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1) Keto represents a drastic change in the diet so he should have been monitoring his blood sugars very closely and adjusted his insulin and other diabetes medication accordingly, in close cooperation with his doctor.  If he wasn’t doing this, he eventually started taking more insulin than he needed for the calories (specifically carbohydrates) he was consuming, and he bottomed out his blood sugar.  Insulin causes cells to absorb sugar from the blood and this causes a drop in blood sugar.

2) The blood sugar has likely been getting lower and lower for days, and his brain wasn’t functioning properly which accounts for the falls.  There may be other reasons as well such a diabetic nerve damage in the feet which can mess up the nerves that allow for normal position sensation.

3) Back in the early part of the last century, they used to treat depression by giving IV injections of insulin which would cause the blood sugar to plummet down into the 20’s and teens and trigger a seizure.  They eventually replaced using insulin with electric shocks to trigger seizures as many patients would lose their IV’s and they couldn’t give them IV sugar and they would die.  So sugars that low can be fatal.  It’s possible that the foam was there due to a seizure, but without anyone witnessing it, it’s hard to say for sure.

4) Low blood sugars can damage the brain.  The most sensitive part is the hippocampus which regulates memory.  If he has only mild damage, then the short-term memory would be affected.  If there is more damage, then it will affect his cerebellum and cause balance problems.  Even further damage will next affect the cerebral cortex and his cognitive function in general will suffer.  Without knowing how long his sugars were critically low, there is no way to tell how much damage was done if any.  If they caught it early enough, there may not be any damage at all.

Prayers sent and please keep us updated if you can.

ETA:  When I was an intern, I took care of a 60 year old Asian woman who had an insulinoma, an insulin producing tumor.  When I would round on her in the morning, she had blood sugars in the teens and would act drunk, laughing and giggling.

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I've been using the FreeStyle Libre since it was approved in the US. They are legit for the most part. You can use your phone to read it. I've had one bad sensor in the whole time I've been using them (readings were nowhere close to the finger stick reader), but Abbott promptly sent me a new one.

If you sweat a lot, they will want to come off. SkinTac and a Tegaderm patch can mitigate this. I liked them better when they were the 7 day ones. The 14 day ones usually come off of me after about 10 days. They need better adhesive.

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Keto diet plus still taking diabetes meds = low blood sugar.  That's just my opinion, of course.
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He is lucky to be alive at 14. Lowest I've gone was low 30's. I was miraculously still conscious and was able to crawl to the fridge and chug a bunch of orange juice. Scared the shit out of me since I was alone, and asleep. I woke up because I felt like I was going to throw up.

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I'm not so much asking for a diagnosis as a "Me/my parent/my friend went through this and..."

I know jack and shit about diabetes.

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He is lucky to be alive at 14. Lowest I've gone was low 30's. I was miraculously still conscious and was able to crawl to the fridge and chug a bunch of orange juice. Scared the shit out of me since I was alone, and asleep. I woke up because I felt like I was going to throw up.

If he is seeing a primary care doc for it, he needs to stop NOW and go to an endocrinologist. He also needs to get a Glucagon kit that can be administered to him by your mom at home in the event this happens again.

Treatment plans for more advanced diabetes need to be custom tailored by the endocrinologist. Everyone is different. Some of the SGLT-2 inhibitors they are prescribing for T2 can knock your BG levels down really low like that if the doses aren't tuned right.

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I'm not so much asking for a diagnosis as a "Me/my parent/my friend went through this and..."

I know jack and shit about diabetes.

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I think you're thinking of ketoacidosis, not ketosis.  Ketosis doesn't wreck your kidneys; it's a normal physiological state that everybody - not just dieters - goes into regularly when the body has depleted ready glucose stores.  A ketogenic diet just keeps you there, continuing to burn fat as fuel instead of switching back over to glucose.

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Since I was repeating what the Doctors told me, Ketosis is the same thing as Ketoacidosis. My super smart medical doctor told me he puts people in the hospital to correct this. It is dangerous and harmful to liver and kidneys.
I prefer to go with the folks who have spent 12 plus years in the medical field on these things.

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Since I was repeating what the Doctors told me, Ketosis is the same thing as Ketoacidosis. My super smart medical doctor told me he puts people in the hospital to correct this. It is dangerous and harmful to liver and kidneys.
I prefer to go with the folks who have spent 12 plus years in the medical field on these things.

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Both my parents were type 2 diabetics. 4 of the 6 sybs are type two diabetics.  My mom went into a diabetic coma. She was in ICU for three weeks.
For the record KETO was not the way to go for a diabetic. I get what he was trying to do. KETOSIS is very hard to manage in diabetics and it damages the kidneys. Someone should have been monitoring him closely.
Diabetics have a hard time balancing sugars in their blood stream. Meds are only 1/2 of that equation. Diet is the rest. Medication has to work with carbs through diet. If he was just on pills as he lost weight he couldn't adjust and the pills may have pushed his insulin level to low (not enough carb to off put the medication)
Everything depends on how long he was without O2, damage to brain, how bad the ketosis is, and how much damage to kidneys there is. Dialysis is a real potential if he's in kidney failure.  
I am not a doctor and just speaking from experience with family. Prayers OP

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Despite the similarity in name, ketosis and ketoacidosis are two different things.

Ketoacidosis refers to diabetic ketoacidosis (DKA) and is a complication of type 1 diabetes mellitus. It’s a life-threatening condition resulting from dangerously high levels of ketones and blood sugar. This combination makes your blood too acidic, which can change the normal functioning of internal organs like your liver and kidneys. It’s critical that you get prompt treatment.

DKA can occur very quickly. It may develop in less than 24 hours. It mostly occurs in people with type 1 diabetes whose bodies do not produce any insulin.

Several things can lead to DKA, including illness, improper diet, or not taking an adequate dose of insulin. DKA can also occur in individuals with type 2 diabetes who have little or no insulin production.

What is ketosis?
Ketosis is the presence of ketones. It’s not harmful.

You can be in ketosis if you’re on a low-carbohydrate diet or fasting, or if you’ve consumed too much alcohol. If you’re in ketosis, you have a higher than usual level of ketones in your blood or urine, but not high enough to cause acidosis. Ketones are a chemical your body produces when it burns stored fat.

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A little more info...

Talked to mom this morning and she said he has been talking to my uncle, who's a doctor, since he started Keto and he's been tapering his meds based on blood sugar readings.

The fact that he hasn't been sleeping combined with not eating probably changed the medication requirement drastically in a short period of time, quicker than he adjusted the dose, is my guess.

The update this morning was not good.  He is in kidney failure and his blood pressure is very low.  They're talking dialysis but his BP has to come back up before they can do that.  I'm worried.

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Way too much that could be "off" (I hesitate to use the term 'wrong') to guess at over the internet.

With T2D, you need a good endocrinologist if you want a second (or even third) opinion. Your dad will likely have an internal medicine doctor providing care in the hospital and he should have a follow-up appointment with primary care.

That said, his weight loss could be key here depending on his meds and other factors.

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No idea.  He also has an infection of some sort so he's on antibiotics and some other meds that my mom didn't write down when she was told.

When the ICU doc is saying "he's really sick", I'm taking that as a bad sign.

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Last update was that his heart rhythm was off and they tried giving it a shock but that didn't work.  The "top part of his heart isn't working right" according to my medically illiterate mom.

He has an infection somewhere so they're bringing in a specialist for that.

I am currently at the airport, flying home to be with him.  I plan to get a fuller picture of what's going on, the sequence of events, etc.  I am confused as to how a diabetic coma (likely due to incorrect dosage of meds after a diet change) turns into kidney failure, a malfunctioning heart, and a serious infection all at once.

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Last update was that his heart rhythm was off and they tried giving it a shock but that didn't work.  The "top part of his heart isn't working right" according to my medically illiterate mom.

He has an infection somewhere so they're bringing in a specialist for that.

I am currently at the airport, flying home to be with him.  I plan to get a fuller picture of what's going on, the sequence of events, etc.  I am confused as to how a diabetic coma (likely due to incorrect dosage of meds after a diet change) turns into kidney failure, a malfunctioning heart, and a serious infection all at once.