Disorders of glucose metabolism in rheumatoid arthritis (RA) patients are more frequent than in the general population. Diabetes is a heterogeneous metabolic disease associated with insulin resistance or dysfunction of pancreatic insulin-secreting cells. Morbidity from diabetes in rheumatoid arthritis is about 13-16%. Disorders of glucose metabolism involved in accelerated cardiovascular complications in RA patients are an important problem influencing rheumatic disease course. Gluco-corticosteroids, anti-inflammatory medications commonly used in RA patients, decrease insulin sensitivity, causing hyperin-sulinaemia and lipid disorders. Patients treated with glucocorticosteroids have increased risk of developing diabetes mellitus and cardiovascular complications, connected with premature atherosclerosis. Some of the disease-modifying drugs, especially hydroxy-chloroquine and TNF-inhibitors, are associated with reduced risk of diabetes and improvement of metabolic compensation in patients with diabetes. Further research, including prospective studies concerning the influence of different antirheumatic drugs on glucose metabolism, is needed to determine optimal approaches to reducing systemic complications and improve the quality of life of RA patients.