The evolving understanding of cystic fibrosis-related diabetes in the highly effective modulator therapy era: a scoping review – Published online 26/01/2026

Heather Sharpe, Grace Y. Lam

Cystic fibrosis-related diabetes (CFRD), a unique form of diabetes with characteristics of both type 1 and type 2 diabetes, is one of the most common complications of cystic fibrosis, with up to 50% of people with cystic fibrosis diagnosed with CFRD over their lifetime. CFRD has been associated with a worse clinical trajectory of progressive deteriorating lung function, more frequent pulmonary exacerbations, poorer nutrition status and higher mortality risk. Recent innovations in modulator therapy are transforming outcomes for individuals living with cystic fibrosis, including improvements in life expectancy, and there is a growing emphasis on non-pulmonary complications in efforts to optimise the overall health of people with cystic fibrosis. In this issue, Sharpe and Lam (https://doi.org/10.1007/s00125-025-06653-7) summarise the recent literature related to CFRD pathophysiology and treatment and discuss how modulator therapy as well as emerging diabetes technologies are impacting the management of CFRD. The authors conclude that there is a growing need to study these new therapies specifically in individuals with CFRD, and to assess how the changing landscape of cystic fibrosis treatment will impact CFRD management in the future. The figure from this review is available as a downloadable slide.

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