Does intensive glucose control save lives in critically ill patients—or put them at risk? The NICE-SUGAR trial compared intensive glucose control (targeting blood glucose levels of 81–108 mg/dL) with conventional control (≤180 mg/dL) in critically ill patients to evaluate the impact on mortality. This large, multicenter randomized controlled trial enrolled over 6000 patients in both medical and surgical ICUs. The findings revealed higher 90-day mortality in the intensive glucose control group, driven by an increased incidence of severe hypoglycemia. Conventional glucose control was associated with better survival and fewer adverse events, reshaping the management of glycemic targets in critically ill patients. The NICE-SUGAR trial established that overly aggressive glucose control may do more harm than good, advocating for a more balanced approach to glycemic management in the ICU.