We study vascular health and dysfunction in humans who are typically “healthy” despite being obese or insulin resistant. We use exercise and environmental stressors to perturb physiology to uncover subtle abnormalities that don’t present at rest. Our goal is to define cardiovascular pathophysiology prior to overt clinical disease. This focus may hold great clinical promise, as it is becoming clear that preventing diabetes related cardiovascular damage is far more effective than trying to stop or reverse damage in middle to old-age. One area of research focuses on vascular control mechanisms in the skeletal muscle circulation of obese humans and insulin resistant adults. A second area of research involves the study of cerebral vascular control in insulin resistant adults, where we are observing substantial subclinical impairments. Related to this, we are interested in understanding how prediabetes alters brain blood flow and cognition. Additionally, we have expanded our goals into T1D and middle-age, as we recently submitted an R01 (October 2021) regarding coronary and carotid atherosclerotic disease detection and progression in adults who have been followed since T1D diagnosis. One component of the T1D grant is focusing on microvascular function in the skin circulation-a research area with high clinical significance for diabetes clinical care. By combining our expertise in vascular physiology in collaboration with endocrinologists, imaging experts, and neurologists, along with exceptional resources at UW Madison, we are positioned at the interface of several disciplines, where exciting discoveries are often made.