BG,
The protein issue depends on what state the kidneys are in right now.
If renal function is normal, no evidence of nephropathy in particular microalbuminuria (small amounts of albumin in the urine) and first evidence of bad things to come, then 50 g a day is probably overkill on the low end.
There is no evidence that higher protein diets in people with otherwise normal renal function who are well hydrated and not loading up daily on NSAIDS will have any long-term problems.
Now, if there is early evidence of renal problems, then he has to be careful.
I am currently training an overweight, African American female, Type I diabetic, age 40 and otherwise healthy, on an insulin pump with HbA1c under 8%. Her docs have had her on a high carb, low protein diet and told her not to lift weights because she is more prone to injury.
Well, so far all that advice has done is allowed her to become increasing fatter.
Since she started training with me she has not incurred any injury, has increased her lean mass, decreased bodyfat and reduced her basal insulin requirements twice.
I suggested that she increase her protein to some degree because she has no current renal problems, decrease her carbs, include some monounsaturated oil in her diet and roll with it.
The problem with the high carb diets is that they require insulin and even small amounts of insulin suppress fat oxidation. Since insulin is being pumped in constantly one is always in a carb oxidation, lipogenic state. Makes no sense because the fatter you get, the more insulin resistant you become and all the bad things follow such as hypertension, renal problems, poorer glycemic control that leads to the destruction of many organ systems.
While it is always wise to error on the cautious side in any disease state, often time’s clinicians are overly conservative and it may not always be the best way to go. One has to balance risk vs quality of life issues and make their own decisions to some extent. But, it is also important to monitor renal function, blood pressure and long-term glycemic control closely.
One thing for sure, if I were a Type I diabetic, I'd make glycemic control my number one priority because almost all the problems associated with Type I diabetes are a function of poor glycemic control.
And, there is no better way to reduce insulin requirements and dispose of blood glucose than aggressive exercise and maintenance of lean muscle mass.
W6