Asymptomatic Parotid Enlargement: Probable Diabetic Origin

To the Editor.— The appearance of asymptomatic, bilateral parotid enlargement is widely recognized as a relatively frequent clinical occurrence. It has been noted in Mikulicz syndrome associated with sarcoidosis, in Reiter syndrome, and in several other disorders. However, it is not generally appreciated that this interesting physical finding can also be associated with diabetes mellitus. Report of a Case.— A 50-year-old woman's condition was first diagnosed as adult-onset diabetes mellitus at age 46. After evaluation at another hospital, she was placed on an American Diabetes Association diet and a daily dose of approximately 100 mg of tolbutamide. During the succeeding four years, the patient demonstrated poor diabetic control on numerous occasions and was eventually switched to tolazamide, 500 mg daily. On the day of admission to our hospital, the patient was complaining of dizziness, weakness, and faintness. She gave a history of diabetes, and a blood glucose level determined at