A Maltese-born endocrinologist has been awarded a £1.4 million grant to lead the national implementation of a new diagnostic test that could transform how adrenal insufficiency is diagnosed across the UK's National Health Service (NHS).
Professor Miguel Debono, a consultant in endocrinology, diabetes and general medicine at Sheffield Teaching Hospitals and honorary professor at the University of Sheffield, secured the funding from the UK's National Institute for Health and Care Research (NIHR).
The grant will support the nationwide rollout of a waking salivary cortisone test for adrenal insufficiency, a condition in which the adrenal glands do not produce sufficient hormones, particularly cortisol.
The innovation offers a significantly simpler alternative to the current diagnostic pathway. Patients can complete the saliva-based test at home, avoiding the need for hospital visits, intravenous procedures and multiple blood samples. The test costs around £20, compared to approximately £398 for the traditional hospital-based stimulation test.
The new approach has already been adopted as first-line practice in Sheffield and is projected to save the NHS around £24 million each year if implemented nationally.
Professor Debono will lead the multi-centre study alongside Dr Charlotte Elder of Sheffield Children's Hospital, with support from several leading organisations, including the Addison's Disease Self Help Group, the Pituitary Foundation, the Shelford Group, the Society for Endocrinology and the NHS Getting It Right First Time (GIRFT) programme.
Born and educated in Malta, Professor Debono has established an international reputation in the field of endocrinology, with particular expertise in cortisol physiology, glucocorticoids and adrenal disorders. He treats patients with a range of endocrine conditions, including thyroid disorders, reproductive health issues, pituitary disease and adrenal disease.
Professor Debono has also maintained strong links with Malta. In 2022, he facilitated a Memorandum of Understanding between Malta's Ministry for Education, Sport, Youth, Research and Innovation and the University of Sheffield, creating opportunities for Maltese clinicians to undertake advanced research training in the UK.
Pilot NHS sites are expected to begin adopting the saliva-based test in the coming months, with the aim of standardising diagnosis and improving outcomes for patients across the country.
