Objective To investigate the clinical features and risk factors of rheumatoid arthritis (RA) with abnormal glucose metabolism. Methods A retrospective analysis was conducted on 1 157 patients with RA who were hospitalized in the department of rheumatology of Yunnan Provincial Hospital of Traditional Chinese Medicine from January 2017 to January 2022. They are divided into RA group, RA combined fasting blood glucose impaired(IFG) group and RA combined type 2 diabetes mellitus(T2DM) group. The clinical data of the three groups were compared, including demographic characteristics, fasting blood glucose (GLU), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), serum uric acid (sUA), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anticyclic citrullinide peptide (CCP) antibody test results. Logistic regression was used to analyze risk factors for IFG and T2DM in patients with RA. Results The age, course, RF-IgM, ESR, CRP, TC, LDL-C and GLU of the combined IFG group were all higher than those in the RA-only group, and the differences were statistically significant(P<0.05). The proportion of patients with age, disease course, RF-IgG, CRP, UA, TC, TG, LDL-C, GLU levels, and hyperlipidemia in the RA group alone was significantly lower than that in the combined T2DM group, and the differences were statistically significant(P<0.05). Logistic multivariate analysis found that ESR, CRP, LDL-C, and elevated GLU levels were independent risk factors for IFG in RA patients and independent risk factors for IFG in RA patients. Long course of RA, high levels of LDL-C, and GLU were independent risk factors for T2DM in patients with RA. Conclusion There were multiple metabolic index abnormalities in patients with RA and IFG and T2DM, and the increase in the levels of ESR, CRP and LDL-C leads to an increase in the possibility of IFG in RA patients. Long courses of RA and high levels of LDL-C can lead to an increased likelihood of T2DM in patients with RA.