Our adrenal glands produce a stress hormone called cortisol. Mild autonomous cortisol excess, or MACE, is a condition where the adrenal glands produce too much cortisol. Too much cortisol has been linked to a higher risk of type 2 diabetes. Dr Prete wants to understand how MACE might cause type 2 diabetes to develop, and find a way to screen people with MACE, to spot anyone with an increased risk of type 2 diabetes as early as possible.
Background to research
The adrenal glands produce a variety of important hormones, including cortisol, a stress hormone. Some people produce too much cortisol, which is often due to a harmless lump in their adrenal glands. Having too much cortisol, a condition called ‘mild autonomous cortisol excess’, or MACE, has been linked to a higher risk of type 2 diabetes and other conditions related to changes in blood glucose levels.
Dr Prete and his team want to understand the link between MACE and risk of developing type 2 diabetes. He wants to look at how MACE changes the way the body breaks down fats and sugars, to see if this increases the risk of type 2 diabetes. He also wants to see if there are any molecules in the blood or urine of people with MACE, which could be used to detect type 2 diabetes early on.
MACE can be treated by surgically removing the harmless lump from the adrenal gland. In people with MACE who also have type 2 diabetes, research shows that this operation improves their diabetes for the vast majority of people. Dr Prete hopes that by developing a type 2 diabetes screening test specifically for people with MACE, this will help doctors decide who would benefit from having the harmless lump removed.
Dr Prete and his team would like to find out more about how MACE affects the breakdown of sugars and fats in the body. They will do this by studying people with and without MACE, to compare how their bodies deal with sugars and fats differently.
He will also use information from the EURINE-ACT project, a collection of data and biological samples from 1,200 people who have lumps in their adrenal glands. The team hopes to discover molecules in the blood or urine that are linked to an increased risk of type 2 diabetes, which will help predict who could get diabetes in the future.
Potential benefit to people with diabetes
This research will help us understand how MACE might lead to type 2 diabetes, and who has the highest risk. In turn, this will help doctors diagnose type 2 diabetes in people with MACE earlier and treat each individual in the most effective way. By understanding exactly how MACE can lead to type 2 diabetes, new ways of preventing type 2 diabetes in people with this condition could be developed in the future.