Common cookware chemicals linked to greater diabetes risk

Exposure to per- and polyfluoroalkyl substances (PFAS) is almost unavoidable in the United States. A new study finds that people with more of these PFAS chemicals in their blood are more likely to develop type 2 diabetes later on.

Researchers working with Mount Sinai’s BioMe biobank examined 180 adults who recently received a diabetes diagnosis and compared them with 180 matched participants who remained diabetes free. Each step up the exposure ladder carried a 31 percent jump in future diabetes risk, the team reports.

The project was led by Dr. Vishal Midya in the Icahn School of Medicine at Mount Sinai and Dr. Damaskini Valvi, who studies environmental drivers of metabolic diseases.

Where PFAS comes from

PFAS make fabrics stain resistant, food wrappers grease proof, and pans easy to clean. Nearly every American carries trace amounts of these “forever chemicals” in their blood.

The molecules linger for years because their carbon fluorine bonds do not break down under normal environmental conditions.

Production of older long chain PFAS is declining, yet replacement compounds are showing up in water, soil, and consumer goods.

“PFAS are synthetic chemicals that resist heat, oil, water, and stains, and are found in countless everyday consumer products,” said Midya.

How PFAS links to diabetes

The study used a nested case control study design, pulling incident cases and matched controls from a wider cohort of more than 70,000 New York City patients.

Blood samples that were collected about six years before diagnosis provided a snapshot of chemical load.

The scientists tested for seven common PFAS chemicals using an extremely precise technique. Next, they used a method called metabolomics to scan about 650 tiny molecules.

To understand the results, the experts used a type of analysis that combined all the PFAS data into one overall score, while also taking into account how the chemicals might be connected.

PFAS raises diabetes risk

Earlier reviews already hinted at a link between PFAS and poor glucose control, but most relied on European or Asian cohorts. A 2024 narrative review concluded that several PFAS classes “show potential associations” with diabetes and other metabolic problems.

The new work strengthens the evidence by adding a multiethnic U.S. sample and by measuring exposures well before disease onset. Its 31 percent odds ratio sits within the range reported by previous prospective studies that tracked single PFAS compounds.

Diabetes remains a major public health burden, affecting 38.1 million U.S. adults according to the latest National Diabetes Statistics Report. Any exposure that nudges risk upward is therefore relevant at the population level.

How PFAS may cause diabetes

Metabolomic signals pointed to disrupted amino acid pathways, especially glutamate, arginine, and proline metabolism. The same pathways surfaced when the team compared metabolite profiles between future diabetes cases and controls.

One molecule, sulfolithocholylglycine, linked both to higher PFAS burdens and to later diabetes, surviving stringent statistical correction. Bile acid conjugates like this one help regulate lipid and glucose homeostasis, supporting the idea of a mechanistic bridge.

PFAS can also bind peroxisome proliferator activated receptors, which fine tune fat storage and insulin sensitivity. Laboratory studies show that long chain PFAS alter cytochrome P450 enzymes in mouse liver, a key hub for drug and hormone metabolism.

The Mount Sinai data showed signs that PFAS may affect the way the body processes drugs, possibly by interfering with detox enzymes. This could also impact how the body handles blood sugar.

While the researchers did not confirm that the chemicals directly caused the metabolic changes, the findings provide important clues for future research.

Public health implications

According to Dr. Valvi, the results of the study can help experts design more effective interventions for the early prevention of type 2 diabetes. She emphasized the need to account for environmental chemicals alongside diet, activity, and genetics.

Several states have begun to set drinking water limits for PFAS, and the Environmental Protection Agency (EPA) proposed national standards earlier this year. Reducing industrial releases and monitoring municipal water could lower population exposures over time.

Health agencies may also consider biomonitoring high risk communities, particularly where water contamination or occupational use is documented. Such surveillance can flag hotspots and guide remediation before disease patterns emerge.

How to reduce personal exposure

Consumers can swap aging nonstick pans for stainless steel or cast iron and choose untreated textiles when possible. Checking local water reports and using certified filters that remove PFAS adds another layer of protection.

Microwave popcorn bags, fast food wrappers, and some waterproof cosmetics still contain fluorinated coatings. Limiting these products can chip away at cumulative intake, even though no single action eliminates risk entirely.

Pregnant women and children, whose metabolic systems are still developing, may benefit most from exposure cuts. Public advisories already warn against eating fish from heavily polluted waters, and similar guidance could apply to other food sources.

Future research and global policies

The Mount Sinai team plans larger exposome projects that integrate genes, lifestyle, and a wider range of chemicals. Replication in bigger samples will refine risk estimates and test whether certain PFAS mixtures hit harder than others.

International cooperation will be crucial because manufacturing shifts often move production to regions with looser regulations. Global treaties that phase out persistent chemicals have worked before, as seen with leaded gasoline and certain pesticides.

Scientists also call for better labeling so consumers can recognize fluorinated ingredients. Transparency can drive market demand for safer alternatives, nudging industries toward less persistent chemistry.

For now, the potential link between PFAS and diabetes reminds clinicians to keep an eye on environmental exposures when counseling patients at elevated metabolic risk.

Policymakers, scientists, and families all have a part to play in cutting the chemical clutter that may push blood sugar in the wrong direction.

The study is published in the journal eBioMedicine.

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