Type 2 diabetes (T2D) is a growing global public health challenge, with a rapidly increasing burden in sub-Saharan Africa. Medical nutrition therapy (MNT) is a cornerstone of T2D management; however, its design, delivery and implementation vary across health systems, cultural contexts and resource environments. Most synthesised evidence and guideline development originate from Western settings, while MNT approaches in African contexts remain heterogeneous and less systematically characterised. This scoping review aims to map and compare MNT strategies for T2D across Western and African contexts.

This scoping review will follow the Arksey and O’Malley framework and its enhancements, aligned with Joanna Briggs Institute guidance. Reporting will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Searches will be conducted in PubMed, Embase, CINAHL, Scopus, CABI Global Health and African Journals Online, supplemented by grey literature and citation searching. Eligible sources will include studies and programme reports describing MNT interventions for adults with T2D published between 2000 and 2025 in Western or African settings. Eligibility will be defined using the Population–Concept–Context framework. Two reviewers will independently screen studies and extract data using a standardised, framework-informed charting form based on the Consolidated Framework for Implementation Research (CFIR) and the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. Data will be synthesised using descriptive numerical summaries, framework-informed thematic synthesis (deductive coding with inductive refinement), and comparative evidence matrices.

This review will use publicly available data and does not require ethical approval. Findings will be disseminated through peer-reviewed publication, conference presentations and stakeholder-oriented knowledge translation activities to inform culturally relevant, context-appropriate and implementation-ready MNT strategies across diverse health system settings.