I would start him on the Plan first. He has to be able to sweat, so you could start to gradually work him into that before starting the Plan. We're carrying a new product called Nutri-oil that can be helpful for the diabetes and heart. I would combine that with either Brain Octane or XCT oil from Bulletproof.
The gauntness can come from the body breaking down his own muscles for fuel. The oils can help with this, as well.
He can start taking BCAA (Branched Chain Amino Acids) to help rebuild and sustain muscle mass.
CoQ10 would be good for the heart, and possibly a mitochondrial product.