Nutritional Screening and Assessment Tools for Patients With Diabetic Foot Ulcers: A Scoping Review

Diabetic foot ulcer (DFU) is one of the most severe and common complications of diabetes mellitus and is associated with peripheral neuropathy, peripheral vascular disease, and infection. DFU is characterized by delayed wound healing, high recurrence rates, and an increased risk of lower-extremity amputation, imposing a substantial burden on patients and healthcare systems. Nutritional status plays a crucial role in the wound healing process. Adequate intake of energy, protein, and micronutrients is essential for maintaining immune function, promoting collagen synthesis, and facilitating tissue repair. However, due to factors such as chronic inflammation, infection-related metabolic stress, and insufficient dietary intake, patients with DFU are at high risk of malnutrition or nutritional risk. Malnutrition has been shown to delay wound healing, prolong hospital stays, and increase healthcare costs, ultimately affecting clinical outcomes and quality of life. Early identification of nutritional risk and comprehensive nutritional assessment are therefore critical steps in developing individualized nutritional interventions for patients with DFU. In clinical practice, several nutritional screening and assessment tools have been developed and widely applied in different populations, including the Nutritional Risk Screening 2002 (NRS-2002), the Malnutrition Universal Screening Tool (MUST), the Mini Nutritional Assessment (MNA), and the Subjective Global Assessment (SGA). Although these tools are commonly used in general hospitalized or elderly populations, their applicability and evidence base in patients with diabetic foot ulcers remain unclear. Moreover, considerable heterogeneity exists across studies regarding the selection of tools and evaluation indicators, and a comprehensive synthesis of available evidence is still lacking. A scoping review is a useful approach to systematically map the existing literature within a specific research field, identify commonly used assessment methods, and highlight gaps in current knowledge. Therefore, this study aims to conduct a scoping review to systematically identify and summarize the nutritional screening and assessment tools used in patients with diabetic foot ulcers. By mapping the types of tools, their application contexts, and key evaluation indicators, this review seeks to clarify current research progress and identify existing limitations, thereby providing evidence to support the development of standardized nutritional assessment strategies and future research in the nutritional management of patients with DFU.