Study Finds PFAS 'Forever Chemicals' Linked to Type 2 Diabetes

New research has linked exposure to per- and polyfluoroalkyl substances, or PFAS, and Type 2 diabetes -- a finding that could have implications for military personnel and families who work around or live on installations contaminated by the chemicals.

A small study of patients at Mount Sinai Hospital in New York City found that individuals with higher levels of PFAS in their bloodstreams were more at risk for developing Type 2 diabetes. According to the research, published Monday in the eBioMedicine journal, increases in a range of PFAS exposure was associated with a 31% increased risk of developing the disease.

Often referred to as "forever chemicals" because they do not break down naturally in the environment, the man-made substances are used in commercial products such as non-stick cookware, food packaging, cosmetics and stain repellents.

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They also have widespread industrial use in lubricants; coatings; electronics; textiles, including flame retardant materials; firefighting foam; and more.

The U.S. armed forces have used aqueous film forming foam to fight fires for decades and, while the services have been phasing it out as directed by Congress, it remains in use on oceangoing vessels, where the risk of fire poses a significant threat to personnel and equipment.

Hundreds of installations also have been contaminated with the chemicals after years of long-term use in training and operations. A Defense Department review of 723 installations and former military sites found that 581 required some degree of remediation and cleanup.

Type 2 diabetes is a metabolic disorder that occurs when the body does not use insulin, which is made by the pancreas, correctly and sugar accumulates in the blood. Over time, if not treated, it can cause organ damage.

The small study involved 180 patients at Mount Sinai who were recently diagnosed with diabetes and compared them to 180 similar individuals without diabetes.

The research found that the association could result from irregularities in amino acid biosynthesis and drug metabolism, disrupting the body's ability to regulate blood sugar.

According to Vishal Midya, an assistant professor of environmental medicine at the Icahn School of Medicine at Mount Sinai, the study is one of the first to explore how the chemicals may disrupt the body's metabolism in ways that increase diabetes risk.

"We divided persons in four different groups [based on the level of PFAS measured in their blood. The results showed that] if exposure goes from one group to another, with the group four being maximum [exposure], the risk of Type 2 diabetes increases by 30%," Midya said during an interview with Military.com.

The research did not prove that PFAS contamination was the cause of the condition but did show the two have an association.

"There has been some literature, particularly animal studies, showing that PFAS actually can cause Type 2 diabetes in animal models, but we had never seen anything like that in a usual, normal population," Midya said.

The patients reviewed in the study were not in jobs normally associated with high PFAS exposure. They were regular New Yorkers who likely were exposed through their drinking water or food packaging, Midya said.

Still, they all had some level of PFAS in their bloodstreams.

"It surprised me, the fact that we found PFAS in all the people," Midya said.

Exposure to PFAS has been linked to health issues such as decreased response to vaccines, kidney cancer and low birth weight, but the research proving a direct link has remained elusive.

A study released in 2023 showed a direct connection between perfluorooctanesulfonic acid, or PFOS, a type of PFAS chemical, and testicular cancer in military firefighters.

It was the first to really measure PFAS levels in a U.S. military population and examine the chemicals' ties to cancer, according to the study co-author Mark Purdue, a researcher at the National Cancer Institute.

Little can be done to reduce the levels of PFAS in one's bloodstream, as they accumulate over time and are not processed by body systems. An Australian study published in 2022 found that firefighters with high levels of PFAS were able to reduce their numbers by 10% by donating blood every 12 weeks, or by 30% if they donated plasma every six weeks.

Given that blood tests for PFAS levels are not standard, the best one can do to reduce the likelihood of developing a PFAS-linked illness is to reduce one's exposure.

This means being mindful about drinking water, choosing any option that has been filtered to reduce PFAS chemicals, reducing the use of non-stick cookware, using PFAS-free cleaning products, and checking labels on personal care products and cosmetics.

"There are ways we can reduce exposure, but we really can't make it zero," Midya said.

The services have been switching over to fluorine-free firefighting foam on installations, but the Defense Department announced in May that it would need an extension to Oct. 1, 2026, to complete the process.

According to the DoD, it has six products available that meet military specifications for firefighting but must adapt more than 1,000 facilities and 6,000 pieces of mobile firefighting equipment to accommodate the new foams.

The authors of the diabetes research said a larger study would be helpful in supporting the findings of their research but added that the information can be useful to understand the impact of PFAS on public health.

"Findings can help us design more effective interventions for the early prevention of Type 2 diabetes in the future, taking into account individuals' exposures to environmental chemicals, along with other well-known genetic, clinical and lifestyle factors implicated in diabetes development," Dr. Damaskini Valvi, associate professor of public health and environmental medicine at the Icahn School of Medicine, said in a statement.

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