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)