Abstract: Diabetic peripheral neuropathy (DPN) is a common chronic complication of diabetes, belonging to Xiaoke Bi in traditional Chinese medicine (TCM). Guided by the theory of warm diseases, this paper reinterprets the etiology, pathogenesis and staged treatment system of DPN. It is considered that the onset of DPN is consistent with the pathogenic law of latent pathogens in warm diseases. Long-term hyperglycemia can be regarded as an endogenous latent pathogen, which consumes Yin-fluid, injures the collaterals after prolonged retention, thereby leading to clinical manifestations such as limb numbness, pain and hypoesthesia. Its progression is similar to that of warm diseases, progressing from superficial to deep and from external to internal. According to the syndrome differentiation of Wei, Qi, Ying and blood, DPN can be divided into early, middle and advanced stages, with the pathogenesis proceeding sequentially as follows: disharmony of Ying and Wei, damp-heat stagnation at the exterior; damage to Ying-Yin, and stasis and heat obstruction; deficiency of Qi, blood, Yin, and Yang, with phlegm, stasis, and turbid toxins obstructing the collaterals. In the early stage, the focus is on clearing, expelling, and harmonizing, nourishing Qi and Yin, and expelling pathogens to block the progression of the disease and expel them from the body. In the middle stage, the focus is on clearing heat, nourishing Yin, unblocking the collaterals, and relieving pain, while also strengthening the spleen and replenishing Qi to prevent the transmission of pathogens to the blood. In the late stage, the approach is to replenish Qi and blood, tonify both Yin and Yang, and unblock the collaterals and remove stasis, combining supporting the body's resistance with eliminating pathogenic factors, and incorporates vine-based and insect-based medicines to enhance the collateral-unblocking effect. The application of the thinking pattern of warm diseases in the diagnosis and treatment of Xiaoke Bi can provide new theoretical support and therapeutic approaches for DPN, and broaden the application scope of warm disease theory in internal miscellaneous diseases.