Elaine Le Roux is precocious and clever. At her home at Adamstown, she sets straight to work unpacking a tower of blocks stacked neatly against the living room wall and starts constructing something complex and precarious. It topples, but she starts again - stronger at the base this time.
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"She is very much, the little one," her mum, Cecile Le Roux says.
Elaine is five years, the youngest of three sisters, and a type one diabetic.
Cecile, her partner Jacques, and their young family had only moved to Newcastle a few months in February last year when Elaine was diagnosed. She had turned five in December. It was hot, and she had started drinking water excessively.
"We came from South Australia where it's hot and dry," Cecile said, "So, for us, it was crazy because it's not that hot (here)."
Elaine was waking up through the night.
"We learned where all the bathrooms are in Newcastle," Cecile said. "It was just ridiculous."
Cecile confided in a neighbour. Bellecourt Circuit is all military housing - military families - Cecile says. It's a close-knit community where the Le Roux family feels like they belong. They are originally from South Africa, where Jacques was a military man before they arrived in Australia. They become citizens and Jacques re-joined the Air Force.
Elaine's condition sounded like diabetes, the neighbour had said. But Cecile has no history of the auto-immune disease in her family.
"We were quite shocked," she said. "I googled, and I realised we need to go to the doctor."
Elaine now takes four insulin injections daily and is on a waiting list for an insulin pump. In the months after her diagnosis, Cecile had stuck a long list of foods and their precise measures of carbohydrates on the kitchen cupboard.
"Six grapes is half an exchange of carbohydrates," she recites. "A third of a cup of rice is one exchange."
Every meal has an exact amount of carbs, divided into portion sizes and converted into an insulin dosage. Elaine needs to eat around 50 grams of carbs in each meal. Cecile needs to know precisely how much food to put on her plate.
"The app does that all for you," Cecile said. She and Elaine have been trialling an app developed by Hunter Medical Research Centre and the University of Newcastle for around eight months. It logs Elaine's meals, her blood glucose levels, and analyses Cecile's home recipes. It calculates carbohydrates, proteins and fats for each meal and delivers a precise dosage amount.
In the living room, Cecile runs a few calculations and within seconds knows how much insulin Elaine would need for half an apple. She is even going to the app to remember and fine-tune her home recipes, and experimenting with more protein.
"We're very much vegetarian," Cecile says. "Legumes and all of those things are carbohydrates, so we eat a lot of carbs and not necessarily a lot of proteins and not as much fat.
We found that when we started introducing more meat that we were in (Elaine's) healthy range for longer."
The OptimAAP trial is led by Dr Carmel Smart, a clinical research fellow and senior paediatric dietitian, and has set out to find if insulin doses for proteins and fats, as well as carbohydrates, improves blood glucose levels.
"The plan is to roll it out nationally and internationally," Dr Smart says.
The study follows previous HNE-led research which looked at how accurately patients needed to count carbohydrate eaten at a meal to calculate the correct insulin dose. The work became a benchmark for international standards and is a critical component of the success of the John Hunter Children's Hospital program.