There is enough anecdotal evidence out there about the value of a ketogenic (keto) diet in successfully managing type 2 diabetes.

But the medical community at large remains unconvinced that the keto diet should be pronounced an approved therapy for managing type 2 diabetes because of the unnaturally high amount of fat consumed to maintain ketosis. Some doctors assert there is no long-term data on the safety of the keto diet in adults.

These vastly conflicting views continue to becloud the widespread acceptance of the keto diet as a mainstream diet with some benefit against type 2 diabetes.

At its core, diabetes is characterized by high blood sugar, impaired insulin function and changes in metabolism. A keto diet can help a person lose excess fat, which is closely linked to type 2 diabetes, prediabetes and metabolic syndrome.

One study found the keto diet improved insulin sensitivity by a massive 75 percent. A person who is insulin sensitive (or who has high insulin sensitivity) will require smaller amounts of insulin to lower blood glucose levels compared to a person with low insulin sensitivity, which is also called insulin resistance.

Another study in people with type 2 diabetes found that 7 out of the 21 participants were able to stop using all diabetes medications after following a keto diet.

Dr. Tro Kalayjian, a board-certified internal medicine and obesity medicine physician, said he lost 150 pounds on the keto diet. In a recent blog post, Dr. Kalayjian vented his anger and frustration over the "closed minds of mainstream physicians" that won’t acknowledge the mounting medical evidence in favor of low-carb diets such as the keto diet.

He listened to speakers at the Obesity Week Conference in Las Vegas from Nov 3 to 7, which brought together more than 4,000 obesity professionals from around the world. The annual conference focused on diabetes this year.

“I don’t quite know how to express my feelings and thoughts about this event, but the words ‘anger’ and ‘hopelessness’ immediately come to mind," Dr. Kalayjian

wrote in his blog.

He said speaker after speaker at the conference continued to promote low-fat diets with multiple small meals featuring plenty of “healthy” grains, fruits and vegetables. Dr. Kalayjian called this “legacy messaging" that ignores the mounting evidence in favor of low-carb diets for diabetes management and reversal.

“My anger and hopelessness are best exemplified by the first keynote speech, delivered by Dr. William Cefalu, who is chief scientific and medical officer of the American Diabetes Association,” Dr. Kalayjian wrote.

Dr. Cefalu emphasized the best diet "is one that a patient can adhere to,” which was effectively a disapproval of the keto diet that is tough to maintain.

On the other hand, Dr. Kalayjian said if adherence is the main issue in the diet wars, then low-carbohydrate and time-restriction (both keto) approaches should be considered the best diets. He also criticized the failed messaging of multiple small meals, lean meats and whole grains in weight loss.

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During the conference, Dr. Kalayjian was dismayed by the fact physicians still refuse to see the big picture. He said it's time for more obesity and diabetes doctors to admit the failure of low-fat diets and multiple small meals, lean meats and whole grains in weight loss.

"Let’s stop the fake open-mindedness, claiming 'there is no best diet' while then continuing to promote only a high-carb, low-fat, eat-often message," Dr. Kalayjian added.