Objective To explore the risk factors of steroid diabetes mellitus (SDM) in patients with systemic lupus erythematosus (SLE) and establish risk warning models. Methods A total of 168 inpatients with SLE in the rheumatology and immunology department of Hebei People's Hospital from February 2021 to October 2023 were retrospectively collected and separated into SDM group and non-SDM group according to the occurrence of SDM. The basic information and SLE related data of the two groups were compared, and the statistically significant indicators in the above data comparison were incorporated into binary Logistic regression analysis to screen out the risk factors of SLE combined with SDM. The predictive value of SDM risk early warning model was analyzed by receiver operating characteristic (ROC) curve. Results The incidence of SDM in SLE was 9.52%. Age, BMI, proportion of family history of hypertension, hypertriglyceridemia, hypercholesterolemia, proportion of family history of DM, duration of SLE, and complement C3/C4 level in SDM group were significantly higher than those in non-SDM group (P＜0.05), while the proportion of blood system involvement and the proportion of anti-dsDNA were significantly lower (P＜0.05). Multivariate Logistic regression analysis showed that older age and family history of DM were independent risk factors for SDM in SLE patients (P＜0.05). A risk warning model for SDM was established based on age and family history of DM: Logit (P)=-4.026+0.062×age +1.573×family history of DM, which predicted the occurrence of SDM with the AUC of 0.845, the sensitivity of 87.50%, and the specificity of 77.63%. Conclusion Older age and family history of DM are independent risk factors of SDM in SLE patients. The predictive model constructed based on this model has good differentiation ability and high sensitivity, but its calibration ability is poor