Cystic Fibrosis-Related Diabetes: Pathophysiology, Spectrum of Glycemic Abnormalities, and Evolving Approaches to Screening

Cystic fibrosis-related diabetes (CFRD) is a well-recognized and increasingly prevalent complication of cystic fibrosis (CF), most frequently developing in adolescence and adulthood. CFRD is associated with pulmonary function decline, poor nutritional status, and increased infection risk, and contributes to increased morbidity and mortality. The objective of this review is (1) to provide a summary of CFRD pathophysiology, highlighting the spectrum of glycemic abnormalities preceding development of CFRD, and (2) to review CFRD screening guidelines, including a narrative review of the current evidence for different CFRD screening approaches. We also review challenges to screening and important considerations in the setting of novel CF therapeutics and increasing longevity in this population.