PFAS Exposure Linked to Increased Type 2 Diabetes Risk

Investigating the Metabolic Impact of Forever Chemicals in U.S. Cohorts

A recent study from the Mount Sinai research team has revealed a concerning connection between PFAS exposure, also known as forever chemicals, and the increased likelihood of developing type 2 diabetes, particularly among women. These per‑ and polyfluoroalkyl substances (PFAS) are persistent environmental chemicals found in everyday products like nonstick cookware, water-repellent clothing, and food packaging.

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In a nested case-control study involving a diverse U.S. cohort, researchers applied an exposomics framework to assess blood PFAS concentrations and their association with changes in glycemic control and key metabolic pathways. The findings suggest that even moderate PFAS levels may alter amino acid biosynthesis and drug metabolism pathways, ultimately contributing to metabolic disruption.

How PFAS May Interfere with Glycemic Pathways

Understanding Metabolic Irregularities from Environmental Chemicals

The study indicated that PFAS and type 2 diabetes may be linked through biochemical pathways responsible for insulin regulation. Researchers found strong associations between PFAS exposure and alterations in pathways related to glycemic control, including those involved in amino acid metabolism, inflammation, and hormonal signaling.

Such disruptions can impact how the body processes glucose, potentially predisposing individuals to insulin resistance. For healthcare professionals, this signals an emerging concern within diabetes epidemiology, where external environmental factors may be just as influential as genetics or lifestyle.

“PFAS are synthetic chemicals that resist heat, oil, water, and stains, and are found in countless everyday consumer products. Because they don’t break down easily, PFAS accumulate in the environment and human bodies. Our study is one of the first to examine how these chemicals may disrupt the body’s metabolism in ways that increase diabetes risk-particularly in diverse US populations.”

– Vishal Midya, PhD, MStat, corresponding author and Assistant Professor, Environmental Medicine

The implications are particularly pressing for vulnerable populations and postmenopausal women, where the body’s resilience to toxic burden may already be compromised. Identifying exposure risk is crucial in early public health prevention efforts.

Environmental Health Meets Diabetes Risk Assessment

Clinical and Preventive Considerations for HCPs

This research highlights the need for integrating environmental medicine insights into chronic disease management. For clinicians and nurses, especially those in endocrinology or primary care, evaluating a patient’s exposure history could support early diabetes risk factor identification.

As chemical exposure assessments become more accessible, HCPs may play a pivotal role in bridging the gap between exposome analysis and actionable patient care. Further longitudinal research is needed, but the data support a growing movement: that safeguarding against environmental toxins may be essential in preventing chronic metabolic diseases.

For More Information: 

Midya, V., et al. (2025). Exposure to per- and poly-fluoroalkyl substances in association with later occurrence of type 2 diabetes and metabolic pathway dysregulation in a multiethnic US population. eBioMedicine. doi.org/10.1016/j.ebiom.2025.105838.