S2E7: When the Room Goes Quiet: Scientific Integrity, Political Pressure, & What Was Lost at the ADA Conference
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S2 E7
Dr. Komal Patil-Sisodia records live from her hotel room on the final night of the ADA 86th Annual Scientific Sessions in New Orleans — still processing what she witnessed earlier that week. The NIH director didn't show up to his own keynote. A substitute speaker framed diabetes research under the MAHA agenda. And five physicians were escorted out of the conference by security for handing out a peer-reviewed article published in the ADA's own journal.
This episode is her unfiltered account of what happened, what the science actually says, and why none of us — patients, clinicians, or researchers — can afford to let it quietly recede.
In this episode:
What the Kahn et al. Diabetes Care editorial actually argues
Why an 89% drop in NIH funding notices is more alarming than it sounds
How a new policy is draining the research pipeline without a single congressional vote
The landmark diabetes trials — DPP, DCCT, TrialNet — that exist because of the infrastructure now being gutted
A frank assessment of the ADA's official statement
Why diverse, long-horizon NIH research is existential for underserved populations
Concrete actions for patients, clinicians, researchers, and ADA members
When the Room Goes Quiet: What Happened at the ADA Conference — And Why It Matters for Every Diabetes Patient in America
By Dr. Komal Patil-Sisodia, MD | Eastside Menopause & Metabolism
I'm writing this from 30,000 feet on my way back to Seattle. I've been at the ADA 86th Annual Scientific Sessions all week, and I've been sitting with what I witnessed since Friday afternoon. I need to tell you about it.
I went to New Orleans with high expectations. I'm a newly appointed member of the ADA Pacific Northwest Community Leadership Board, four weeks in. I've been building an ADA-recognized diabetes program for twelve years. I've been an endocrinologist for seventeen. Both my parents have diabetes. This conference meant something to me — professionally, personally, and in every dimension in between.
What happened there was something I've never seen in my career, and I'm not willing to let it quietly recede into a news cycle.
What Actually Happened
The scheduled keynote speaker was Dr. Jay Bhattacharya, the current director of the National Institutes of Health. He canceled last minute, the ADA announced, to attend an in-person meeting with President Trump. His replacement was Dr. Richard Woychik, a senior NIH advisor. The title projected on the screen in front of thousands of clinicians, researchers, patients, and advocates: The NIH's Vision for Transforming Diabetes Research in Alignment with the MAHA Agenda.
The room went quiet. I mean that literally.
In the hallways and lobby that same day, a group of physicians and researchers who are leading voices in diabetes care were distributing a peer-reviewed editorial. Not a protest pamphlet. Not a flyer. An article published in Diabetes Care, the ADA's own flagship journal, written by the journal's editor-in-chief and deputy editors. They were asked to stop. Some continued. Five were escorted out by security and threatened with arrest.
Physicians handing out a peer-reviewed article from their own field's flagship journal were removed from a conference while a MAHA representative stood at the podium. I've been sitting with that image since Friday.
What the Editorial Actually Says
The Kahn et al. editorial titled "Misguided Brushes of a Pen Continue to Dismantle and Destroy Biomedical Research in the United States. We Can No Longer Afford Complacency and Fear. We Must All Act Now" makes three core arguments. And before you scroll past the footnotes, let me translate the numbers.
The funding collapse is worse than it looks. Congress actually protected the NIH budget. Bipartisan votes rejected the White House's proposed $18 billion cut, resulting in a 1% budget increase to $47.5 billion. I want to acknowledge that. But here's what happened in spite of it: over the first 13 months of the current administration, NIH issued only 84 notices of funding opportunities. The year before? 787. That's an 89% reduction. Actual funded grants dropped 66%. Research dollars flowing to investigators dropped 54% from approximately $1.3 billion to around $600 million. Congress said yes to the money. The administration found other ways to ensure it didn't reach science.
Independent scientific oversight is being gutted. Every NIH institute has a medical advisory council that consists of subject matter experts whose job is to ensure grant funding follows scientific merit, not political preference. These councils are running at one-third capacity because the administration has simply stopped appointing new members. And the vetting process, historically nonpartisan, is shifting toward direct HHS oversight with political appointees replacing scientists. As former NIH director Francis Collins recently said: "Mix politics and science, you get politics. You kind of lose everything else."
A new policy is draining the pipeline without a single congressional vote. Under a new rule, NIH institutes must now fund the entire duration of a multi-year grant upfront, rather than year by year. If an institute has $10 million and the average grant runs $500k per year over five years, it used to fund 20 new projects annually. Now it funds four. Congressional dollars are being legally depleted in a way that's starving future science, and Congress didn't vote for it.
Why I Chose to Stay
When I understood the weight of what I was watching, I genuinely asked myself whether I was going to leave the conference. I think a lot of people in that building were asking themselves the same thing.
I stayed, and here's why. The conference is not the keynote. It is days of research presentations by investigators who spent months or years preparing to share their findings. People studying precision nutrition, metabolic outcomes across diverse populations, the exact science the Kahn editorial is fighting to protect. If I had walked out, I wouldn't have been walking out on the administration or the NIH director who didn't even show up to his own keynote. I would have been walking out on the researchers, on the science, on the very thing worth defending.
So I stayed, I listened, and I took notes.
What Was Actually in Those Slides
I want to be honest: there were places where I found genuine common ground in what Dr. Woychik presented. The framework's core premise that chronic diseases arise from complex genetic, environmental, behavioral, and social factors, and that the NIH needs more integrated cross-institute coordination is real science. That's what I've been telling patients for 17 years.
But Dr. Woychik also used a diabetes conference keynote to address fluoride in drinking water, autism, and vaccines. And here's the contradiction I could not move past: you cannot present a vision for "gold standard science" while your administration has simultaneously cut the infrastructure that produces that science by more than half. When the ADA's own chief scientific officer, Dr. Rita Kalyani, pressed him on funding cuts during Q&A, his response was to call it "change." I want to be clear about why I found that insufficient. Change is being used as an excuse for a 66% reduction in funded grants, an 89% reduction in funding notices, and the deliberate gutting of independent scientific oversight. That is not change. That is a choice. Choices carry accountability in a way that change does not.
On the ADA's Response
The ADA issued an official statement signed by CEO Charles Henderson and conference chair Dr. Mark Atkinson. I want to be fair to it before I critique it. It addressed the incident directly. It didn't pretend it didn't happen. It validated the journal's editorial independence and committed to meeting with the parties involved.
But the statement treated the removal as a policy enforcement matter, and that framing misses the point. Physicians who paid to attend this conference were escorted out by security and police for distributing a peer-reviewed article from the ADA's own journal, written by the journal's own editorial leadership, on the same day a substitute keynote speaker told the room that the gutting of research funding is simply "change."
The policy may be real. The optics are indefensible. What the statement does not acknowledge is the conditions that created the situation. You cannot ask for grace about what happened in that lobby without naming the tension that produced it. And the closing language of “moving forward together” sincerely meant as I believe it to be, functionally asks a scientific community to stop talking about something it is not finished talking about.
I know, because I was there, and we are not finished.
What's Actually at Stake
I want to bring this to the specific patients at highest risk, because this is not abstract.
Standard clinical risk thresholds, like the BMI cutoffs that define "at risk" and the glucose levels that trigger screening, were built on predominantly white Western cohorts. We now know that South Asian, East Asian, Hispanic, Black, and Indigenous populations develop insulin resistance and type 2 diabetes at meaningfully different BMI cutoffs and ages of onset. A patient can present with numbers that look normal by every guideline and be well along a disease trajectory those tools weren't designed to detect.
This isn't theoretical. I see it in the exam room, and in my own family.
The menopause-metabolism connection I discuss on this podcast, the insulin resistance that accelerates during perimenopause, and the cardiovascular risk that shifts after estrogen loss are all areas where we still lack sufficient data across ethnicities. Not because these questions are unimportant, but because research has not been funded or designed inclusively enough to answer them. Women were not routinely included in medical research until 1993.
The research gap that is widening right now will not widen equally. It will widen most for the patients who are already furthest from the center of how medicine has historically been studied.
What You Can Do
If you are a patient: contact your congressional representatives. You need your story, not a medical degree. "I have diabetes. The research guiding my care is funded by the NIH. Protect that funding and provide real oversight of how it's spent."
If you are a clinician: use your specialty society's advocacy arm. Sign open letters. Show up to advocacy days. Speak publicly. The Kahn editorial is explicit in stating it is no longer appropriate to stay quiet out of fear. That time has passed.
If you are a researcher: the editorial is calling your work out by name. Reach out through the same channels and advocate for your funding.
If you are an ADA member: contact the organization directly before the meeting they've committed to hold. Tell them that escorting physicians out of your own conference for distributing your own journal's editorial is not a policy enforcement matter — it is an integrity failure. Tell them the response did not meet the moment. What happens in that meeting is shaped by the volume of voices that reach their leadership.
Links to the editorial, ADA contact tools, and congressional representative resources are below.
I'll be at the table where I can be. I'll keep telling you what I see. None of us can afford normal right now.
Resources mentioned:
Listen to this episode of Clearly Hormonal wherever you get your podcasts, or find it at eastsidemm.com/podcast.
Follow Dr. Komal Patil-Sisodia:@drpatilsisodia on Instagram and TikTok
This content is for educational purposes only and does not constitute personalized medical advice. Please discuss your specific health concerns with your own healthcare provider.