and every sentence takes the band edges and unit as parameters through `glucoseBandParams`, formatted with the reader's number format. The unit-preference guard now also reads the locale bundles: a string that names mg/dL or mmol/L fails unless it is allowlisted with a reason. Refs #1067
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@@ -10,7 +10,7 @@
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*
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* Mutation check: add `unit="kg"` back to any swept page and this goes red.
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*/
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import { readFileSync } from "node:fs";
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import { readdirSync, readFileSync } from "node:fs";
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import { join } from "node:path";
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import { stripComments, walkSourceFiles } from "./helpers/source-files";
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@@ -515,3 +515,74 @@ describe("unit-preference display guard — AI and Coach producers", () => {
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expect(offenders).toEqual([]);
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});
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});
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/**
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* Locale strings that may name a glucose unit literally, each with the reason
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* it is not a reading shown in the reader's unit. Keys are dotted paths and
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* apply to every locale bundle.
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*/
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const GLUCOSE_UNIT_LITERAL_ALLOWLIST: Record<string, string> = {
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"dashboard.metric.unit.glucose":
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"the unit token the dashboard summary wire hands the native client; the web resolves the glucose unit from the account instead",
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"labs.biomarker.form.unitPlaceholder":
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"an example of a free-text lab unit in an input placeholder, not a reading",
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};
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const GLUCOSE_UNIT_LITERAL = /mg\/dl|mmol\/l\b/i;
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function flattenStrings(
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node: unknown,
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path: string,
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out: Array<[string, string]>,
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): void {
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if (typeof node === "string") {
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out.push([path, node]);
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} else if (node && typeof node === "object") {
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for (const [key, value] of Object.entries(node)) {
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flattenStrings(value, path ? `${path}.${key}` : key, out);
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}
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}
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}
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describe("unit-preference display guard — locale strings", () => {
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const MESSAGES = join(process.cwd(), "messages");
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const bundles = readdirSync(MESSAGES).filter((f) => f.endsWith(".json"));
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it("reads every locale bundle", () => {
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expect(bundles.length).toBeGreaterThanOrEqual(7);
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});
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it("no locale string fixes a glucose unit outside the allowlist", () => {
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// A sentence that prints "70–180 mg/dL" shows mg/dL to a reader who
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// chose mmol/L. Band and unit go in as parameters (`glucoseBandParams`).
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const offenders: string[] = [];
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for (const file of bundles) {
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const entries: Array<[string, string]> = [];
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flattenStrings(
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JSON.parse(readFileSync(join(MESSAGES, file), "utf8")),
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"",
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entries,
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);
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for (const [key, value] of entries) {
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if (key in GLUCOSE_UNIT_LITERAL_ALLOWLIST) continue;
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if (GLUCOSE_UNIT_LITERAL.test(value)) offenders.push(`${file}: ${key}`);
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}
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}
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expect(offenders).toEqual([]);
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});
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it("every allowlisted key still exists and still names a unit", () => {
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// An entry whose string was reworded or removed is a stale exemption.
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const en: Array<[string, string]> = [];
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flattenStrings(
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JSON.parse(readFileSync(join(MESSAGES, "en.json"), "utf8")),
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"",
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en,
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);
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const byKey = new Map(en);
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const stale = Object.keys(GLUCOSE_UNIT_LITERAL_ALLOWLIST).filter(
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(key) => !GLUCOSE_UNIT_LITERAL.test(byKey.get(key) ?? ""),
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);
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expect(stale).toEqual([]);
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});
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});
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@@ -5,8 +5,12 @@ import { Droplet } from "lucide-react";
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import { HealthKitMetricPage } from "@/components/insights/healthkit-metric-page";
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import { GlucoseClinicalPanel } from "@/components/insights/glucose/glucose-clinical-panel";
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import { useAuth } from "@/hooks/use-auth";
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import { useTranslations } from "@/lib/i18n/context";
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import { MGDL_PER_MMOL, resolveGlucoseUnit } from "@/lib/glucose";
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import { useFormatters, useTranslations } from "@/lib/i18n/context";
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import {
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glucoseBandParams,
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MGDL_PER_MMOL,
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resolveGlucoseUnit,
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} from "@/lib/glucose";
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/**
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* v1.7.0 — `/insights/blood-glucose`.
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@@ -27,6 +31,7 @@ import { MGDL_PER_MMOL, resolveGlucoseUnit } from "@/lib/glucose";
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export default function InsightsBlutzuckerPage() {
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const { user } = useAuth();
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const { t } = useTranslations();
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const fmt = useFormatters();
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const glucoseUnit = resolveGlucoseUnit(user?.glucoseUnit ?? null);
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const isMmol = glucoseUnit === "mmol/L";
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@@ -38,6 +43,9 @@ export default function InsightsBlutzuckerPage() {
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chartKey="bloodGlucose"
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i18nPrefix="insights.bloodGlucose"
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explainerMetric="bloodGlucose"
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// The definition names the fasting cut-points; they follow the
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// reader's glucose unit like the chart does.
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explainerParams={glucoseBandParams(glucoseUnit, fmt.number)}
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color="var(--chart-3)"
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unit={glucoseUnit}
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yAxisUnit={glucoseUnit}
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@@ -2,6 +2,8 @@ import { describe, it, expect, vi } from "vitest";
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import { renderToStaticMarkup } from "react-dom/server";
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import { I18nProvider } from "@/lib/i18n/context";
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import { glucoseBandParams } from "@/lib/glucose";
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import { makeFormatters } from "@/lib/format-locale";
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import { SubPageShell } from "../sub-page-shell";
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vi.mock("next/navigation", () => ({
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@@ -68,6 +70,27 @@ describe("<SubPageShell>", () => {
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);
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});
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it("fills the explainer's figures from the explainer parameters", () => {
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// The glucose definition names the fasting cut-points; a reader on
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// mmol/L reads them in mmol/L, never a fixed "100 mg/dL".
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const html = render(
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<SubPageShell
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title="Blood glucose"
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explainerMetric="bloodGlucose"
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explainerParams={glucoseBandParams(
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"mmol/L",
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makeFormatters("en", "UTC", "AUTO", "AUTO").number,
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)}
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>
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<span />
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</SubPageShell>,
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);
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expect(html).toContain(
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"a fasting reading under 5.6 mmol/L is normal, 5.6–6.9 is prediabetes, and 7.0 or above",
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);
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expect(html).not.toContain("{");
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});
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it("no longer paints the round `?` explainer trigger next to the heading", () => {
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const html = render(
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<SubPageShell title="Blood pressure" explainerMetric="bloodPressure">
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@@ -148,6 +148,30 @@ describe("<GlucoseClinicalPanel> asserted state", () => {
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expect(html).toContain("J-index");
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});
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it("states the target band in the reader's unit and number format", () => {
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// The caption used to print "70–180 mg/dL" to every reader, beside
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// values the panel had already converted to mmol/L.
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authMock.mockReturnValue({
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user: { glucoseUnit: "mmol/L" },
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isAuthenticated: true,
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});
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analyticsMock.mockReturnValue({
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isLoading: false,
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data: { glucoseClinical: assertedClinical(), glucoseByContext: {} },
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});
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const de = render(<GlucoseClinicalPanel />, "de");
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expect(de).toContain("(3,9–10,0 mmol/L ist das Ziel)");
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expect(de).not.toMatch(/mg\/dl/i);
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authMock.mockReturnValue({
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user: { glucoseUnit: "mg/dL" },
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isAuthenticated: true,
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});
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expect(render(<GlucoseClinicalPanel />)).toContain(
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"(70–180 mg/dL is the target)",
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);
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});
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it("flags the CV badge unstable at CV% >= 36", () => {
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// wide spread → CV well above 36
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const values = Array.from({ length: 20 }, (_, i) =>
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@@ -12,8 +12,12 @@ import { LearnMoreLink } from "@/components/ui/learn-more-link";
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import { Skeleton } from "@/components/ui/skeleton";
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import { useAuth } from "@/hooks/use-auth";
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import { useAnalyticsQuery } from "@/lib/queries/use-analytics-query";
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import { useTranslations } from "@/lib/i18n/context";
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import { convertGlucose, resolveGlucoseUnit } from "@/lib/glucose";
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import { useFormatters, useTranslations } from "@/lib/i18n/context";
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import {
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convertGlucose,
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glucoseBandParams,
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resolveGlucoseUnit,
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} from "@/lib/glucose";
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import type { DataSummary } from "@/lib/analytics/trends";
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import { GlucoseTirBar } from "./glucose-tir-bar";
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import { GlucoseAdvancedDisclosure } from "./glucose-advanced-disclosure";
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@@ -41,6 +45,7 @@ import { GlucoseAdvancedDisclosure } from "./glucose-advanced-disclosure";
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export function GlucoseClinicalPanel() {
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const { user, isAuthenticated } = useAuth();
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const { t } = useTranslations();
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const fmt = useFormatters();
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const query = useAnalyticsQuery({});
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const glucoseUnit = resolveGlucoseUnit(user?.glucoseUnit ?? null);
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@@ -158,7 +163,10 @@ export function GlucoseClinicalPanel() {
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</div>
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<GlucoseTirBar distribution={dist} />
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<p className="text-muted-foreground text-xs">
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{t("insights.bloodGlucose.clinical.tir.caption")}
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{t(
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"insights.bloodGlucose.clinical.tir.caption",
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glucoseBandParams(glucoseUnit, fmt.number),
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)}
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</p>
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</section>
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) : null}
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@@ -153,6 +153,8 @@ export interface HealthKitMetricPageProps {
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* Resolves `insights.subPage.explainer.<explainerMetric>{Title,Body}`.
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*/
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explainerMetric?: string;
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/** Interpolation values for the explainer sentence (`SubPageShell`). */
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explainerParams?: Record<string, string>;
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/**
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* v1.8.5 W5 — when set, renders `<MetricTargetSummary slug=…>` beneath
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* the chart. Used by blood glucose, whose per-context ADA / DDG bands
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@@ -227,6 +229,7 @@ export function HealthKitMetricPage({
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coachPrefill,
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valueScale,
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explainerMetric,
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explainerParams,
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targetSummarySlug,
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statusMetric,
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statIcon,
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@@ -334,7 +337,10 @@ export function HealthKitMetricPage({
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: rawSummary;
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const title = t(`${i18nPrefix}.title`);
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const description = t(`${i18nPrefix}.description`);
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// A description that names its unit ("in mg/dL") reads the resolved one.
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const description = t(`${i18nPrefix}.description`, {
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unit: resolvedUnit ?? "",
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});
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// v1.12.7 — in-flight skeleton. The page consumed only `{data, isEmpty}`
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// before, so the ~30 HealthKit sub-pages painted nothing until the
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@@ -347,6 +353,7 @@ export function HealthKitMetricPage({
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title={title}
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description={description}
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explainerMetric={explainerMetric}
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explainerParams={explainerParams}
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statStrip={<StatStripSkeleton />}
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>
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<ChartSkeleton />
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@@ -364,6 +371,7 @@ export function HealthKitMetricPage({
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title={title}
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description={description}
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explainerMetric={explainerMetric}
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explainerParams={explainerParams}
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>
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<QueryErrorRow
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slot="healthkit-metric-error"
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@@ -389,6 +397,7 @@ export function HealthKitMetricPage({
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title={title}
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description={description}
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explainerMetric={explainerMetric}
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explainerParams={explainerParams}
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>
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<MetricEmptyState
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icon={emptyStateIcon}
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@@ -406,6 +415,7 @@ export function HealthKitMetricPage({
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title={title}
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description={description}
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explainerMetric={explainerMetric}
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explainerParams={explainerParams}
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statStrip={
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<MetricStatStrip
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summary={summary}
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@@ -70,6 +70,11 @@ export interface SubPageShellProps {
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* one- to two-sentence definition, no tap required.
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*/
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explainerMetric?: string;
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/**
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* Interpolation values for the explainer sentence, for a definition that
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* names figures in the reader's own unit (the glucose cut-points).
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*/
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explainerParams?: Record<string, string>;
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/**
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* v1.4.27 MB7 / CF-35 — opt-in programmatic focus on mount.
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*
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@@ -155,6 +160,7 @@ export function SubPageShell({
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badge,
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description,
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explainerMetric,
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explainerParams,
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focusOnMount = false,
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statStrip,
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coachReadStrip,
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@@ -385,7 +391,10 @@ export function SubPageShell({
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data-slot="metric-explainer-inline"
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className="text-foreground text-sm leading-relaxed"
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>
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{t(`insights.subPage.explainer.${explainerMetric}Body`)}
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{t(
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`insights.subPage.explainer.${explainerMetric}Body`,
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explainerParams,
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)}
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</p>
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) : null}
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{description && !explainerMetric ? (
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@@ -594,6 +594,30 @@ describe("doctor-report clinical glucose panel", () => {
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expect(text).toContain("Glucose Management Indicator");
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});
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it("labels the time-in-range bands in the owner's glucose unit", async () => {
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// The band labels used to read "Low (< 70 mg/dL)" in a report whose
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// values were all in mmol/L.
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const data = makeData({
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glucoseUnit: "mmol/L",
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glucoseClinical: computeGlucoseClinicalMetrics(denseReadings(), {
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now: FIXED_NOW,
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windowDays: 90,
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}),
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});
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const bytes = renderDoctorReportPdfBytes(data, {
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timeFormat: "AUTO",
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dateFormat: "AUTO",
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t: getServerTranslator("de").t,
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locale: "de",
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now: FIXED_NOW,
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});
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const text = await extractText(bytes);
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expect(text).toContain("Zeit im Zielbereich (3,9–10,0 mmol/L)");
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expect(text).toContain("Sehr niedrig (< 3,0 mmol/L)");
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expect(text).toContain("Sehr hoch (> 13,9 mmol/L)");
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expect(text).not.toMatch(/mg\/dl/i);
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});
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it("omits the clinical panel when there are no glucose readings", async () => {
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const data = makeData(); // empty (zero-reading) glucose panel
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const bytes = renderDoctorReportPdfBytes(data, {
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@@ -9,7 +9,11 @@ import {
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glucoseContextBucket,
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groupByGlucoseContext,
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GLUCOSE_CONTEXT_UNSPECIFIED,
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GLUCOSE_FASTING_CUT_POINTS,
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GLUCOSE_TIR_CUT_POINTS,
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glucoseBandParams,
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} from "../glucose";
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import { makeFormatters } from "../format-locale";
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describe("glucose conversion", () => {
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it("converts mg/dL to mmol/L with 1 decimal", () => {
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@@ -157,3 +161,45 @@ describe("glucose context buckets (#943)", () => {
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);
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});
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});
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describe("glucose band parameters", () => {
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const de = makeFormatters("de", "UTC", "AUTO", "AUTO").number;
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const en = makeFormatters("en", "UTC", "AUTO", "AUTO").number;
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it("states the consensus bands in mg/dL as whole numbers", () => {
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expect(glucoseBandParams("mg/dL", en)).toMatchObject({
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unit: "mg/dL",
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veryLow: "54",
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low: "70",
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high: "180",
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veryHigh: "250",
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prediabetesFrom: "100",
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prediabetesTo: "125",
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diabetesFrom: "126",
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});
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});
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it("states them in mmol/L with the locale's decimal separator", () => {
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expect(glucoseBandParams("mmol/L", de)).toMatchObject({
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unit: "mmol/L",
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veryLow: "3,0",
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low: "3,9",
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high: "10,0",
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veryHigh: "13,9",
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prediabetesFrom: "5,6",
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prediabetesTo: "6,9",
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diabetesFrom: "7,0",
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});
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});
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it("carries SI figures that agree with the conversion", () => {
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// The consensus bands convert exactly; the ADA cut-points are within
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// one rounding step of it (100 mg/dL is printed as 5.6, converts to 5.5).
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for (const point of Object.values(GLUCOSE_TIR_CUT_POINTS)) {
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expect(point.mmol).toBe(mgdlToMmol(point.mgdl));
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}
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for (const point of Object.values(GLUCOSE_FASTING_CUT_POINTS)) {
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expect(Math.abs(point.mmol - point.mgdl / 18.0182)).toBeLessThan(0.1);
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}
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});
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});
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@@ -39,6 +39,8 @@
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* Diabetes Care 29(11):2433-2438, DOI 10.2337/dc06-1085.
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*/
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import { GLUCOSE_TIR_CUT_POINTS } from "@/lib/glucose";
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// ── Inputs ───────────────────────────────────────────────
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|
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/** A single spot blood-glucose reading. Value is canonical mg/dL. */
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@@ -79,11 +81,13 @@ export interface GlucoseMetricsOptions {
|
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}
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// ── Consensus thresholds (Battelino 2019) ────────────────
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// Bands in mg/dL. These are consensus FACTS, cited above.
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const TBR_LEVEL2_MAX = 54; // very low: G < 54
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const TBR_LEVEL1_MAX = 70; // low: G < 70 (level-1 sub-band is 54–69)
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const TAR_LEVEL1_MIN = 180; // high: G > 180 (level-1 sub-band is 181–250)
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const TAR_LEVEL2_MIN = 250; // very high: G > 250
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// Bands in mg/dL. These are consensus FACTS, cited above. The values live in
|
||||
// `GLUCOSE_TIR_CUT_POINTS` so the band labels a reader sees and the bands
|
||||
// this engine counts are the same numbers.
|
||||
const TBR_LEVEL2_MAX = GLUCOSE_TIR_CUT_POINTS.veryLow.mgdl; // very low: G < 54
|
||||
const TBR_LEVEL1_MAX = GLUCOSE_TIR_CUT_POINTS.low.mgdl; // low: G < 70 (level-1 sub-band is 54–69)
|
||||
const TAR_LEVEL1_MIN = GLUCOSE_TIR_CUT_POINTS.high.mgdl; // high: G > 180 (level-1 sub-band is 181–250)
|
||||
const TAR_LEVEL2_MIN = GLUCOSE_TIR_CUT_POINTS.veryHigh.mgdl; // very high: G > 250
|
||||
// Time-in-range target band is [70, 180] inclusive.
|
||||
/** The time-in-range band, mg/dL, inclusive at both ends. */
|
||||
export const TIME_IN_RANGE_MGDL = {
|
||||
|
||||
@@ -1,7 +1,11 @@
|
||||
import type { jsPDF } from "jspdf";
|
||||
import { GLUCOSE_CONTEXT_BUCKETS } from "@/lib/glucose";
|
||||
import autoTable from "jspdf-autotable";
|
||||
import { convertGlucose, resolveGlucoseUnit } from "../glucose";
|
||||
import {
|
||||
convertGlucose,
|
||||
glucoseBandParams,
|
||||
resolveGlucoseUnit,
|
||||
} from "../glucose";
|
||||
import { reportStatValue } from "../doctor-report/stat-display";
|
||||
import type { MeasurementType } from "@/generated/prisma/client";
|
||||
import { MEASUREMENT_TYPE_LABEL_KEYS } from "../measurements/type-label-keys";
|
||||
@@ -303,26 +307,29 @@ export function buildMeasurementsChartsSection(
|
||||
const clinical = data.glucoseClinical;
|
||||
if (clinical && clinical.readingCount > 0 && clinical.distribution) {
|
||||
const pct = (fraction: number) => `${num(fraction * 100)} %`;
|
||||
// The band edges follow the reader's glucose unit, like every value in
|
||||
// the table beside them.
|
||||
const bands = glucoseBandParams(glucoseUnit, num);
|
||||
const clinicalRows: string[][] = [];
|
||||
const dist = clinical.distribution;
|
||||
clinicalRows.push([
|
||||
t("doctorReport.glucoseClinical.tirInRange"),
|
||||
t("doctorReport.glucoseClinical.tirInRange", bands),
|
||||
pct(dist.tir),
|
||||
]);
|
||||
clinicalRows.push([
|
||||
t("doctorReport.glucoseClinical.tirLow"),
|
||||
t("doctorReport.glucoseClinical.tirLow", bands),
|
||||
pct(dist.tbrLevel1),
|
||||
]);
|
||||
clinicalRows.push([
|
||||
t("doctorReport.glucoseClinical.tirVeryLow"),
|
||||
t("doctorReport.glucoseClinical.tirVeryLow", bands),
|
||||
pct(dist.tbrLevel2),
|
||||
]);
|
||||
clinicalRows.push([
|
||||
t("doctorReport.glucoseClinical.tirHigh"),
|
||||
t("doctorReport.glucoseClinical.tirHigh", bands),
|
||||
pct(dist.tarLevel1),
|
||||
]);
|
||||
clinicalRows.push([
|
||||
t("doctorReport.glucoseClinical.tirVeryHigh"),
|
||||
t("doctorReport.glucoseClinical.tirVeryHigh", bands),
|
||||
pct(dist.tarLevel2),
|
||||
]);
|
||||
if (clinical.meanMgdl !== null) {
|
||||
|
||||
@@ -42,6 +42,59 @@ export function toCanonicalMgdl(value: number, from: GlucoseUnit): number {
|
||||
return from === "mmol/L" ? mmolToMgdl(value) : Math.round(value);
|
||||
}
|
||||
|
||||
/**
|
||||
* A published glucose cut-point, in both units as its source states it.
|
||||
*
|
||||
* The SI figure is carried rather than converted because a guideline prints
|
||||
* its own rounding: ADA's fasting cut-point is 100 mg/dL and 5.6 mmol/L, and
|
||||
* `mgdlToMmol(100)` gives 5.5. A reader on mmol/L must see the number their
|
||||
* own guideline prints, not a re-rounded neighbour of it.
|
||||
*/
|
||||
export interface GlucoseCutPoint {
|
||||
mgdl: number;
|
||||
mmol: number;
|
||||
}
|
||||
|
||||
/** Consensus time-in-range band edges (Battelino 2019). */
|
||||
export const GLUCOSE_TIR_CUT_POINTS = {
|
||||
veryLow: { mgdl: 54, mmol: 3.0 },
|
||||
low: { mgdl: 70, mmol: 3.9 },
|
||||
high: { mgdl: 180, mmol: 10.0 },
|
||||
veryHigh: { mgdl: 250, mmol: 13.9 },
|
||||
} as const satisfies Record<string, GlucoseCutPoint>;
|
||||
|
||||
/** Fasting-glucose diagnostic cut-points for adults (ADA 2024). */
|
||||
export const GLUCOSE_FASTING_CUT_POINTS = {
|
||||
prediabetesFrom: { mgdl: 100, mmol: 5.6 },
|
||||
prediabetesTo: { mgdl: 125, mmol: 6.9 },
|
||||
diabetesFrom: { mgdl: 126, mmol: 7.0 },
|
||||
} as const satisfies Record<string, GlucoseCutPoint>;
|
||||
|
||||
/**
|
||||
* The interpolation parameters every glucose band sentence takes: each
|
||||
* cut-point in the reader's unit, formatted by the caller's locale-aware
|
||||
* number formatter, plus the unit symbol. A sentence that names a band
|
||||
* reads its numbers from here, so no locale string carries a fixed unit.
|
||||
*/
|
||||
export function glucoseBandParams(
|
||||
unit: GlucoseUnit,
|
||||
formatNumber: (value: number, fractionDigits: number) => string,
|
||||
): Record<string, string> {
|
||||
const digits = unit === "mmol/L" ? 1 : 0;
|
||||
const v = (point: GlucoseCutPoint) =>
|
||||
formatNumber(unit === "mmol/L" ? point.mmol : point.mgdl, digits);
|
||||
return {
|
||||
unit,
|
||||
veryLow: v(GLUCOSE_TIR_CUT_POINTS.veryLow),
|
||||
low: v(GLUCOSE_TIR_CUT_POINTS.low),
|
||||
high: v(GLUCOSE_TIR_CUT_POINTS.high),
|
||||
veryHigh: v(GLUCOSE_TIR_CUT_POINTS.veryHigh),
|
||||
prediabetesFrom: v(GLUCOSE_FASTING_CUT_POINTS.prediabetesFrom),
|
||||
prediabetesTo: v(GLUCOSE_FASTING_CUT_POINTS.prediabetesTo),
|
||||
diabetesFrom: v(GLUCOSE_FASTING_CUT_POINTS.diabetesFrom),
|
||||
};
|
||||
}
|
||||
|
||||
export function resolveGlucoseUnit(
|
||||
userPreference: string | null | undefined,
|
||||
): GlucoseUnit {
|
||||
|
||||
Reference in new issue
Block a user