Review of Current Evidence on the Impact of Environmental Chemicals on Gestational Diabetes Mellitus

Pregnancy is a naturally insulin-resistant state and may be an important window of susceptibility in determining a woman’s lifetime risk of type 2 diabetes. Exposures to environmental chemicals that act as endocrine active compounds may mimic or disrupt hormones that regulate insulin action or maintain glucose homeostasis. In this commentary, we present the animal evidence that explains the biological plausibility for an association between environmental chemicals and gestational diabetes mellitus (GDM). We review the current epidemiological evidence examining the associations between GDM and bisphenol A, phthalates, air pollution, and toxic metals including arsenic and cadmium. We briefly discuss the strengths and limitations of the current evidence and offer recommendations for future studies that attempt to assess the impact environmental chemical exposure has on GDM. Lastly, we discuss the health implications for women that experience GDM during pregnancy and the importance for examining how environmental chemicals may play a role in the etiology of GDM.