Hidden Fat, Clear Vision: How One Scientist’s Prize-Winning Research Offers Hope to People with Diabetes
- Rebecca Guldberg
- Sep 3
- 4 min read
Original Source: novo nordisk foundation
A big breakthrough in diabetes research just earned international recognition. Professor Gerald I. Shulman has been awarded the 2025 Diabetes Prize for Excellence, a major honor from the Novo Nordisk Foundation, for uncovering how “hidden” fat inside muscle and liver cells drives insulin resistance and type 2 diabetes. His discoveries are transforming how doctors think about prevention, treatment, and long-term care for people living with the condition. Shulman is George R. Cowgill Professor of Internal Medicine and Cellular & Molecular Physiology at Yale School of Medicine where also serves as Co-Director of the Yale Diabetes Research Center, and Investigator Emeritus at the Howard Hughes Medical Institute.
From Childhood Observations to a Lifetime Question
Shulman’s fascination with diabetes began in an unexpected setting: a summer camp for children with type 1 diabetes, run by his physician father in northern Michigan. In his own words:
“As a nine-year-old, I watched my fellow cabinmates having their urine checked daily for glucose and ketones, standing in line for their daily insulin injections, and adjusting their diet just to stay healthy.”“Sometimes they’d get it wrong — their blood glucose would crash, and we’d rush to get them orange juice before they lost consciousness. I saw what could happen if you didn’t get it under control fast. It made me wonder — why does the body lose its ability to handle glucose in the first place? That question stayed with me.” (novonordiskfonden.dk)
That early curiosity propelled Shulman into decades of research, always seeking the “why” behind diabetes—not just how to treat it, but how to fundamentally understand and reverse its roots.
Discovering the Real Villain: Ectopic Fat
Shulman unearthed a pivotal insight: it’s not general obesity that causes insulin resistance—it’s the presence of fat stored in the wrong places, particularly within muscle and liver cells.
As he puts it:
“We realised it wasn’t obesity itself that caused insulin resistance. It was where the fat was stored. Fat under the skin is relatively harmless — but in muscle or liver cells, it’s like oil spilled on the street.”
Using advanced imaging methods like magnetic resonance spectroscopy (MRS), Shulman compared metabolic snapshots to real-time movies, showing how misplaced fat interferes with insulin signaling.
A Ray of Hope: Reversing the Damage
Shulman and his team have shown that reducing this harmful fat—even modestly—can restore insulin sensitivity:
“One of the most encouraging things we’ve found is how quickly this can change. Within several weeks, the right intervention can drop hepatic fat content and improve hepatic insulin action even without normalization of body weight.”
His lab is also developing new drugs that help liver and muscle cells burn more fat and reduce harmful lipids:
“Based on this molecular mechanism, we have developed several new drugs that increase the ability of the liver and muscle cells to burn more fat and reduce harmful lipids inside these cells. This lowers the activity of key enzymes that block insulin action and reverse insulin resistance — targets we’ve been chasing for three decades.”
A Survival Mechanism Gone Awry
Shulman explains how an evolutionary survival tool now fuels disease:
“That survival adaptation was great when food was scarce. In today’s world of chronic overnutrition, the same process promotes insulin resistance, type 2 diabetes and other diseases,” continuing,“ectopic lipid-induced insulin resistance has become harmful, leading not only to type 2 diabetes but also fatty liver disease, heart disease, Alzheimer’s disease and obesity-associated cancers.”
Looking Ahead: Early Detection and Prevention
Shulman hopes to treat insulin resistance the same way doctors treat high blood pressure or cholesterol—long before major damage sets in:
“My long-term goal is early detection and reversal of insulin resistance — fixing the plumbing before the flood — in this case, restoring insulin sensitivity before diabetes starts.”
Why This Matters for You
Improvements Can Be Fast: Insulin sensitivity can bounce back in weeks with the right intervention.
Treatment Isn’t Just Weight Loss: Where fat is stored matters more than how much.
Prevention Is Possible: With early detection, people may avoid type 2 diabetes altogether.
New Medicines Are Coming: Shulman’s research is opening the door to therapies that work alongside diet and exercise.
Professor Shulman’s award-winning work gives new hope to millions. His discoveries prove that diabetes doesn’t have to be inevitable—or irreversible.
“I’m honoured to receive this prize... What excites me most is turning those discoveries into strategies that improve people’s lives. That’s why we do the science.”
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