1. Cardiovascular Failure: Dopamine or dobutamine \> 5 mcg/kg/min, or any dose of epinephrine, norepinephrine, phenylephrine, milrinone or vasopressin if used to treat hypotension.
2. Respiratory Failure: Acute mechanical ventilation via endotracheal tube or tracheostomy.
Age \>= 2 weeks and corrected gestational age \>= 42 weeks
Age \< 18 years (has not yet had 18th birthday)
You may not be if
No longer has cardiovascular or respiratory failure (as defined in inclusion criterion 1), or is expected to be extubated in the next 24 hours
Expected to remain in ICU \< 24 hours
Previously randomized in HALF-PINT
Enrolled in a competing clinical trial
Family/team decision to limit/redirect from aggressive ICU technological support
Chronic ventilator dependence prior to ICU admission (non-invasive ventilation and ventilation via tracheostomy overnight or during sleep are acceptable)
Type 1 or 2 diabetes
Cardiac surgery within prior 2 months or during/planned for this hospitalization (extra-corporeal life support or non-cardiac surgery is acceptable)
Diffuse skin disease that does not allow securement of a subcutaneous sensor
Therapeutic plan to remain intubated for \>28 days
Receiving therapeutic cooling with targeted body temperatures \<34 degrees Celsius
Current or planned ketogenic diet
Ward of the state
Pregnancy
Clareo Health | Heart And Lung Failure - Pediatric INsulin Titration Trial
