The aim of the study was to investigate the characteristics and risk factors for hyperglycemia in Chinese female patients with systemic lupus erythematosus (SLE). One hundred and forty-six female SLE patients without a history of diabetes underwent a 75 g oral glucose tolerance test to evaluate glucose tolerance, insulin sensitivity and pancreatic beta cell function. According to the 1999 World Health Organization criteria, all patients were divided into three groups: normal glucose regulation, impaired glucose tolerance and diabetes mellitus. Glucocorticoid doses, insulin sensitivity and pancreatic beta cell function were compared among these groups. Risk factors for hyperglycemia were analyzed by univariate and multi-variate regression analysis. Our results showed that 46 of the 146 female SLE patients (31.5 %) were hyperglycemic, including 21 (14.4%) diabetes mellitus patients and 25 (17.1%) impaired glucose tolerance patients. These female SLE patients with hyperglycemia were characterized by insulin resistance and reduced pancreatic beta cell function, and they were relatively young. Age ≥35 years and high glucocorticoid doses were risk factors for hyperglycemia in Chinese female SLE patients. The prevalence of diabetes mellitus and impaired glucose tolerance are quite high in Chinese female SLE patients. It is suggested that plasma glucose concentration should be monitored regularly and oral glucose tolerance test should be recommended for SLE patients who have risk factors for hyperglycemia.