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Excess steroid hormones can trigger type 2 diabetes, latest evidence shows

A medical condition which overproduces the stress steroid hormone cortisol can prompt the development of type 2 diabetes and cause rising blood pressure, a new study suggests.

Researchers from the University of Birmingham have found that type 2 diabetes and high blood pressure can be trigged by Mild Autonomous Cortisol Secretion (MACS), a condition that produces too much cortisol in an adrenal incidentaloma or benign tumour.

Adrenal incidentalomas are small lumps within the adrenals, which are triangular-shaped glands located on top of both kidneys that produce hormones to regulate the body’s metabolism, immune system, blood pressure, stress responses and other essential functions.

Prior research has revealed that one in three adrenal incidentalomas overproduce cortisol and that more than 10 per cent of people have either an adrenal incidentaloma or benign tumour.

During the trial, the scientists examined urine samples of thousands of participants both with and without adrenal incidentalomas to measure their blood pressure and type 2 diabetes risk.

They found that MACS is a more common condition in the UK than first expected, with it affecting 1.3 million adults in the UK – particularly females.

Additionally, they found that MACS did trigger type 2 diabetes and high blood pressure, mainly in older women.

Top author, Dr Alessandro Prete said: “Compared to those without MACS, we observed that people with MACS were more likely to be diagnosed with high blood pressure and to require three or more tablets to achieve an adequate blood pressure control.

“When we looked at people with a diagnosis of type 2 diabetes, those with MACS were twice more likely to be treated with insulin, indicating that other medications haven’t helped managing their blood sugar levels.”

He added: “The impact of MACS on high blood pressure and type 2 diabetes risk has been underestimated until now.”

Lead research, Professor Wiebke Arlt said: “Previous studies suggested that MACS is associated with poor health. However, our study is the largest ever study to establish conclusively the extent of the risk and severity of high blood pressure and type 2 diabetes in people with MACS.

“Our hope is that this research will put a spotlight on this condition and increase awareness of its impact on health.”

The Head of Research Communications at Diabetes UK, Dr Lucy Chambers said: “This important research, funded by Diabetes UK, reveals that a condition associated with benign adrenal tumours – MACS – is more common and may have more of a negative impact on health, including increasing the risk of type 2 diabetes, than previously thought.

“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.”

The study has been published in the journal Annal of Internal Medicine.

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