Reprogramming metabolic dysfunction in diabetes: The emerging role of taurine from molecular mechanisms to clinical translation

Abstract

Diabetes mellitus is a complex metabolic disorder marked by high blood sugar, insulin resistance, β-cells dysfunction, oxidative stress, inflammation, and mitochondrial dysfunction. Current treatments mainly focus on controlling blood sugar but do not fully tackle these related causes. Taurine, a sulfur-containing amino acid , has emerged as a multi-functional metabolic regulator with protective effects. This review summarizes that taurine affects important signaling pathways, including AMPK and PI3K/Akt, improves mitochondrial function, manages calcium balance, attenuates oxidative stress primarily by reducing mitochondrial ROS production and enhancing endogenous defense systems, and protects the integrity of pancreatic β-cells. Taurine also plays a role in the metabolism of bile acids by combining with primary bile acids to make taurine-conjugated bile salts. These salts act as signaling molecules through receptors like FXR and TGR5, which affect the gut microbiota and metabolic balance, indicating a broader role as metabolic regulators. Preclinical and early clinical studies have shown improvements in insulin sensitivity, fat metabolism, and inflammation, as well as a favourable safety and tolerability profile. However, current clinical evidence is limited due to small sample sizes, short durations of studies, and differences in dosing and study goals. Therefore, even though the basic and practical findings are promising, strong, large-scale, long-term clinical trials and studies focused on biomarkers are necessary to confirm taurine as a clear therapeutic target for diabetes management.