Delayed puberty in males a red flag for T2D risk

Male teens with delayed puberty have an increased likelihood of developing type 2 diabetes (T2D) in early adulthood, regardless of BMI, according to a retrospective study.

The study included 964,108 Israeli male adolescents who underwent medical examination before military recruitment (mean age at evaluation 17.3 years). Of these, 4,307 were found to have delayed puberty.

Diabetes was defined as glycated haemoglobin concentrations of >6.5 percent, serum glucose concentrations of >200 mg/dL in two tests at least 1 month apart, or repeated purchases of glucose-lowering medications. T2D was classified according to medication records.

Over a cumulative follow-up of 15,242,068 person-years, more individuals with vs without delayed puberty received a diagnosis of T2D (2.6 percent vs 0.7 percent; mean age at diagnosis 35.5 vs 36.8 years). The incidence rates of T2D were 140.3 cases per 10⁵ person-years among individuals with delayed puberty and 41.3 cases per 10⁵ person-years among those without delayed puberty (absolute difference, 99, 95 percent confidence interval [CI], 72.9–125.1; p<0.0001).

In multivariable analysis, delayed puberty was associated with a more than twofold increased risk of T2D (hazard ratio [HR], 2.47, 95 percent CI, 2.04–2.99; p<0.0001). The risk estimate was attenuated following additional adjustment for baseline BMI, although the association remained significant (HR, 1.37, 1.13–1.66; p=0.0015).

These findings suggest that delayed puberty is not just a benign developmental condition but might serve as an early marker for the later development of abnormal glucose metabolism.