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Hormonal condition MACS linked to type 2 diabetes

Research we've funded has shown for the first time the scale and impact of MACS, a hormonal condition, that's linked to an increased risk of type 2 diabetes. 

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Mild Autonomous Cortisol Secretion (MACS)

Our adrenal glands produce a stress hormone called cortisol. Some people have harmless lumps in their adrenal glands, which can cause them to produce too much cortisol and this can lead to a condition called Mild Autonomous Cortisol Secretion, or MACS.

Working with an international team of researchers, our researcher Dr Alessandro Prete at the University of Birmingham, carried out the largest ever study of people who had adrenal lumps, with and without MACS, to look at their risk of high blood pressure and type 2 diabetes.

In the 1,305 people studied, they found that MACS is much more common than previously reported. Almost half of the people in the study with adrenal lumps had MACS. The study also told us more about who has the highest risk of MACS. 70% of those with MACS were women, and the majority were over the age of 50.  

Research results

The findings also revealed that MACS were linked to an increased risk of high blood pressure and type 2 diabetes. And researchers discovered that people who had type 2 diabetes and MACS were more likely to use insulin to manage their condition, compared to those without MACS. This suggests that MACS could be affecting the progression of type 2 diabetes.

Based on their results, the researchers estimate that up to 1.3 million adults in the UK could have MACS and that the condition is potentially a key contributor to type 2 diabetes risk in this group. Dr Prete explained, “Our study found that MACS is very frequent, especially in older women, and the impact of MACS on high blood pressure and type 2 diabetes risk has been underestimated until now.”

Dr Lucy Chambers, our Head of Research Communications, said:

This important research, funded by Diabetes UK, reveals that a condition associated with benign tumours – Mild Autonomous Cortisol Secretion (MACS) –  is more common and has a more negative impact on health, including increasing the risk of type 2 diabetes, than previously thought.  

“These findings suggest that screening for MACS could help to identify people – particularly women, in whom the condition was found to be more common – who may benefit from support to reduce their risk of type 2 diabetes.

“We look forward to further research to uncover how MACS is linked to increased risk of type 2 diabetes, which could in the future lead to new ways of treating and preventing type 2 diabetes in those with MACS.”

“If you have MACS and are concerned about your risk of type 2 diabetes, it’s important to speak to your GP.”

With our funding, the researchers now plan to investigate precisely how MACS is linked to an increased risk of type 2 diabetes by investigating how the condition changes the way the body breaks down fats and sugars. Dr Prete is also working to develop a type 2 diabetes screening test specifically for people with MACS, this will help doctors decide who could benefit from having their adrenal lump removed to help prevent them from going on to develop type 2 diabetes.  

This research has been published in the Annals of Internal Medicine. 

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