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When the Room Goes Quiet: Scientific Integrity, Political Pressure, & What Was Lost at the ADA Conference · Clearly Hormonal

• 0:01
  Dr. Komal Patil-Sisodia: Welcome to Clearly Hormonal, the podcast where we stop googling our symptoms at midnight and actually start understanding what's going on in our bodies.
• 0:09
  Dr. Komal Patil-Sisodia: I'm Dr.
• 0:10
  Dr. Komal Patil-Sisodia: Komal Patil-Sisodia, an endocrinologist, internist, obesity medicine specialist, and a Menopause Society certified practitioner, which is really just a whole lot of words to say hormones are kind of my jam.
• 0:21
  Dr. Komal Patil-Sisodia: I've spent 17 years watching women try to navigate their hormonal health without ever having been taught the language for what's happening in their own bodies, and then meeting clinicians who want nothing more than to help them figure it out, but are up against 10-minute appointments and a system that just wasn't built for it.
• 0:37
  Dr. Komal Patil-Sisodia: This podcast is my answer to that gap.
• 0:40
  Dr. Komal Patil-Sisodia: We'll cover menopause, metabolism, hormones, and everything in between with real evidence, not trends, and without the overwhelm.
• 0:48
  Dr. Komal Patil-Sisodia: A quick disclaimer: I'm a physician, but this is education, not personalized medical advice.
• 0:53
  Dr. Komal Patil-Sisodia: Take what resonates and discuss it with your own healthcare team.
• 0:56
  Dr. Komal Patil-Sisodia: Now, let's get into it and talk about what's clearly hormonal and what's not.
• 1:04
  Dr. Komal Patil-Sisodia: I'm writing and recording this episode from my hotel room.
• 1:07
  Dr. Komal Patil-Sisodia: It's the last night of the ADA conference, and I'm still reeling from the events of Friday.
• 1:12
  Dr. Komal Patil-Sisodia: The conference wraps tomorrow, and I'm flying home tomorrow afternoon.
• 1:16
  Dr. Komal Patil-Sisodia: I couldn't wait until I got home to record this because what happened here this week is something I need and want to tell you about while I'm still here.
• 1:24
  Dr. Komal Patil-Sisodia: It's easy to go home and let the intensity of the week fade a bit, but that's not being true to the experience.
• 1:30
  Dr. Komal Patil-Sisodia: Before I dive into the ADA keynote and the removal of physicians and researchers from the conference, I want you to get a sense of my background so you know where I'm coming from.
• 1:38
  Dr. Komal Patil-Sisodia: I'm not just an endocrinologist.
• 1:40
  Dr. Komal Patil-Sisodia: I'm also the eldest daughter in an immigrant family in a South Asian community where diabetes is rampant.
• 1:48
  Dr. Komal Patil-Sisodia: Diabetes isn't just a professional focus for me.
• 1:52
  Dr. Komal Patil-Sisodia: Both my parents have diabetes.
• 1:53
  Dr. Komal Patil-Sisodia: I grew up watching this disease move through my family and the South Asian community, and evidence-based treatments did not work for them the same way that they did for other populations.
• 2:05
  Dr. Komal Patil-Sisodia: I've been taking care of patients with diabetes and metabolic disease for seventeen years, twenty-two really, if you count my residency and fellowship.
• 2:14
  Dr. Komal Patil-Sisodia: I've also had the incredible opportunity to build a diabetes program from the ground up for the community that I grew up in, one that the ADA has recognized for the last two years as a leader in diabetes care.
• 2:26
  Dr. Komal Patil-Sisodia: Four weeks ago, I formally joined the ADA Pacific Northwest Community Leadership Board.
• 2:32
  Dr. Komal Patil-Sisodia: I walked into this conference with high expectations of what I would learn, who I would meet, and how I could take this back home to help impact my community.
• 2:42
  Dr. Komal Patil-Sisodia: I'm sad to say that a shadow has been cast over this entire experience.
• 2:47
  Dr. Komal Patil-Sisodia: I've been to a lot of medical conferences over the years, and I've never seen anything quite like what I witnessed here.
• 2:53
  Dr. Komal Patil-Sisodia: Here's what happened.
• 2:55
  Dr. Komal Patil-Sisodia: The keynote address, which is the biggest presentation of the first day and sets the tone for the rest of the conference, was supposed to be given by Dr.
• 3:02
  Dr. Komal Patil-Sisodia: Jay Bhattacharya, the current director of the National Institutes of Health.
• 3:07
  Dr. Komal Patil-Sisodia: He didn't show up.
• 3:08
  Dr. Komal Patil-Sisodia: The ADA announced a last-minute cancellation.
• 3:11
  Dr. Komal Patil-Sisodia: Dr.
• 3:11
  Dr. Komal Patil-Sisodia: Bhattacharya had a scheduling conflict.
• 3:13
  Dr. Komal Patil-Sisodia: He was required to attend an in-person meeting with President Trump.
• 3:17
  Dr. Komal Patil-Sisodia: In his place, the keynote was delivered by Dr.
• 3:19
  Dr. Komal Patil-Sisodia: Richard Woychik, a senior advisor to the NIH director.
• 3:23
  Dr. Komal Patil-Sisodia: The title of his talk projected on a screen in front of thousands of clinicians, researchers, patients, and diabetes advocates was The NIH's Vision for Transforming Diabetes Research in Alignment with the MAHA Agenda.
• 3:38
  Dr. Komal Patil-Sisodia: My stomach dropped when I saw that.
• 3:41
  Dr. Komal Patil-Sisodia: I'm familiar with the MAHA talking points.
• 3:43
  Dr. Komal Patil-Sisodia: I'm familiar with the anti-science sentiment and the cuts to federal funding that are impacting my patients and underserved populations.
• 3:51
  Dr. Komal Patil-Sisodia: I looked around the room to see the reaction of my colleagues and fellow attendees.
• 3:55
  Dr. Komal Patil-Sisodia: Shocked silence had taken over the room.
• 3:58
  Dr. Komal Patil-Sisodia: For those of you who may not be familiar, MAHA, or Make America Healthy Again, is the health initiative of the current administration operating under the Department of Health and Human Services.
• 4:09
  Dr. Komal Patil-Sisodia: Either during or after the talk, I'm still a little unclear on the timing, in the hallways in the lobby of the conference center, a group of physicians and researchers who are leading voices in diabetes care were handing out an editorial, not a flyer, not a protest pamphlet, but a peer-reviewed editorial published in Diabetes Care, the ADA's own flagship journal.
• 4:31
  Dr. Komal Patil-Sisodia: The editorial was written by the journal's editor-in-chief and deputy editors.
• 4:36
  Dr. Komal Patil-Sisodia: They were asked to stop distributing them.
• 4:38
  Dr. Komal Patil-Sisodia: Some of them continued, and five were escorted out of the building by security and threatened with arrest.
• 4:45
  Dr. Komal Patil-Sisodia: Physicians, researchers, experts handing out an article from Diabetes Care were removed from the conference while a MAHA representative stood at the podium I've been sitting with that image all week.
• 5:00
  Dr. Komal Patil-Sisodia: This isn't a story about a conference incident.
• 5:03
  Dr. Komal Patil-Sisodia: It's a story about what happens when the systems that protect scientific integrity come under pressure and what each of us needs to do about it.
• 5:12
  Dr. Komal Patil-Sisodia: I want to walk you through everything: the editorial article, the keynote, the ADA's response, and why all of it lands differently when you understand what's at stake.
• 5:23
  Dr. Komal Patil-Sisodia: The editorial that the physicians were handing out is titled,"Misguided Brushes of a Pen Continue to Dismantle and Destroy Biomedical Research in the United States.
• 5:34
  Dr. Komal Patil-Sisodia: We Can No Longer Afford Complacency and Fear.
• 5:36
  Dr. Komal Patil-Sisodia: We Must All Act Now." It was published in June 2026 issue of Diabetes Care.
• 5:44
  Dr. Komal Patil-Sisodia: The lead author is Dr.
• 5:45
  Dr. Komal Patil-Sisodia: Steven Kahn, the editor-in-chief of that journal.
• 5:47
  Dr. Komal Patil-Sisodia: The co-authors are the three deputy editors, Cheryl Anderson, John Buse, and Elizabeth Sowers.
• 5:54
  Dr. Komal Patil-Sisodia: These scientists are the head of one of the most respected diabetes journals in the world, and they hold NIH grant funding, so they know what they're talking about.
• 6:03
  Dr. Komal Patil-Sisodia: They're not activists or outsiders.
• 6:05
  Dr. Komal Patil-Sisodia: They are experts who concluded that the situation with the NIH grant funding has become so serious that they needed to say something loudly and publicly.
• 6:16
  Dr. Komal Patil-Sisodia: So let's get into what they were actually saying.
• 6:19
  Dr. Komal Patil-Sisodia: Number one, funding for the studies has collapsed, and the numbers are frightening.
• 6:24
  Dr. Komal Patil-Sisodia: Number two, scientific oversight is being dismantled.
• 6:29
  Dr. Komal Patil-Sisodia: And number three, MAHA policy changes have created a loophole that funds less studies than ever before.
• 6:36
  Dr. Komal Patil-Sisodia: First, let's get into the funding collapse and some context that's easy to miss.
• 6:42
  Dr. Komal Patil-Sisodia: Congress actually protected the NIH budget.
• 6:45
  Dr. Komal Patil-Sisodia: Both Republicans and Democrats rejected the White House's proposed eighteen-billion-dollar cut to the NIH for fiscal year 2026.
• 6:55
  Dr. Komal Patil-Sisodia: This resulted in a one percent increase to the budget, bringing the NIH's total budget to forty-seven point five billion dollars.
• 7:03
  Dr. Komal Patil-Sisodia: The editorial does a great job of giving credit to that change, and I give credit to that change.
• 7:08
  Dr. Komal Patil-Sisodia: The bipartisan vote is meaningful and reflective of how both sides of the aisle are looking at scientific research and innovation in high regard.
• 7:17
  Dr. Komal Patil-Sisodia: It all sounds great on paper, but here's what happened despite that show of bipartisanship.
• 7:23
  Dr. Komal Patil-Sisodia: Over the first 13 months of the current administration, NIH issued only 84 notices of funding opportunities.
• 7:31
  Dr. Komal Patil-Sisodia: These are the formal calls that tell researchers where to direct their work and what money is available.
• 7:37
  Dr. Komal Patil-Sisodia: In the year before, seven hundred and eighty-seven of those were issued.
• 7:42
  Dr. Komal Patil-Sisodia: That is an eighty-nine percent reduction.
• 7:45
  Dr. Komal Patil-Sisodia: Congress said yes to the money, but the administration found other ways to ensure it didn't reach science.
• 7:51
  Dr. Komal Patil-Sisodia: And when you look at actual grant awards from October 2025 through February 2026, the number of funded grants dropped by approximately sixty-six percent.
• 8:02
  Dr. Komal Patil-Sisodia: Research dollars flowing to investigators dropped fifty-four percent, from about one point three billion to around six hundred million.
• 8:10
  Dr. Komal Patil-Sisodia: Those aren't rounding errors.
• 8:12
  Dr. Komal Patil-Sisodia: That is a fundamental restructuring of American biomedical science accomplished without a single congressional vote.
• 8:20
  Dr. Komal Patil-Sisodia: For context, every NIH institute has a medical advisory council.
• 8:25
  Dr. Komal Patil-Sisodia: This is a group of subject matter experts whose jobs it is to ensure that grant funding goes to the best science, not the politically favored science.
• 8:34
  Dr. Komal Patil-Sisodia: They are the checks and balances between scientific merit and political preference.
• 8:39
  Dr. Komal Patil-Sisodia: These councils have terms, the members rotate, and in the past year, the administration has simply not been appointing new members.
• 8:46
  Dr. Komal Patil-Sisodia: Some of these councils are operating at one-third capacity.
• 8:50
  Dr. Komal Patil-Sisodia: Backlogs are massive, and the vetting process, which has historically been nonpartisan, is shifting toward direct HHS oversight, with political appointees replacing scientists on these councils.
• 9:04
  Dr. Komal Patil-Sisodia: And as a result, grant funding decisions are becoming a political alignment tool rather than a scientific one.
• 9:11
  Dr. Komal Patil-Sisodia: The former NIH director, Dr.
• 9:13
  Dr. Komal Patil-Sisodia: Francis Collins, the man who oversaw the Human Genome Project, recently said,"Mix politics and science, you get politics.
• 9:21
  Dr. Komal Patil-Sisodia: You kind of lose everything else." And I keep coming back to that line.
• 9:25
  Dr. Komal Patil-Sisodia: Lastly, let's discuss how a MAHA policy change is creating a loophole that funds less studies.
• 9:31
  Dr. Komal Patil-Sisodia: The editorial does a great job of pointing this out, and I had to read through that section a few times so I'm going to do my best to explain it.
• 9:39
  Dr. Komal Patil-Sisodia: Normally, NIH institutes fund new grants every year.
• 9:43
  Dr. Komal Patil-Sisodia: If an institute has ten million dollars and the average grant is about five hundred thousand dollars, they're able to fund 20 projects a year, and the pipeline stays full.
• 9:54
  Dr. Komal Patil-Sisodia: New science begins every year.
• 9:56
  Dr. Komal Patil-Sisodia: But under a new policy, institutes are now being required to fund the entire duration of a multi-year grant.
• 10:05
  Dr. Komal Patil-Sisodia: Under the previous policy, they only had to fund the year that was coming up.
• 10:09
  Dr. Komal Patil-Sisodia: So if we assume a grant is for five years and is a five hundred thousand dollar per year project, that's an upfront cost of two point five million dollars.
• 10:19
  Dr. Komal Patil-Sisodia: Now, that ten million dollars that was going to fund twenty studies might only fund four projects instead.
• 10:25
  Dr. Komal Patil-Sisodia: Across an institute's full budget, you're looking at a significant reduction in new grants funded each year.
• 10:32
  Dr. Komal Patil-Sisodia: Congress actually acted to protect the budget, but the administration made a new rule that's choking the pipeline.
• 10:37
  Dr. Komal Patil-Sisodia: Researchers can't get new projects off the ground, early career scientists leave the field, and congressional funding is being depleted in a way that is starving future science.
• 10:47
  Dr. Komal Patil-Sisodia: When I'm managing my patients with diabetes, there are several specific studies that I reference on a daily basis that came from this infrastructure.
• 10:54
  Dr. Komal Patil-Sisodia: The editorial does a great job of pointing them out.
• 10:58
  Dr. Komal Patil-Sisodia: Number one, the Diabetes Prevention Program, which is the landmark trial that showed intensive lifestyle intervention and metformin could reduce the risk of developing type 2 diabetes.
• 11:08
  Dr. Komal Patil-Sisodia: That study is why Medicare now covers the diabetes prevention programs.
• 11:12
  Dr. Komal Patil-Sisodia: It directly changes what I can offer my patients today.
• 11:16
  Dr. Komal Patil-Sisodia: Number two, the DCCT is the trial that established glucose standards for type 1 diabetes and showed that tight control significantly reduces complications.
• 11:27
  Dr. Komal Patil-Sisodia: After forty-four years, it's still producing new findings.
• 11:30
  Dr. Komal Patil-Sisodia: And then number three, teplizumab is an FDA-approved drug that can actually prevent type 1 diabetes in high-risk individuals.
• 11:38
  Dr. Komal Patil-Sisodia: It emerged from TrialNet, which is a multicenter NIH-funded consortium.
• 11:43
  Dr. Komal Patil-Sisodia: For the first time in history, we are on the verge of preventing a form of diabetes.
• 11:48
  Dr. Komal Patil-Sisodia: That possibility exists because of a long-term coordinated NIH investment.
• 11:53
  Dr. Komal Patil-Sisodia: We should be deeply concerned that new studies with the potential to become as influential as these landmark studies are at risk of never being initiated.
• 12:04
  Dr. Komal Patil-Sisodia: I want to tell you something I've been sitting with since the keynote.
• 12:07
  Dr. Komal Patil-Sisodia: When I learned what happened to my colleagues, when the weight of that keynote title settled in, when I felt the tension in that room, I genuinely asked myself whether I was going to stay at the rest of the conference or not.
• 12:21
  Dr. Komal Patil-Sisodia: I don't think that's a shameful thing to admit.
• 12:24
  Dr. Komal Patil-Sisodia: I think a lot of people in this building have been asking themselves versions of that question all week.
• 12:30
  Dr. Komal Patil-Sisodia: When an institution does something that unsettles you, when you're disappointed or angry or uncertain, there's a pull towards the gesture of leaving, towards making your discomfort visible by walking out.
• 12:43
  Dr. Komal Patil-Sisodia: I chose to stay, and I want to tell you exactly why, because I think it matters more than it might seem This conference is not only a keynote address, it is days of research presentations by brilliant scientists, clinicians, and investigators who spent months or years preparing to share their work.
• 13:05
  Dr. Komal Patil-Sisodia: People studying precision nutrition and diabetes, people tracking metabolic outcomes across diverse populations, people doing the exact science that the Kahn editorial is fighting to protect.
• 13:16
  Dr. Komal Patil-Sisodia: They had nothing to do with the political circumstances of that opening session.
• 13:21
  Dr. Komal Patil-Sisodia: They showed up to share what they found in service of the patients we all share.
• 13:26
  Dr. Komal Patil-Sisodia: And I kept asking myself, if I leave, who am I actually punishing?
• 13:32
  Dr. Komal Patil-Sisodia: Not the administration, not the NIH director who didn't even show up to his own keynote.
• 13:37
  Dr. Komal Patil-Sisodia: I would have been walking out on the researchers, on the science, on the very thing that makes a conference like this worth defending in the first place.
• 13:45
  Dr. Komal Patil-Sisodia: The brilliant people presenting their work deserve to be heard, and I wasn't willing to deny them that or deny myself the privilege of hearing it because of decisions that were made far above our heads.
• 13:56
  Dr. Komal Patil-Sisodia: So I stayed, I listened, I took notes, I photographed the slides, and I'm glad I did because what I witnessed in that keynote deserves to be described carefully and honestly, not dismissed.
• 14:09
  Dr. Komal Patil-Sisodia: Let me tell you what was actually in those slides.
• 14:12
  Dr. Komal Patil-Sisodia: Dr.
• 14:12
  Dr. Komal Patil-Sisodia: Woychik, the substitute speaker, opened with something I found striking.
• 14:17
  Dr. Komal Patil-Sisodia: Reflecting on when he first encountered the MAHA agenda last October, he said, and I'm quoting directly,"I could have written the MAHA agenda." The framework he presented, called the NIH MAHA Strategic Framework, centers on what they call"whole person health." The idea that chronic diseases like diabetes arise from complex interacting genetic, environmental, behavioral, dietary, and social factors, and that the NIH needs a more integrated cross-institute approach to address them.
• 14:46
  Dr. Komal Patil-Sisodia: Yes, that's the science.
• 14:48
  Dr. Komal Patil-Sisodia: That's what I've been telling my patients for seventeen years, and that's what my colleagues and I have been working towards.
• 14:55
  Dr. Komal Patil-Sisodia: Interestingly, the framework goes on to outline thematic coordination groups focused on nutrition and metabolism, environmental exposure, sleep and physical activity, mental health, immunology, and cancer biology.
• 15:08
  Dr. Komal Patil-Sisodia: It talks about real-world data, AI, life course prevention, translating evidence into primary care and community settings.
• 15:16
  Dr. Komal Patil-Sisodia: And sitting in that room, I found genuine common ground in this.
• 15:19
  Dr. Komal Patil-Sisodia: I want to be honest about that, because I think dismissing it outright would be its own kind of intellectual failure.
• 15:26
  Dr. Komal Patil-Sisodia: But here's my clinical read on the full picture, the same way I read a lab result or a patient history.
• 15:32
  Dr. Komal Patil-Sisodia: Dr.
• 15:32
  Dr. Komal Patil-Sisodia: Woychik used the keynote stage at a diabetes conference to address fluoride in drinking water, autism, and vaccines.
• 15:41
  Dr. Komal Patil-Sisodia: On vaccines, he argued for a better understanding of individual biological responses.
• 15:47
  Dr. Komal Patil-Sisodia: This echoes Maha's talking points and hints at endorsing the long-debunked vaccine-autism connection.
• 15:53
  Dr. Komal Patil-Sisodia: These topics did not belong in a diabetes research keynote, and their presence was a sign.
• 16:00
  Dr. Komal Patil-Sisodia: And here's the core contradiction I couldn't move past during the presentation and still can't sitting in this hotel room tonight.
• 16:08
  Dr. Komal Patil-Sisodia: 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.
• 16:18
  Dr. Komal Patil-Sisodia: You cannot call for precision nutrition research while funding notices that would support that research have been reduced by eighty-nine percent.
• 16:26
  Dr. Komal Patil-Sisodia: You cannot champion rigorous reproducible science while the independent advisory councils that ensure scientific rigor are operating at a third of the capacity with political appointees replacing subject matter experts.
• 16:40
  Dr. Komal Patil-Sisodia: You can't.
• 16:42
  Dr. Komal Patil-Sisodia: When the ADA's own chief scientific officer, Dr.
• 16:45
  Dr. Komal Patil-Sisodia: Rita Kalyani, pressed Dr.
• 16:47
  Dr. Komal Patil-Sisodia: Woychik on these funding cuts during the Q&A, she received loud applause from the room that told you everything you needed to know about where the scientific community stands His response was disappointing.
• 16:59
  Dr. Komal Patil-Sisodia: His response was to call it change.
• 17:02
  Dr. Komal Patil-Sisodia: He said, quote,"I think we all have to acknowledge that we're in a very changing environment.
• 17:07
  Dr. Komal Patil-Sisodia: We have a new administration.
• 17:09
  Dr. Komal Patil-Sisodia: We have new NIH directors.
• 17:11
  Dr. Komal Patil-Sisodia: We just have to acknowledge that things are changing." I want to be clear about why I think that's insufficient and frankly a bunch of BS.
• 17:19
  Dr. Komal Patil-Sisodia: Not because change is inherently wrong, but because change is being used as an excuse for the deliberate sixty-six percent reduction in funded grants and eighty-nine percent reduction in funding opportunities.
• 17:31
  Dr. Komal Patil-Sisodia: The deliberate gutting of independent scientific oversight, a policy that depletes future research budgets despite bipartisan votes from Congress to prevent exactly that.
• 17:43
  Dr. Komal Patil-Sisodia: That is not change.
• 17:44
  Dr. Komal Patil-Sisodia: That is a choice, and choices carry accountability in a way that change does not.
• 17:50
  Dr. Komal Patil-Sisodia: Five of the people who were trying to make a case against Dr.
• 17:53
  Dr. Komal Patil-Sisodia: Woychik's claims peacefully were removed from the building.
• 17:57
  Dr. Komal Patil-Sisodia: As the presentation wrapped up, I found myself asking the women who were sitting next to me if I was hallucinating.
• 18:03
  Dr. Komal Patil-Sisodia: We were all disturbed by the unapologetic nature of Dr.
• 18:07
  Dr. Komal Patil-Sisodia: Woychik's comments and his assertions that the MAHA initiatives were somehow superior to the work that has been going on for decades.
• 18:15
  Dr. Komal Patil-Sisodia: Following the events of Friday, the ADA issued an official statement addressing the incident.
• 18:20
  Dr. Komal Patil-Sisodia: It was signed by CEO Charles Henderson and the Scientific Sessions Planning Committee Chair, Dr.
• 18:25
  Dr. Komal Patil-Sisodia: Mark Atkinson.
• 18:27
  Dr. Komal Patil-Sisodia: I'm going to tell you exactly what I think, despite being four weeks into being an ADA Community Leadership Board member and building an ADA recognized diabetes program.
• 18:37
  Dr. Komal Patil-Sisodia: I have skin in the game, and as I sit in my hotel room in New Orleans right now still attending this conference, I want you to feel the weight of that as I say what I'm about to say In summary, the ADA statement says the attendees were distributing materials, specifically the Diabetes Care editorial, both inside session rooms and in lobby areas.
• 18:59
  Dr. Komal Patil-Sisodia: The ADA's policy requires prior authorization for any material distribution, and that authorization was not obtained.
• 19:06
  Dr. Komal Patil-Sisodia: The attendees were asked to stop.
• 19:08
  Dr. Komal Patil-Sisodia: Some continued, and they were escorted out by on-site security and police following standard protocols.
• 19:15
  Dr. Komal Patil-Sisodia: The removal was for policy violation, not for the viewpoints expressed.
• 19:20
  Dr. Komal Patil-Sisodia: When I read that statement, I thought about what did it do well and what did it totally flop on, and here's what I think.
• 19:27
  Dr. Komal Patil-Sisodia: What I think the statement does well is that it doesn't pretend that the incident didn't happen.
• 19:32
  Dr. Komal Patil-Sisodia: It addresses it directly.
• 19:33
  Dr. Komal Patil-Sisodia: It doesn't denounce the editorial.
• 19:35
  Dr. Komal Patil-Sisodia: In fact, it uses the phrase"respecting editorial independence," in a way that validates the journal's publication of that particular editorial.
• 19:44
  Dr. Komal Patil-Sisodia: It commits to meeting with the parties involved after the conference concludes, and I think these things matter, and I want to call them out.
• 19:51
  Dr. Komal Patil-Sisodia: But here's where I think the statement falls short.
• 19:54
  Dr. Komal Patil-Sisodia: I agree that the policy cited is real.
• 19:56
  Dr. Komal Patil-Sisodia: Conferences have material distribution policies, and I understand why those policies exist.
• 20:02
  Dr. Komal Patil-Sisodia: But sit with the full picture for a moment.
• 20:04
  Dr. Komal Patil-Sisodia: Physicians and researchers, people who paid to attend this conference, were escorted out by security and police for distributing a peer-reviewed article published in the ADA's own flagship journal, written by the journal's own editorial leadership about the systemic dismantling of research funding the ADA exists to advance.
• 20:24
  Dr. Komal Patil-Sisodia: On the same day that a substitute keynote speaker filling in for a director who skipped the conference to meet with the president stood at this organization's podium and told the room that funding cuts are just change.
• 20:38
  Dr. Komal Patil-Sisodia: The policy may be real, but the optics are indefensible.
• 20:43
  Dr. Komal Patil-Sisodia: The apology in this statement is for the escalation, for the distraction from the science and community that brings people together.
• 20:50
  Dr. Komal Patil-Sisodia: What is missing is any acknowledgement of the conditions that created the situation.
• 20:55
  Dr. Komal Patil-Sisodia: You cannot ask for grace about what happened in that lobby without acknowledging the tension that produced it.
• 21:00
  Dr. Komal Patil-Sisodia: And the closing language, moving forward together, grace, mutual respect, is sincerely meant.
• 21:06
  Dr. Komal Patil-Sisodia: I believe that.
• 21:08
  Dr. Komal Patil-Sisodia: But functionally, it asks everyone to stop talking about something the scientific community is not finished talking about.
• 21:14
  Dr. Komal Patil-Sisodia: I know because I'm here, and I can tell you we are not finished.
• 21:19
  Dr. Komal Patil-Sisodia: I think it's important to acknowledge my own perspective here.
• 21:22
  Dr. Komal Patil-Sisodia: I joined the ADA Community Leadership Board four weeks ago.
• 21:26
  Dr. Komal Patil-Sisodia: This was actually my first ADA conference I've attended.
• 21:29
  Dr. Komal Patil-Sisodia: In my defense, endocrinologists have four societies that we have to keep up with, so I've been running the circuit on the others.
• 21:37
  Dr. Komal Patil-Sisodia: I've spent the last twelve years building a program that this organization has recognized for the past two years, and I'm offering these observations because I care about the mission of the ADA because of the tremendous amount of work it's done on behalf of patients and communities affected by diabetes.
• 21:55
  Dr. Komal Patil-Sisodia: I want to see it succeed.
• 21:58
  Dr. Komal Patil-Sisodia: My intent isn't to criticize from the sidelines, but to contribute honestly to a conversation about how we can do better.
• 22:04
  Dr. Komal Patil-Sisodia: Healthy organizations make room for that kind of feedback, and I really hope that this feedback is received in that spirit.
• 22:12
  Dr. Komal Patil-Sisodia: I want to bring this home because the research infrastructure being dismantled has specific consequences for specific patients.
• 22:19
  Dr. Komal Patil-Sisodia: As I said before, both of my parents have diabetes.
• 22:23
  Dr. Komal Patil-Sisodia: I grew up watching this disease move through my family, and I became an endocrinologist in part because of what I witnessed.
• 22:30
  Dr. Komal Patil-Sisodia: I'm not saying that for sympathy, but because it shaped what I know clinically.
• 22:35
  Dr. Komal Patil-Sisodia: Metabolic disease does not present the same way across all populations, and the research infrastructure we have built has not kept pace with that reality.
• 22:44
  Dr. Komal Patil-Sisodia: The risk thresholds that define overweight or high risk in standard clinical guidelines were determined using predominantly white Western cohorts.
• 22:54
  Dr. Komal Patil-Sisodia: We now know that different ethnic groups develop insulin resistance, visceral adiposity, and type two diabetes at meaningfully different BMI cutoffs and ages of onset.
• 23:05
  Dr. Komal Patil-Sisodia: South Asian, East Asian, Hispanic, Black, and Indigenous populations each carry distinct metabolic risk profiles that standard screening tools were not designed to detect accurately.
• 23:17
  Dr. Komal Patil-Sisodia: A patient can present with numbers that look normal by textbook standards and be well along a disease trajectory those tools weren't built to see.
• 23:26
  Dr. Komal Patil-Sisodia: This isn't a theoretical problem.
• 23:28
  Dr. Komal Patil-Sisodia: I see it in the exam room every day.
• 23:31
  Dr. Komal Patil-Sisodia: It's why precision medicine requires diverse, well-powered cohort studies that actually include the populations most affected by these diseases.
• 23:40
  Dr. Komal Patil-Sisodia: And that research requires NIH infrastructure, the multi-center cohorts, the long horizon longitudinal studies, the funding mechanisms that allow investigators to follow populations across decades and ask questions that a single site, single cycle grant cannot answer.
• 23:57
  Dr. Komal Patil-Sisodia: And that is the infrastructure that's being gutted.
• 24:00
  Dr. Komal Patil-Sisodia: The menopause metabolism connection I talk about on this show, the insulin resistance that accelerates in perimenopause, the cardiovascular risk that shifts after estrogen loss, we do not have nearly enough data on how this plays out across ethnicities, not because the question isn't important, but because it hasn't been funded or designed inclusively enough to answer it.
• 24:21
  Dr. Komal Patil-Sisodia: Women were only included in medical research starting in 1993.
• 24:26
  Dr. Komal Patil-Sisodia: Women across every demographic deserve that science.
• 24:30
  Dr. Komal Patil-Sisodia: Right now, the pipeline is shrinking.
• 24:33
  Dr. Komal Patil-Sisodia: The research gap being widened is not widening equally.
• 24:37
  Dr. Komal Patil-Sisodia: It will widen most for the patients who are already furthest from the center of how medicine has historically been studied.
• 24:44
  Dr. Komal Patil-Sisodia: Communities where chronic disease burden is the highest, populations whose biology has been most underrepresented in the trials that set the standards of care we all use.
• 24:53
  Dr. Komal Patil-Sisodia: That's what's at stake, not a conference incident.
• 24:57
  Dr. Komal Patil-Sisodia: The health of the patients who need us to get this right.
• 25:00
  Dr. Komal Patil-Sisodia: Tomorrow, I get on a plane and go home.
• 25:03
  Dr. Komal Patil-Sisodia: The conference ends tomorrow too, and the hallways that have been full of conversation and tension and brilliant science all week will go quiet.
• 25:12
  Dr. Komal Patil-Sisodia: And I've been thinking about what it means to carry this home, what the responsibility is for those of us who were here, and for all of you who weren't but are listening now.
• 25:21
  Dr. Komal Patil-Sisodia: What happened this week is easy to let recede, a conference incident, a statement, a news cycle, and then back to normal.
• 25:29
  Dr. Komal Patil-Sisodia: I don't think we can afford normal right now.
• 25:32
  Dr. Komal Patil-Sisodia: So here's what I think we can all do.
• 25:35
  Dr. Komal Patil-Sisodia: If you're a patient, contact your congressional representatives.
• 25:39
  Dr. Komal Patil-Sisodia: You need your story, not a medical degree.
• 25:41
  Dr. Komal Patil-Sisodia: Tell them,"I have diabetes," or,"My parents have diabetes," or,"My community has diabetes.
• 25:47
  Dr. Komal Patil-Sisodia: The research that guides my care is funded by the NIH.
• 25:50
  Dr. Komal Patil-Sisodia: Protect that funding and provide real oversight of how it's spent." Links to the ADA's advocacy tools will be in the show notes.
• 25:58
  Dr. Komal Patil-Sisodia: If you're a clinician, use your specialty society's advocacy arm.
• 26:02
  Dr. Komal Patil-Sisodia: Sign on to open letters, show up to advocacy days, and speak publicly.
• 26:07
  Dr. Komal Patil-Sisodia: Your patients need your voice outside the exam room right now.
• 26:10
  Dr. Komal Patil-Sisodia: I want to address the physicians thinking,"Well, I don't want to be seen as political.
• 26:14
  Dr. Komal Patil-Sisodia: I can't afford the backlash," and I understand it.
• 26:17
  Dr. Komal Patil-Sisodia: I felt it myself in this hotel room deciding on whether I'm going to record this episode.
• 26:22
  Dr. Komal Patil-Sisodia: And also immediately after the keynote when I was debating about whether I should post my reaction video.
• 26:28
  Dr. Komal Patil-Sisodia: But the con editorial is explicit.
• 26:30
  Dr. Komal Patil-Sisodia: It is no longer appropriate to work only behind the scenes or stay quiet out of fear.
• 26:35
  Dr. Komal Patil-Sisodia: The editorial leadership of one of the most important journals in our field is saying that time has passed.
• 26:42
  Dr. Komal Patil-Sisodia: If you're a researcher, you're living this in real time, and thank you for doing the work that you do.
• 26:49
  Dr. Komal Patil-Sisodia: The editorial is calling you and your work out by name, and I would encourage you to reach out through the same channels to advocate for your funding.
• 27:00
  Dr. Komal Patil-Sisodia: If you belong to a community historically underrepresented in research, the studies that would finally center your biology and your outcomes depend on the pipeline being closed right now.
• 27:10
  Dr. Komal Patil-Sisodia: Tell your elected representatives that loudly.
• 27:14
  Dr. Komal Patil-Sisodia: And also for everyone, contact the ADA directly.
• 27:19
  Dr. Komal Patil-Sisodia: The ADA needs to hear before the meeting they promised happens that what took place this week was a failure the scientific community will not quietly absorb.
• 27:28
  Dr. Komal Patil-Sisodia: Tell them you're disappointed.
• 27:30
  Dr. Komal Patil-Sisodia: Tell them that escorting physicians out of your own conference for distributing your own journal's editorial is not a policy enforcement matter.
• 27:38
  Dr. Komal Patil-Sisodia: It's an integrity failure.
• 27:40
  Dr. Komal Patil-Sisodia: Tell them the response did not meet the moment.
• 27:43
  Dr. Komal Patil-Sisodia: Tell them that platforming a MAHA keynote while removing clinicians who distributed evidence-based pushback sent a message about whose voice this organization is willing to protect, and it was the wrong message.
• 27:55
  Dr. Komal Patil-Sisodia: If you're a member, use that standing.
• 27:58
  Dr. Komal Patil-Sisodia: If you're a clinician or researcher whose work this organization has recognized, they need to know how this week landed.
• 28:04
  Dr. Komal Patil-Sisodia: The contact link is in the show notes.
• 28:07
  Dr. Komal Patil-Sisodia: The ADA has committed to meeting with the parties involved after this conference ends.
• 28:11
  Dr. Komal Patil-Sisodia: What happens in that meeting is shaped by the volume of voices that reach their leadership.
• 28:16
  Dr. Komal Patil-Sisodia: Make yours one of them.
• 28:18
  Dr. Komal Patil-Sisodia: I will be at the table where I can be, and I will keep telling you what I see.
• 28:23
  Dr. Komal Patil-Sisodia: I've spent seventeen years as an endocrinologist watching what happens when the science keeps up and what happens when it doesn't.
• 28:29
  Dr. Komal Patil-Sisodia: I'm not willing to be quiet about what threatens that, not ever.
• 28:33
  Dr. Komal Patil-Sisodia: Thank you for being here for this episode.
• 28:35
  Dr. Komal Patil-Sisodia: Links to everything, the Kahn editorial, the stat news coverage, how to contact the ADA, how to reach your congressional representatives will all be in the show notes.
• 28:44
  Dr. Komal Patil-Sisodia: Share this if it gave you something worth passing on.
• 28:47
  Dr. Komal Patil-Sisodia: And if you were in New Orleans this week or if this hits close to home, find me@drpatilsisodia on Instagram and TikTok.
• 28:55
  Dr. Komal Patil-Sisodia: I'd love to hear from you.
• 28:56
  Dr. Komal Patil-Sisodia: Take care of yourselves and take care of each other.
• 28:59
  Dr. Komal Patil-Sisodia: I'll see you on the next episode.