The plan was for a polite, academic act of dissent.
For its biggest conference, the American Diabetes Association had invited Dr. Jay Bhattacharya, director of the National Institutes of Health, as keynote speaker, and scientists were mad. Here was one of the officials behind slashed research grants, an existential threat to American science, some thought, and he was being billed as the star of their scientific meeting?
There was talk of a walkout. Dr. Steven Kahn, director of the University of Washington’s diabetes research center, had another idea. Before the speech, he and other scientists would distribute copies of an editorial he had coauthored decrying federal funding cuts — a quiet counterpoint, given that audience questions would not be allowed.
“Don’t want this to be a big deal,” one of the action’s participants, Dr. Desmond Schatz, told the A.D.A.’s then chief scientific and medical officer, Dr. Rita Kalyani, by text. “You may want to CALL Steve and tell him where he can and can’t give out his copies. Should not in any way be disruptive.”
“Thanks Des,” Dr. Kalyani responded. “I’m on plane and will find out details of where it can be given out when I land.”
But Dr. Kahn says the association never reached out.
On the morning of June 5, he divided 1,000 printouts of the editorial among a dozen colleagues, and they fanned out around the lecture hall.
The A.D.A.’s Scientific Sessions is the Super Bowl of diabetes research. Data on household-name drugs like Ozempic are often unveiled there. The Banting Medal, among the field’s highest honors, is presented there. Diabetes Care, the A.D.A.’s most prestigious journal, has its annual meeting there. This year, over 12,000 attendees were expected.
It didn’t take long for police and security to notice “disruptions,” as the A.D.A.’s chief executive, Charles Henderson, would later describe them. Guards — some with guns and handcuffs on their belts — yanked away editorials, grabbed researchers and escorted them outside. Five scientists were expelled. When a few returned, they were kicked out again and threatened with arrest.
The event laid bare long-simmering tension between a formidable nonprofit and the scientists it works with to fight a disease that affects more than 40 million Americans.
To the New Orleans Five — as the ejected researchers call themselves — the struggle is about righting an institution gone rogue. “The A.D.A. is a microcosm of the Trump administration,” Dr. Kahn said. To Aaron Kelly, a University of Minnesota physiologist who was among those expelled, the organization’s response embodies nothing less than “a quelling of dissent in the United States of America.”
Researchers have accused the nonprofit of censorship. A.D.A. officials have resigned. Donors have excised the association from their wills. And since September, Dr. Kahn has been coleading a boycott of the organization, with nearly 1,200 experts refusing to work with the A.D.A.’s medical journals or present at its conferences. At Diabetes Care, editors have stopped editing and submissions have slowed.
By now, the conflict is less about the expulsion and more about what it represents. Dr. Kalyani said she had no hand in the researchers’ ejection and agreed with their editorial. The A.D.A. declined to answer questions beyond a report released last month that said the association had received threats of disruption before the conference, creating security concerns, and that no constitutional rights had been violated because free speech is not protected in privately leased spaces. Still, it conceded that three of the New Orleans Five “likely shouldn’t have been removed.”
But that partial apology wasn’t enough to end the standoff and bring American diabetes research back to normal. International scientists who usually clamored to speak at the A.D.A.’s meeting wondered whether it would be worth traveling to the United States in 2027 at all.
A costly tug of war
Look at the résumés of top diabetes researchers and you’ll see “A.D.A.” appear and reappear as a three-letter leitmotif. Many of the field’s stars have both given and received support. By its own count, last year, the association invested $27.5 million in research and introduced 70 pieces of legislation. According to its latest public tax filings, in 2024, the C.E.O.’s total compensation package neared $1.3 million. It’s not the Gates Foundation, but it isn’t a neighborhood nonprofit, either.
Dr. Kahn first joined in the 1980s, soon after arriving in the United States from South Africa. His emigration was a pilgrimage of sorts. The National Institutes of Health was the biggest funder of biomedical research on earth, the United States a scientific mecca. Dr. Kahn wanted in and the A.D.A. was instrumental, giving him an early grant to study the genetics of diabetes. In the 2000s, he served on the organization’s board. In 2023, he became editor in chief of Diabetes Care. Last year, he received the Banting Medal.
But suddenly, he was on the sidewalk outside the association’s biggest conference and told not to come back.
“‘What do I do now? I’m supposed to chair a session,’” he remembered writing to an A.D.A. leader. “I never heard back from her. Not a word. They whitewashed my name from the program.”
The story might have ended there. Dr. Bhattacharya, the N.I.H. director, hadn’t even shown up; he sent a deputy instead. If A.D.A. leaders had apologized, met with the ejected researchers and returned their badges, the episode might have been a blip. That was what Dr. Mark Atkinson, volunteer chair of the Scientific Sessions planning committee, had proposed on June 5.
Instead, the next day, the A.D.A. sent an email blast saying that Dr. Kahn and his peers had “violated conference policies regarding unauthorized distribution of materials.” It was signed with Mr. Henderson’s name — but also Dr. Atkinson’s.
“I did not agree to sign that letter,” Dr. Atkinson said. He resigned as chair that evening and booked the next flight out, he said, too ashamed to show his face at the event he had helped organize.
Though Mr. Henderson eventually released a video apology, the situation had become a tug of war over the truth. Dr. Kahn and his fellow editors at Diabetes Care compiled a post-mortem on the incident, but the A.D.A. blocked its publication. Dr. Kahn cried censorship. The A.D.A. said it was waiting for “authenticated facts” established by an “arms-length review.” Dr. Kahn and his colleagues were dismayed that the review was run by current and former A.D.A. board members, including a lawyer representing the association in court.
In early September, when Mr. Henderson announced that the investigation was complete and deemed the removals appropriate, Dr. Kahn’s camp was incensed. The researchers wanted to see both the full report and the A.D.A. bylaws governing such internal investigations. The organization refused.
There was a sense on both sides that this conflict had become a distraction. “This is not a moment our community can afford to spend fighting itself,” Mr. Henderson wrote in an editorial for STAT.
“I, personally, was really tired of hearing about the New Orleans Five, really tired of hearing about how horrible the A.D.A. is and really just wanted to get a resolution so that we could move on and fight the good fight,” said Dr. Jane Reusch, professor at the University of Colorado Anschutz, who had distributed editorials but was not expelled.
More important, to her, was a broader pattern of A.D.A. decisions that undermined its scientific integrity. She wanted that fixed so everyone could focus on Trump’s dismantling of American science. “The current administration wins when we’re fighting ourselves like this,” she said.
It was that very animosity from the Trump administration toward academia that kept researchers from backing down. “We expect our leaders to have a spine and stand up and not take part in this anticipatory obedience,” said Dr. Kelly, the University of Minnesota physiologist.
Last year, he had watched Immigration and Customs Enforcement agents grab people in Minneapolis with impunity; the lack of legal recourse felt overwhelming. Here was a squashing of dissent he could make a difference against. Here was an executive branch he could hold to account.
‘The biggest opportunity’
“I really wrestled with this,” said Michael Donnelly-Boylen, a patient advocate with Type 2 diabetes and obesity. He had been invited to join an A.D.A. advisory committee and was scheduled to moderate a webinar for the organization soon after the boycott began. His participation felt important. Too often, people with obesity were left out of decisions that affected their own bodies.
He couldn’t stand the idea of researchers being thrown out by police for distributing an editorial. But he worried that the chance to shape diabetes care could be lost if he spoke up. As he understood it, he was among the first patients to be invited to join the A.D.A.’s obesity and weight management advisory group. “Would patients in the future be given the same opportunity I was?”
Though he ultimately honored the boycott, his nervousness was a testament to the A.D.A.’s outsize influence. The whole operation was based in mutualism. The prestige of its journals depended on peer review, its clinical guidelines on knowledgeable experts writing them. In turn, the organization gave weight and credibility to those in its orbit. The controversy threatened that circular economy.
Last month, the A.D.A. sent invitations to speak at next year’s Scientific Sessions. Many worried that the boycott would put recent graduates in a bind. “For the junior scientists, this may be the biggest opportunity that has ever happened to them,” said Dr. Reusch. “They might be going up for promotion this year and require national recognition.”
On Oct. 22, the A.D.A. published its review of the June incident, which differed from the organization’s previous accounts of what had happened. The report recognized that the association had gotten its own code of conduct wrong when accusing the New Orleans Five of breaking rules. It apologized to three of them, including Dr. Kahn.
But there were still points of contention. The independence of the investigation. The disregard for evidence. The A.D.A.’s suggestion that Dr. Kelly had posed a security threat, which he called “a baldfaced lie.”
When asked about these and other issues, the A.D.A. said, “Our focus is now on the work ahead: rebuilding trust within the diabetes community through meaningful action.”
The report, though, hadn’t accomplished that. “It was close to the truth, but it was not all the truth,” Dr. Kahn said. He wanted the association’s bylaws released publicly. He wanted a meeting with its board.
By Nov. 6, Dr. Kalyani had resigned. The A.D.A.’s vice president for publications announced his resignation, too, citing worries about editorial independence and scientific integrity after the organization insisted on appointing interim editors for Diabetes Care while the official editors were not working.
Amid all this, pre-boycott submissions to Diabetes Care had come out. One probed links between disruptions in the microbiome and Type 1 diabetes. Another examined the risks and survival rates of patients whose blood sugar had so damaged the vessels in their feet that they needed amputation.
Like so much of science, the findings were incremental, data that yielded new questions and more data, which at some point might become an intervention that could change people’s lives. Depending on how negotiations go, Diabetes Care’s editors might resume work any day now. Or these might be among its last contributions for a while.
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