Warsaw Method Calculator

Created by Łucja Zaborowska, MD, PhD candidate
Reviewed by Dominika Śmiałek, MD, PhD candidate and Steven Wooding
Based on research by
Pańkowska E, Szypowska A, Lipka M, Szpotańska M, Błazik M, Groele L. Application of novel dual wave meal bolus and its impact on glycated hemoglobin A1c level in children with type 1 diabetes. Pediatric Diabetes (August 2009)See 1 more source
Pańkowska E The Warsaw School of Insulin Pump Therapy: achievements and widespread implications for the diabetes clinic Diabetes Management (2012)
Last updated: Jul 30, 2022

The Warsaw method calculator presents the Warsaw School Program for patients with post-meal spikes of blood glucose.

The tool computes the additional insulin dose for fat and proteins, allowing for better control of insulin-dependent diabetes. 🍕

Keep on reading to discover:

  • What are carb equivalents and how to calculate them;

  • How to use the insulin-to-carb ratio for calculating insulin for fat and protein;

  • What are the typical lengths of extended boluses during two-wave insulin pump administration; and

  • Equations used in the Warsaw method calculator, explained.

What is Warsaw method and how does it work?

The Warsaw method describes the management of diabetes mellitus type I, treated with an insulin pump. The technique works best in children with high post-meal glucose spikes. The Warsaw school established this approach thanks to nationwide studies and the widespread use of insulin pumps in Poland in children younger than 7 years old.

The researchers found out that the dual wave meal bolus (insulin given in two different doses during a given time) works better in controlling glucose spikes caused by high-fat foods. The Polish scientists followed this idea and discovered that fat also modulates levels of blood sugar and should be accounted for when calculating the insulin dose. As a result, the two-doses approach allowed us to mimic the natural release of insulin better and lower the incidence of diabetic ketoacidosis.

The entire idea of a Warsaw school program follows the concept of fat-protein units (FPUs) – a conversion factor that allows us to translate fats & proteins to the effect of carbs they represent.

You can compute the number of FPUs by adding the total amount of calories in a meal that comes from both fats & proteins. 1 FPU equals the energy of 100 kcal.

What is FPU?

The acronym FPU extends into fat-protein units. Fat-protein units allow us to translate the effect of fat and proteins into that of carbohydrates. Thanks to that, we can calculate the additional insulin dose and the dual wave meal bolus length.

How to calculate the carb equivalents?

Let's get through it step by step:

  1. Calculate your calories from fats & proteins:

    Fat calories (kcal) = Fat (g) × 9

    Protein calories (kcal) = Protein (g) × 4

  2. Sum up all the additional calories:

    Total calories = Fat calories + Protein calories

  3. Finally, compute the carb equivalents:

    Carbohydrates equivalent = Total calories / 10

How to calculate insulin dose for fat and protein?

Let's calculate insulin for fats and proteins – as simple as possible.

  1. First, we ought to find the carbohydrates equivalents.

    a) Calculate the total number of calories:

    Fat calories (kcal) = Fat (g) × 9

    Protein calories (kcal) = Protein (g) × 4

    Total calories = Fat calories + Protein calories

    b) Compute carb equivalents:

    Carbohydrates equivalent = Total calories / 10

  2. Finally, let's calculate the insulin:

    Insulin dose(units) = Carb equivalent / IC

    where:

    • IC – Insulin-to-carb ratio.

How to calculate FPUs?

Here's how we can easily calculate FPUs (Fat-Protein Units):

  1. Find the total amount of calories present in your meal:

    Fat calories (kcal) = Fat (g) × 9

    Protein calories (kcal) = Protein (g) × 4

    Total calories = Fat calories + Protein calories

  2. Compute the FPUs:

    FPU = Total calories / 100

How to calculate the duration of an extended bolus of insulin?

The Warsaw method calculations use a chart that determines the duration of an extended bolus for your insulin pump.

This diabetes type I management is based on calculating the carb equivalents of proteins and fats. When calculating the insulin dose, the patient needs to consider the additional portion of calories and subsequently administer the dual wave meal bolus.

FPU

Extended bolus duration

1

Over 3 hours

2

Over 4 hours

3

Over 5 hours

4

Over 8 hours

❗ The Warsaw method calculator cannot be used as a substitute for clinical knowledge and/or consultation with a medical specialist. Always consult your doctor.

Łucja Zaborowska, MD, PhD candidate
Fat
oz
Protein
oz
IC ratio
Results
Total calories
kcal
Carb equivalent
oz
FPU
Insulin
units
Extended bolus
hours
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