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help inform treatment decisions and optimize patient outcomes. Diabetogenic effects of per- and polyfluoroalkyl substances (PFAS) have been suggested. However, evidence based on prospective cohort studies is limited. We examined the association between serum PFAS concentrations and incident diabetes in the Study of Women's Health Across the Nation Multi-Pollutant Study (SWAN-MPS). We included 1237 diabetes-free women aged 45-56years at baseline (1999-200 who were followed up to 2017. At each follow-up visit, women with incident diabetes

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