Hyperglycemia is common in critically ill children. It does not appear to be associated with a particular diagnostic category but is significantly associated with the severity of illness. Severe hyperglycemia may be associated with complications, this in turn could result in end-organ dysfunction. A prospective, randomized trial of strict glycemic control in this subset of critically ill children who are at high risk of mortality is both warranted and feasible. Continuous insulin infusion can rapidly and safely improve intravenous glucose tolerance.

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