Application of Monascus fermentation products in prevention and treatment of diabetes and their potential molecular mechanisms

Monascus spp. are important fungal resources used for produce Hongqu (red yeast rice, RYR) with various pharmacological activities. Many studies have suggested that Monascus fermentation products have the potential to prevent and treat diabetes because of their hypoglycemic effect. Based on the data from 2019 to 2024 in the SciFinder, PubMed and Web of Science, this article summarized the physiological activities of different metabolites produced by Monascus fermentation, the experimental effects in the treatment and prevention of Type 2 diabetes mellitus (T2DM) and its complications. Meanwhile, the molecular mechanisms were reviewed underlying the effectiveness of several substances, including Monacolin K (Lovastatin), γ-aminobutyric acid (GABA), and pigments against T2DM. In addition, Monascus strains can ferment a variety of grains and plants to produce hypoglycemic substances, which can be used as a dietary supplement to prevent T2DM, but the underlying mechanisms of most compounds are still unclear. In the future, it is necessary to conduct further research on the structure-activity relationship of bioactive compounds produced by Monascus fermentation, contributing to the development of potential anti-T2DM drugs.