A large-scale study involving nearly one million adolescent boys has revealed a significant link between delayed puberty and an elevated risk of developing type 2 diabetes in early adulthood, challenging the long-held belief that late puberty is medically inconsequential.
Presented at the inaugural Joint Congress of the European Society of Paediatric Endocrinology (ESPE) and the European Society of Endocrinology (ESE), the research highlights delayed puberty as a newly identified risk factor for type 2 diabetes in males.
Type 2 diabetes, accounting for over 90% of diabetes cases globally, stems from the body’s insufficient production or ineffective use of insulin. While traditionally considered a condition of middle-aged adults, its prevalence among children, teenagers, and young adults has been rising steadily. This trend has prompted scientists to investigate underlying causes beyond the well-known socio-economic, genetic, and environmental contributors.
The Israeli research team examined health data from 964,108 boys, aged 16 to 19, who were assessed for military service between 1992 and 2015. Among them, 4,307 were diagnosed with delayed puberty. The participants were followed until the end of 2019, with researchers meticulously tracking the onset of type 2 diabetes through national health registries.
The study’s findings were striking: boys who experienced delayed puberty faced a 2.5-fold increase in the risk of developing type 2 diabetes in early adulthood compared to their peers. This association persisted even after adjusting for factors such as birth year, socio-economic background, cognitive abilities, and educational attainment. Notably, even after accounting for body weight—a known risk factor—the likelihood of developing type 2 diabetes remained 37% higher in boys with delayed puberty.
Incidence rates further underscored this disparity. Among boys with delayed puberty, approximately 140 out of every 100,000 developed type 2 diabetes annually, compared to just 41 per 100,000 among those with typical pubertal timing.
“Our study is the first, to our knowledge, to establish a clear association between delayed puberty in boys and an increased risk of type 2 diabetes,” stated Professor Orit Pinhas-Hamiel of Sheba Medical Center, lead author of the study. She contrasted her team’s robust findings with previous, less conclusive research, noting that prior studies suffered from low response rates and relied on self-reported data using voice changes as an imprecise marker of puberty onset.
Professor Pinhas-Hamiel emphasized the unexpected nature of the results: “Delayed puberty has traditionally been viewed as a benign developmental variation. However, our data suggest that it may signal a critical window of vulnerability where hormonal and environmental factors significantly impact long-term metabolic health.”
She further explained that, much like early childhood shapes cognitive abilities and puberty influences bone density, the timing of puberty could play a pivotal role in determining future susceptibility to metabolic disorders.
The researchers advocate for heightened clinical awareness of delayed puberty as a potential early-life marker for type 2 diabetes risk in males. Early identification could pave the way for targeted interventions and proactive monitoring, potentially mitigating future health burdens.
This comprehensive study was a collaborative effort among Sheba Medical Center, Tel Aviv University, Maccabi Healthcare Services, the Israel Defense Forces Medical Corps, the Gertner Institute for Epidemiology and Health Policy Research, and the Israel Center for Disease Control. Data regarding delayed puberty diagnoses were sourced from the Israel Defense Forces Medical Corps, while diabetes incidence data were obtained from the Israeli National Diabetes Registry.
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