Recent advances in pyruvate studies indicate that pyruvate may be a novel therapy in care of diabetes and its organ complications. The major action of pyruvate protection against diabetes may be in rejuvenation of glucose oxidation by preserving glycolysis and reactivating pyruvate dehydrogenase activity in the tricarboxylic acid cycle, reversing the Warburg effect in diabetic glucometabolic disorders. Pyruvate preservation of glucose metabolism plus its beneficial effects, such as

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... -oxidative stress, -acidosis, -apoptosis and -advanced glycation end products and stimulation of insulin secretion, may turn diabetic vicious circle virtuous in initiation and development of diabetic process. This review proposed a novel opinion focused on pyruvate superior biomedical and pharmacological properties in diabetes treatment and experimental and clinical evidence of pyruvate intervention in diabetes. The novel pyruvate modified oral rehydration salt (Pyr-ORS), based on WHO-ORS, may be helpful in the prevention and treatment of diabetes in a large population. Further studies and clinical trials are urgently required.