Plausibly, greater CERT expression combats the negative impact of lipid molecules on insulin signaling (106,107) and thus may help to distinguish muscle lipid profile in T2DM patients from the ‘similarly’ highly lipid-laden but high IS state of endurance trained muscle (108), revealing further molecular details of the ‘lipid paradox’ (106). The gene discussed is CERT1; the disease is type 2 diabetes mellitus.