Recent evidence suggests that exposure of human monocytes to glucolipotoxic media to mimic the composition of plasma of patients with type 2 diabetes (T2D) results in the induction of endoplasmic reticulum stress markers and formation of reactive oxygen species (ROS). The extent to which these findings translate to patients with T2D remains unclear. Thus, we first measured ROS (dihydroethidium fluorescence) in peripheral blood mononuclear cells (PBMCs) from whole blood of T2D patients (n=8) and compared to age matched healthy controls (n=8). T2D patients exhibited greater basal intracellular ROS (mean±SD, +3.4±1.4 fold; p<0.05) compared to controls. Next, increased ROS in PBMCs isolated from T2D patients was partially recapitulated in cultured human monocytes (THP-1 cells) exposed to plasma from T2D patients for 36 hours (+1.3±0.08 fold vs. plasma from controls; p<0.05). In addition, we found that increased ROS formation in THP-1 cells treated with T2D plasma was NADPH oxidase-derived and led to increased endothelial cell adhesion (+1.8±0.5 fold; p<0.05) and lipid uptake (+1.3±0.3 fold; p<0.05). Notably, we found that T2D plasma-induced monocyte ROS and downstream functional effects were abolished by treating cells with tauroursodeoxycholic acid, a chemical chaperone known to inhibit ER stress. Collectively, these data indicate that monocyte ROS production with T2D can be, in part, attributed to signals from the circulating environment. Furthermore, an interplay between ER stress and NADPH oxidase activity contributes to ROS production and may be a mechanism mediating endothelial cell adhesion and foam cell formation in T2D.