Use of Continuous Glucose Monitoring for Detecting and Understanding Early Dysglycemia in Cystic Fibrosis

Cystic fibrosis-related diabetes (CFRD) is a common extrapulmonary manifestation of cystic fibrosis (CF) affecting up to 50% of adults. Cystic fibrosis-related diabetes is associated with poorer lung function, lower nutrition, and increased mortality. Abnormal blood glucoses, especially post-prandial hyperglycemia, can precede a diagnosis of CFRD by many years, and even the prediabetic state has been associated with poorer health outcomes in people with CF (pwCF). With the advent of cystic fibrosis transconductance regulator (CFTR) modulator therapies, the clinical landscape of CF is changing. With increasing longevity, the prevalence of CFRD is anticipated to rise. Continuous glucose monitoring (CGM) technology has been applied in research and clinical settings for insights into CFRD pathophysiology, and its use for early dysglycemia detection in the CF population is increasing. However, guidance around management of these early glucose abnormalities is limited. This article aims to review and summarize the current literature on use of CGM in the prediabetic state in pwCF and to highlight ongoing areas of research need.