Abstract: Objective To determine the correlation between serum uric acid (SUA) and insulin secretion function in patients with pre-diabetes and type-2 diabetes mellitus (T2DM). Methods A total of 4 112 adult people participated in this study. They were divided into three groups according to the results of oral glucose tolerance test (OGTT): 493 with normal glucose regulation (NGR), 1 251 with impaired glucose regulation (IGR), and 2 368 with T2DM. Their levels of SUA, fasting insulin (FIns), 2 h post-meal insulin (2 h-Ins), and insulin resistance index (HOMA-IR) were determined. Correlations between SUA and insulin secretion and HOMA-IR were estimated. Results IGR patients had higher levels of SUA and 2 h-Ins compared with those with NGR and T2DM (P<0.000 1). T2DM patients had higher levels of FIns, glucosylated hemoglobin (HbA1c） and HOMA-IR compared with those with NGR and IGR (P<0.000 1). In both male and female participants, the highest level of 2 h-Ins appeared in those with IGR, while T2DM had the highest level of HOMA-IA and HbA1c. FIns, 2 h-Ins and HOMA-IR increased with SUA in both patients with IGR and T2DM. HbA1c decreased with SUA in T2DM patients. Conclusion High serum SUA is correlated with islet β-cell dysfunction. It may become an indicator of progression from pre-diabetes to T2DM.