A growing body of evidence suggests that everyday exposure to forever chemicals may be quietly increasing the risk of gestational diabetes, according to a major new scientific review.
Researchers have found that pregnant people with higher exposure to per- and polyfluoroalkyl substances, known as PFAS, are more likely to develop gestational diabetes and show changes in how their bodies regulate insulin.
The findings come from the most comprehensive systematic review and meta-analysis to date examining PFAS exposure and diabetes-related outcomes across the lifespan.
The research brings new clarity to a field that has produced mixed results and highlights pregnancy as a particularly vulnerable period.
Sandra India-aldana, co-first author of the study from the Icahn School of Medicine at Mount Sinai, explained: “This is the most comprehensive synthesis of evidence to date examining how PFAS exposure relates not only to diabetes risk, but also to the underlying clinical markers that precede disease.
“Our findings suggest that pregnancy may be a particularly sensitive window during which PFAS exposure may increase risk for gestational diabetes.”
The dangers of PFAS
PFAS are a large group of synthetic chemicals used for decades in consumer and industrial products.
They are commonly found in food packaging, nonstick cookware, water- and stain-resistant fabrics, and firefighting foams. Their chemical structure makes them extremely resistant to breaking down, earning them the nickname ‘forever chemicals.’
Because PFAS persist in the environment and accumulate in the human body over time, nearly everyone has some level of exposure.
Scientists have increasingly linked these substances to health concerns ranging from immune dysfunction to hormonal disruption, prompting closer investigation into their role in metabolic disease.
Stronger evidence for gestational diabetes risk
The new review analysed data from numerous population studies to evaluate whether PFAS exposure is associated with diabetes and related metabolic markers.
The most consistent and compelling evidence emerged around gestational diabetes, a condition marked by high blood sugar levels during pregnancy.
Across multiple studies, higher PFAS exposure was associated with a greater likelihood of developing gestational diabetes.
In addition, individuals with higher exposure showed changes in insulin resistance and insulin secretion, two key biological processes involved in blood sugar control. These findings suggest that PFAS may interfere with normal metabolic adaptations that occur during pregnancy.
While gestational diabetes was strongly linked to PFAS exposure, the evidence for type 1 and type 2 diabetes in the general population remained inconclusive. Researchers say this reflects gaps in existing studies rather than proof that no relationship exists.
Why gestational diabetes deserves attention
Gestational diabetes affects millions of pregnancies worldwide and can lead to serious complications if not properly managed.
Short-term risks include high birth weight, preeclampsia, and the need for caesarean delivery. Long term, both mother and child face an increased risk of developing type 2 diabetes later in life.
The new findings are particularly concerning because PFAS exposure is so widespread and often unavoidable. Even modest increases in gestational diabetes risk could have significant public health implications, given how common both PFAS exposure and pregnancy are.
Implications for healthcare and prevention
The review suggests that environmental exposures may deserve more attention in reproductive and prenatal care.
Understanding a patient’s potential contact with PFAS through drinking water, diet, or consumer products could become part of a more comprehensive approach to gestational diabetes risk assessment.
For people planning a pregnancy or who are already pregnant, reducing PFAS exposure where possible may be a sensible precaution.
This could include being mindful of food packaging, avoiding heavily treated fabrics, and staying informed about local water quality. While individual actions cannot eliminate exposure entirely, awareness is an important first step.
Next steps in PFAS research
Researchers emphasise that more large-scale, long-term studies are needed to understand how PFAS influence diabetes risk over time.
Future work aims to explore how environmental exposures interact with genetics, as well as how PFAS may contribute to related conditions such as obesity and chronic liver disease.
For now, the evidence strengthens concerns that environmental chemicals play a role in gestational diabetes and underscores the need to consider chemical exposures as part of maternal health.
As scientists continue to unravel the links between PFAS and metabolic disease, the findings add urgency to discussions about environmental regulation, public health protection, and safer alternatives to persistent chemicals.
