The Diabetes Burden Inside and Outside the ADA Conference Hall

I did not see the police officers muscle the five diabetes experts out of the convention center in New Orleans at the American Diabetes Association (ADA) meeting because I was inside the meeting room where the opening session of the conference was about to unfold and they were in the hallway outside. I was already seated in the cavernous General Session hall, opening my computer, getting ready to take notes on the keynote presentation by Richard Woychik, PhD — the last-minute substitute for NIH Director Jay Bhattacharya, MD, PhD, who had to cancel because, we were told, he was speaking in person with the president instead.

The five experts were pushed by the police outside of the conference hall for handing out printed copies of an editorial from Diabetes Care, the flagship journal of the ADA, that details the alarming effects of the Trump administration’s cuts to NIH staffing and changes to grant review procedures, as well as the looming threat of Trump’s proposed budget calling for $5 billion in cuts to the NIH.

The experts were subsequently stripped of their conference credentials and barred from the remainder of the meeting. The ADA leadership’s decision to eject them has sparked outrage across the scientific and medical community.

I was unaware of the preemptive silencing of these scientists as it unfolded because I was listening to Woychik — the senior advisor to the NIH director for the Make America Healthy Again (MAHA) strategy — tell a story that did not remotely resemble that in the Diabetes Care editorial. He told the hundreds of scientists, doctors, and researchers listening in the darkened hall that diabetes research is a priority for the NIH and that it fully aligns with the administration’s MAHA agenda: “If there’s one prototypical chronic disease that fits the MAHA agenda, it’s diabetes.” He spoke of the need to pay attention to diet, to environment, to exercise, to sleep, to “exposomics” — the kind of exposures that affect chronic disease and principles of “whole person health.”

But during the “fireside chat” conversation that followed the presentation, Rita Rastogi Kalyani, MD, MHS, chief scientific and medical officer of the ADA, held Woychik’s feet to the fire on the issue of the Trump administration’s funding of diabetes research. She asked about the 66% reduction in NIH grant awards in 2026 compared to 2021 through 2024, and about the comments of Sen. Tammy Baldwin (D-Wis.) in Congress that the “administration has thrown NIH into chaos,” terminating over 5,000 NIH grants and slashing a quarter of the NIH workforce. The audience erupted in applause.

Woychik appeared to stick to his script, although he did seem flustered at moments as he repeatedly stated that both he and Bhattacharya are “feverishly” working the halls of Congress “on your behalf.”

I am not a doctor — or not the kind of doctor that most of the other attendees are. My doctoral degree is in Comparative Literature and I am an English professor who specializes in the literature of the 18th-century Atlantic world. I am also a type 1 diabetic writing a book about the history of sugar, from the 18th-century sugar plantation to the 21st-century diabetes epidemic. I’m writing the book because these histories — of what is outside my body and what is inside my body — are connected.

I do not have expertise in metabolic signaling pathways but I do have expertise in linguistic signaling. I counted that Woychik used the word “feverishly” five times in the space of 6 minutes in his defense of the NIH and Bhattacharya. He used the word “Congress” five times; he used the word “president” zero times. I know a talking point when I hear one, especially when I hear it five times. It appeared that Woychik had been charged to deliver the message that Congress, not Trump, was to blame for funding cuts. That when it comes to the scourge of diabetes and chronic disease, we are all on the same side.

That is also essentially what the ADA said in the email that went out to members on June 6 regarding the ejection of the five experts from the meeting: we are all on the same side. That seems true — to an extent. I do not doubt the commitment of ADA leaders to treating and preventing diabetes. But when you forcibly boot scientists from a scientific meeting, you are taking sides. You are drawing a line between inside and outside and dictating who is allowed to stand on which side.

Inside: the double-speak.

Outside: the effort to draw attention to the larger policies that are shaping what is happening in the lived world of diabetes care and research. Where labs are being shuttered due to lack of funding. Where patients are not educated because of program cuts. Where healthy food is not purchased or eaten because of newly restrictive policy guidelines.

Also outside the convention center: the city of New Orleans and the majestic Mississippi River, including 144 miles of levee running north to Baton Rouge. This undulating river corridor was once lined with more than 200 sugar plantations. Today there are more than 150 petrochemical companies on that same land. The story of the shift from sugar to toxic chemicals is one that I have researched for my book: it’s a long but continuous history of the cultivation of diabetogenic substances that are the financial lifeblood of the region; and also toxins in the blood of the many residents who live in the River Road parishes. The area is known as “cancer alley” but the pollutants from the plastics and fertilizer plants are also endocrine disruptors and cause metabolic disease such as diabetes.

Louisiana consistently has among the highest rates of diabetes in the nation. Each of the three Uber drivers I chatted with during my time in New Orleans for the conference told me they have type 2 diabetes. Each unspooled a story about Coca-Cola, beignets, insurance nightmares, doctor’s disturbing diagnoses, and their own efforts to survive and thrive in New Orleans.

The inside and the outside must be connected if we’re to make any progress in addressing the chronic health disease burden of diabetes. This includes the work of research, the work of truth-telling about policy and funding, and the work of understanding how the sugar in the fields and the diabetogenic chemicals in the soil and air are related to the insulin delivery systems and the GLP-1s that are displayed in the Exhibit Hall at the ADA conference.

It’s not that clinicians and researchers do not know this. It’s that we all exist in professional silos and often lack the structures to work across them. The ADA and professional medical organizations should not be supporting these boundaries but rather making them easier to traverse.