Exposure to per- and polyfluoroalkyl substances (PFAS), chemicals often called "forever chemicals" due to their persistence in the environment, has been linked to an increased risk of gestational diabetes mellitus as well as changes in markers related to insulin resistance and secretion. These findings come from a systematic review and meta-analysis led by researchers at the Icahn School of Medicine at Mount Sinai and published in The Lancet eClinicalMedicine.
PFAS are used widely in products such as food packaging, nonstick cookware, water-resistant textiles, and firefighting foams. Because they do not break down easily, PFAS can accumulate in both the environment and the human body over time.
The review is described by its authors as the most comprehensive evaluation so far of how PFAS exposure relates to diabetes risk and clinical markers of glycemic control throughout life. Previous studies on this topic have produced mixed results, with few focusing on continuous clinical markers like insulin resistance or secretion.
Gestational diabetes can lead to complications during pregnancy and has long-term health implications for mothers and their children, including an increased chance of developing type 2 diabetes later.
“These results are alarming as almost everyone is exposed to PFAS, and gestational diabetes can have severe long-term complications for mothers and their children. We need larger longitudinal studies with well-characterized type 1 and type 2 diabetes cases to fully characterize PFAS impacts on diabetes risk and its long-term complications for affected individuals and their families,” said Damaskini Valvi, MD, PhD, MPH, Professor and Director of Graduate Education in Public Health at Icahn School of Medicine at Mount Sinai, who was senior author of the paper. “These results underscore the importance of considering PFAS and other hazardous environmental chemical exposures as part of comprehensive clinical risk assessment and preventive care, particularly during pregnancy.”
“Gestational diabetes has lasting implications for both mother and child,” said Xin Yu, PhD, MS, postdoctoral fellow in Environmental Medicine and Public Health at Icahn School of Medicine at Mount Sinai, who was co-first author. “This research supports the growing recognition that environmental exposures like PFAS should be part of conversations around preventive care and risk reduction during pregnancy.”
The study’s findings suggest that people who are pregnant or planning a pregnancy may face higher risks if exposed to PFAS through certain consumer products or contaminated food or beverages. The authors recommend reducing exposure where possible as a precautionary measure.
Researchers note that further high-quality studies are needed to clarify how PFAS might affect other forms of diabetes but say current evidence highlights the need for greater awareness about these chemicals during pregnancy. The team plans additional population-based research examining how broader environmental exposures interact with genetics in influencing diseases such as diabetes, obesity, and chronic liver disease.
This work received support from the National Institutes of Health under Grant R01ES033688.
