Renal transplant recipients have increased risk of premature death compared to a non transplant population. Valderhaug and colleagues report that early diagnosed hyperglycemia after renal transplantation is associated with increased long term mortality from any cause among renal transplant patients. Valderhaug also reports that the prevalence of new-onset diabetes after renal transplantation has been reduced during the last decades, possible due to improvements in immunosuppressive therapy, lower infection rates and reduced rejection episodes. Patients with new-onset diabetes often have no symptoms and are thus unaware of the increased risk they may possess. Valderhaug and colleagues have developed a screening tool for the identification of new-onset diabetes after renal transplantation that may be cost-effective in the identification of patients with undetected diabetes and increased long term mortality risk after renal transplantation.