Delayed Puberty in Boys Linked to Higher Risk of Type 2 Diabetes: Study

A new study study presented at a joint meeting of the European Society of Paediatric Endocrinology and the European Society of Endocrinology, boys who experience delayed puberty are 2.5 times more likely to develop type 2 diabetes in early adulthood. This increased risk is independent of weight and socioeconomic status, highlighting pubertal timing as a key factor in long-term metabolic health.

Type 2 diabetes affects more than 90% of diabetics and is influenced by genetic, environmental, demographic, and socioeconomic variables. Previously known as adult-onset diabetes, type 2 diabetes often strikes individuals 45 years of age or older, but it is also increasingly being diagnosed in children, teenagers, and young adults, and researchers are looking at the different risk factors. Uncertainty surrounds the association between male delayed puberty and adult-onset type 2 diabetes. Therefore, Orit Pinhas-Hamiel and colleagues looked at the relationship between the chance of acquiring type 2 diabetes in early adulthood and delayed puberty throughout adolescence.

Nearly, 9,64,108 Israeli teenage boys (mean age 17.3 years) who were screened before military enlistment between 1992 and 2015 and monitored until December 31, 2019, were the subjects of this population-based study conducted nationally. Board-designated specialists used laboratory testing and physical examination to diagnose delayed puberty. The Israeli National Diabetes Registry was connected to the data. We used Cox proportional hazard models.

Almost, 0.45% of teenage boys were diagnosed with delayed puberty. Over a total follow-up of 15,242,068 years, T2D was identified in 6,259 people without delayed puberty and 111 people (2.58%) with delayed puberty. Teenagers without delayed puberty had an incidence rate of 41.3 T2D per 105 person-years, whereas those with delayed puberty had an incidence rate of 140.3.

After adjusting for birth year, socioeconomic position, cognitive function, education level, and country of birth, the hazard ratio (HR) for T2D among those with delayed puberty remained almost constant at 2.52. The HR was 1.37 with further modification to the baseline BMI. When limited to those diagnosed at or before the age of 35, the link was much stronger (1.65), and it remained after adjusting for baseline health condition.

Using adolescents without hypogonadism as the baseline group, the adjusted HR was 1.31 in a sensitivity analysis restricted to overweight and obese adolescents. Overall, independent of baseline BMI and other variables, teenage boys who have delayed puberty have a much higher risk of developing type 2 diabetes in their early adult years. These results point to delayed puberty as a possible indicator of metabolic risk that needs more research.

Source:

Pinhas-Hamiel, O., Simchoni, M., Derazne, E., Bardugo, A., Bendor, C. D., Vinograd, A., Lutski, M., Zucker, I., Afek, A., & Twig, G. (2025). Delayed puberty and early-onset type 2 diabetes: a nationwide cohort study of 1.6 million adolescents. Endocrine Abstracts. https://doi.org/10.1530/endoabs.110.oc2.6