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For adults with cystic fibrosis, endocrine manifestations such as cystic fibrosis\u2010related diabetes, metabolic bone disease, and reproductive health are becoming increasingly important, and emerging evidence on the endocrine effects of CFTR modulator therapies is promising and is shifting paradigms in our understanding and management of these conditions.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>The management of cystic fibrosis\u2010related diabetes will likely need to pivot for high responders to modulator therapy with dietary adaptions and potential use of medications traditionally reserved for adults with type 2 diabetes, but evidence to support changing clinical care needs is currently lacking. Increased attention to diabetes\u2010related complications screening will also be required.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Increased exercise capacity due to improved lung function, nutrition and potentially direct modulator effect may have a positive impact on cystic fibrosis\u2010related bone disease, but supporting evidence to date is limited.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Fertility can improve in women with cystic fibrosis taking modulator therapy. This has important implications for pregnancy and lactation, but evidence is lacking to guide pre\u2010conception and antenatal management.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Provision of multidisciplinary clinical care remains ever\u2010important to ensure the emergence of endocrine and metabolic complications are optimised in adults with cystic fibrosis.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p>","DOI":"10.5694\/mja2.52119","type":"journal-article","created":{"date-parts":[[2023,10,15]],"date-time":"2023-10-15T14:01:35Z","timestamp":1697378495000},"page":"496-502","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effects of modulator therapies on endocrine complications in adults with cystic fibrosis: a narrative 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