All Over the Internet, But Not in Your Journal

Photo courtesy of Dr. Saleh Aldasouqi

Photo courtesy of Dr. Saleh Aldasouqi

 At the annual meeting of the American Association of Clinical Endocrinologists, Dr. Saleh A. Aldasouqi presented the case of patient with type 1 diabetes who had decided to get a permanent tattoo on his wrist that identified him as a diabetic. The patient, who had lived with diabetes for 35 of his 36 years, had frequent bouts of hypoglycemia but didn’t want to wear medical identification jewelry. According to the patient, the tattoo had been carved at a professional tattoo parlor under sterile conditions.

Dr. Aldasouqi, who practices endocrinology in Cape Girardeau, Mo., had not encountered this practice before, so he and his colleagues first searched the medical literature and found just one similar case report. There were no published guidelines or consensus on the practice.  Then they tried Google.  Bingo—The topic of “medical tattoos” is all over the Internet, with diabetes patients blogging and chatting about tattoos in general, and “medical tattoos” in particular. Indeed, the concept has been around for a while. Here’s a 2005 entry from one of the more popular diabetes blogs:  http://www.diabetesmine.com/2005/08/tattoos_for_lif.html

Tattoos pose potential health risks for people with diabetes, since uncontrolled blood sugars increase the risk for infection.  While no official, evidence-based guidelines exist, an “unofficial” consensus from healthcare providers and patients on the Internet appears to be that the practice is okay as long as blood sugars are well-controlled.  Some also suggest avoiding tattoos on the feet, ankles, and lower limbs, since those areas are most often affected by poor circulation and neuropathy. 

Dr. Aldasouqi told me that he had submitted this case report to an endocrinology journal and a family practice journal and it was rejected by both.  So here’s an idea: Medical journals could launch a column called “All Over the Internet,” devoted to informing physicians about unorthodox and potentially harmful practices such as this one (“diabulemia” is another example), unproven uses of medications or supplements, unsubstantiated beliefs (i.e., the anti-vaccine stance), as well as positive and potentially helpful things that patients are sharing in blogs, chats, Twitter, and other social media but that are currently absent from the medical literature because they lack hard data. Front-line clinicians would be encouraged to contribute.

In a press briefing, Dr. Aldasouqi stressed that he is not advocating the use of medical tattoos, but merely calling attention to a phenomenon that patients are already doing. “Because this is happening, I thought we needed to talk about it,” he said. ###

–Miriam E. Tucker

(@MiriamETucker on Twitter)

4 Comments

Filed under Endocrinology, Diabetes, and Metabolism, Family Medicine, Infectious Diseases, Internal Medicine, Primary care

4 responses to “All Over the Internet, But Not in Your Journal

  1. Great idea. But what if the patient recovers from diabetes? Does he have to add “No More” in front?

  2. Miriam

    Hi Junyong,

    Thanks for your comment. Actually, there is currently no cure for diabetes. Some people with type 2 diabetes are able to stop using insulin and other medications by managing their disease with intensive lifestyle, but are still considered to have diabetes. With type 1 diabetes, it is not possible to “recover” at this point in time. Hopefully that will change in the future.

    Best,

    Miriam

  3. Thanks for the quick reply, Miriam. I didn’t know there is no cure for diabetes. Yeah, hopefully they can find a cure soon.

    Regards.

  4. Pingback: Do Medical Tattoos Need Guidelines? | EGMN: Notes from the Road

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s