Background: Thermoregulation and thermal perception was considered as two independent processes involved with perceiving hot or cold stimuli which reflected small-fiber dysfunction in diabetic peripheral neuropathy (DPN). Objective: To explore and synthesize the existing evidence for thermoregulation and thermal perception for their testing and treatment methods in DPN from a pathophysiological perspective. Methods: A systematic review of PubMed, CINAHL and Google scholar was done using search terms “thermoregulation, thermal-hot/cold” to identify relevant citations for their inclusion after a three-level scrutiny for data extraction and descriptive synthesis into evaluation and management. Results: Of the total 30 included studies, 16 studies were on thermoregulation (body temperature=4, cold immersion recovery=1, warm immersion recovery=1, bronchial cold reactivity=1, cold pressor response=1, heat evoked potentials=2, thermal biofeedback=1, thermography/thermometry=3, device-specific use=2) and five studies were on thermal perception thresholds, one study on cooling detection thresholds and one study on heat pain thresholds. There were seven studies on interventions (cucumin=1, lycopene=1, quercetin=1, resveratrol=1, tapentadol=1, bone marrow transplantation=1, trolox=1). Conclusion: Thermoregulation and thermal sensory perception were altered in DPN, which was evidently demonstrated as changes in temperature, responses to immersion, heat evoked potentials, thermal perception thresholds, and thermal pain thresholds during assessment, and was positively reflecting therapeutic effects, efficacy and effectiveness of variety of interventions. 

Keywords: Thermoregulation; Thermal sensory examination; Thermoreception; Diabetic neuropathy.