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hey there!   Under 40 grams of carbs is VERY LOW. Your mothers friend who did this, if she wound up in the hospital with ketones, was because of high blood sugars associated with low-carb diet. The ketones produced during a lower-carb diet when your blood sugars are in control, are different and not toxic in the same extreme way because your body is able to flush them out (with a controlled blood sugar).   Check out these articles on carbs & diet:   Determining a proper amount of fats, carbs & protein: http://www.healthcentral.com/diabeteens/c/26446/67539/changing-eating   http://www.healthcentral.com/diabeteens/c/27511/51113/carbohydrates   http://www.healthcentral.com/diabeteens/c/27511/29450/hypoglycemia   http://www.healthcentral.com/diabeteens/c/27511/52047/interview-berry     When I followed a lower-carb nutrition plan, I reduced my long-acting insulin gradually, in the end by a total of 5 units, and I took a small amount of short-acting with every meal.   -Ginger