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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19453
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have recently had a pancreas and kidney transplant and previous

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I have recently had a pancreas and kidney transplant and previous to this I was diabetic for 21 years. Currently everything is working fantastically but I have some nerve damage due to the diabetes. I am suffering with low blood pressure as I stand and I have been told my body over time will adjust. I wanted to know if nerve damage can repair themselves?. If so will my hypotension get better? I am on fludrocortisone but not really helping is there other medication that can help?
Hello from JustAnswer.

The nerve damage that is due to diabetes generally does not repair itself. Certain types of nerve damage can heal, particularly sudden injuries to a peripheral nerve, but the damage to a nerve that happens with diabetes occurs gradually over many years and by the time that damage has occurred, it is beyond spontaneous healing.

However, it is possible for the body to accommodate to some of the changes that occur from the nerve damage. Specifically, if the low blood pressure is due to an autonomic neuropathy, then there are compensatory mechanisms that may result in improvement over time that can occur independent of whether the nerves heal, and these compensatory mechanisms may be more effective after the transplant.

The fludrocortisone is the usual medicine that is used for hypotension. There is another medicine that can be tried, called midodrine. There is not the same level of evidence of effectiveness for the midodrine, but it is useful for certain people.

If I can provide any further information, please let me know.
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