A retrospective study was performed to determine whether there is an increased incidence of hyperglycemia in patients not predisposed to hyperglycemia (n = 102) who receive total parenteral nutrition (TPN) dextrose in excess of 4 to 5 mg/kg/min. Of the 37 subjects administered dextrose at > 5 mg/kg/min, 18 exhibited hyperglycemia. None did so who received dextrose at < or = 4 mg/kg/min (n = 19). TPN dextrose infusion rate was positively correlated with blood glucose concentration, over and above other variables considered in a multiple regression, including kcal/kg administered, furosemide or dopamine use, gender, age, or diagnosis. Thus, TPN dextrose infusion rates > 4 to 5 mg/kg/min increase risk of hyperglycemia.