Glycemic control, wound morphological characteristics, and healing progression in diabetic foot ulcers: a scoping...

Delayed healing of diabetic foot ulcers (DFUs) remains a clinical challenge, and the relationships among glycemic control, wound healing progression, and morphological characteristics in DFUs remain systematically unmapped. This scoping review synthesized current evidence on these relationships. Following PRISMA-ScR guidelines, PubMed, Scopus, MEDLINE, and CINAHL were searched on April 2026. Eligible studies included adults with DFUs reporting glycemic parameters alongside wound morphology or healing progression. Twenty-two studies were included. HbA1c was the most frequently evaluated glycemic parameter, followed by fasting and postprandial glucose. Poorer glycemic control was associated with less favorable healing outcomes in several studies, including delayed healing, reduced healing velocity, treatment failure, and amputation; however, the direction and strength of these associations varied across studies. Direct evidence linking glycemic parameters to specific wound morphological characteristics was limited and heterogeneous, with reported associations involving wound size and depth, while other studies found no significant associations. Dynamic glycemic monitoring was rarely assessed, with glycemic variability evaluated in only one study. Current evidence does not establish a unidirectional causal relationship between glycemic control and wound morphological changes or specific glycemic targets for individual healing progression. Prospective longitudinal studies integrating repeated dynamic glycemic monitoring with standardized serial wound morphology assessment are needed.