Diabetes type 2 tattoo

Tattoos are a popular form of body art that involves using needles to inject ink under the skin.

Having diabetes doesn’t mean you can’t have a tattoo, but before deciding to have one done you must be well and ensure that your diabetes is well controlled.

High blood sugar levels, for example, can complicate the healing process and increase the risk of infection. Blood pressure should also be kept within the recommended target range.

Bear in mind that your blood sugar level may rise whilst your tattoo is being applied.

As this process can be quite long, painful and somewhat stressful, particularly if you’ve chosen a large and complex design – another reason why they must be stable before the procedure starts.

However, they should return to normal the next day.

Other things to consider before getting a tattoo include:

Contents

Placement

Permanent body art can be applied to nearly every part of the body.

For people with diabetes, there are certain areas that should be avoided including those with poor circulation, such as:

  • Buttocks
  • Shins
  • Ankles
  • Feet
  • Common insulin injection sites such as arms, abdomen and thighs.

Tattoos in these places usually take longer to heal, which can lead to complications (e.g. infection).

Design

Tattoo designs are usually based on things that are meaningful or significant to the individual.

For a person with diabetes, this could be something that includes clear medical symbols and/or text that indicates their condition.

These so-called ‘diabetes tattoos’ have become quite common in recent years, with many diabetics using them to replace medical jewellery as a permanent form of diabetes identification

Design inspiration

Members of the Diabetes.co.uk Facebook page shared their tattoos with us. Have a look, they’re certainly a source of inspiration.

Post by Diabetes.co.uk.

Tattooist quality

Before going ahead with your tattoo, make sure that the tattoo studio you have in mind is licensed or accredited.

To reduce the risk of any problems arising from the tattoo application, you should also try and research the company’s reputation and hygiene and safety practices.

This research is particularly important if you are planning on getting a tattoo at a festival

Safety and awareness

Make sure that you let the tattooist know about your diabetic condition so that they can tailor the procedure and aftercare information to best suit your needs/condition.

Risks

The main risks of having a tattoo include:

  • Allergic reactions – you may suffer a reaction to the substances used in the inks and equipment.
  • Skin infection – the tattooed area of skin may become infected if the studio and/or tattoo equipment is not clean or proper aftercare is not applied.
  • Scarring – tattoo application can cause the formation of an oversized scar known as a keloid, which can be irritable and slightly painful.
  • Blood-borne diseases – if the tattoo needle or ink has not been sterilised, it could put you at risk of blood-borne illnesses such as HIV and Hepatitis B or C.
  • Wound healing – abnormally high levels of blood glucose could delay healing of the tattooed skin and increase the risk of infection.
  • Change of heart – having a tattoo removed is much harder and more expensive than having one done, so make sure you are 100% sure about your tattoo plan before going ahead with it.

If you feel unwell or see any sign of infection after your tattoo has been completed, you should seek immediate help from your GP or diabetes healthcare team

Nanotechnology tattoos and diabetes – what the future holds

In the near future, tattoos could provide an easier, quicker and more accurate way for people with diabetes to track and control their blood glucose levels.

Over the past few years, scientists at the Massachusetts Institute of Technology (MIT) and Draper Laboratory, American, have been developing a skin-borne continuous blood glucose monitor that consists of a ‘tattoo’ of tiny particles of nanotechnology ink that are sensitive to glucose concentrations.

How do nanotechnology tattoos work?

The ink is injected below the skin and is designed to fluoresce when it encounters glucose.

A wristwatch-like device worn over the nano-tattoo would be used to detect and measure the amount of fluorescence, and thus monitor glucose concentrations in the blood.

Constant blood glucose readings would then be sent to the patient, which would hopefully lead to better glycemic control.

If successful in clinical trials, the researchers say such technology could revolutionise glucose monitoring and lead to larger innovations for the diabetes healthcare industry.

Diabetes & Tattoos: The ONLY 2 Things You Need to Know

“Diabetics can’t or shouldn’t get tattoos” would likely be uttered from the same person who would say people with diabetes can’t or shouldn’t eat carbs. Not only is it an ignorant, projected opinion filled with misinformation, but it is simply incorrect.

For some odd reason, people with diabetes get treated like we have leprosy and get told we cant do anything and that gets pretty frustrating at times — especially because it is the furthest thing from the truth!

Getting a tattoo is a personal choice and if you decide to get a tattoo, diabetes or no diabetes, you need to make sure of the following:

  • The tattoo shop is accredited, licensed, up-to-date legally, and clean
  • The tattoo artist has good reviews not only of the quality of his or her work (no one wants a bad tat, right?) but the healing process
  • You are willing to 100% adhere to the healing procedure as directed by your artist

There are many in-home, or street tattoo artists that might be cheaper but never risk your health to save a buck. After all, cheaper doesn’t mean better and, in most cases, means worse in terms of quality.

By simply following the advice above, getting a tattoo shouldn’t be a problem for the average non diabetic but as a diabetic, there are 2 huge areas of caution you need to be aware of: your A1C and your healing time.

A1C Requirements for Diabetics Getting Tattoos

As much as we sometimes HATE checking and living by our A1C, it is a relatively good tool that let’s us know how are blood sugar has been. If you really want to get some fresh ink, whether it’s a small tattoo or a sick sleeve, you need to be sure your A1C is in check.

Having a high A1C going into a tattoo session can provide a plethora of problems. Elevated blood sugar levels mean decreased immune response. When you decide to get under the needle, your skin barrier is being perceived up to 3000 times a minute. Having a higher A1C puts you at higher risk for an infection and infected tattoos are not only dangerous to your health but just aren’t sexy.

Some doctors recommend having an A1C <8% while some Certified Diabetes Educators recommend an A1C <7% prior to getting a tattoo.

A higher A1C might suggest blood sugar management could be a struggle for you possibly because a change in your life, activity level, or even stress level so be sure to reach out to your endocrinologist or CDE to see if they can help you!

The last thing you want is to be sitting for a tattoo for 4-8 hours while riding the blood sugar roller coaster. Food generally isn’t allowed in a tattoo shop for hygiene purposes and I can assure you going outside constantly to combat lows is no fun just as hearing your pump scream at you for high blood sugar isn’t fun. Getting tattooed will induce a stress response that will most likely increase your blood sugar temporarily. Talk to your doctor in seeing how you can best manage your sugars during your tattoo session.

If you plan on investing in a tattoo, invest the months prior into your diabetes management as well.

Tattoo Healing for Diabetics

Getting a quality artist to do quality work is only half of the battle. If your tattoo doesn’t heal properly, it can looked faded, discolored and just not as sharp as you hoped for. I don’t know about you, but when I invested over $1000 into my tattoo sleeve and 14 hours of pain, I made sure to follow every single healing protocol verbatim.

Having diabetes means you will most likely take longer to recover and your tattoo artist will know this. Don’t listen to all your other friends with $19 “I Heart Mom” tattoos who offer their non-medical, non-professional advice on how to heal your new tattoo. Listen to your tattoo artist.

While most people take around 2 weeks to optimally heal from a tattoo, diabetics can sometimes be double that. Don’t risk your health, money, or tattoo quality by shorting or getting lazy with the healing process. Whether your artist recommends Tegaderm, A&D ointment or anything of the sort, follow their instructions for an extended period of time to be sure your tattoo heals healthily and beautifully.

Some people will say to not get your feet, hands, or other areas tattooed because of slower healing times especially associated with poor blood circulation but there are quite a few tatted type 1 diabetics who have lower A1Cs with ankle, foot, and practically full body tattoos! If you are currently fighting complications or have poor circulation, it is best to consult your doctor before getting a tattoo so they can help you stay as safe and healthy as possible.

Because we as diabetics heal slower and are more prone to infection, it is vital to control our blood sugars months prior to getting a tattoo as well as adhering to the healing process and procedure as best as possible. As diabetics, we are not banned from getting tattoos nor is it dangerous for us given we are smart with our condition and decision to follow safety protocols.

Whether you want a meaningful tattoo, a medical tattoo or just an epic design because you appreciate the art form, T1Ds and T2Ds with tattoos are not a problem!

Getting Inked: Tattoos and Diabetes

Though you need to take extra precautions, tattoos are generally safe for people with well-controlled diabetes, and they can even be designed as medical alert identification. Should you get one? Written by Karina M Erdelyi 1

Permanent body art has become more and more popular with each generation since World War II, with 38 percent of Millennials (ages 18 to 34 in 2015) and 32 percent of Gen X-ers (ages 35-50) sporting tattoos, according to Pew Research Center. That’s more than twice the number of tattooed Baby Boomers (ages 51 to 69) and five or six times the number of those 67 and over.

Ink Identity

Tattoos may be a way of identifying with a group, or even a generation, but they are also a way of expressing uniqueness. Most college students surveyed about the process and significance of their tattoos said they considered the pros and cons for months before committing to permanent ink. Most had their tattoos applied at professional studios and were happy with the results. The majority chose an area of their body for tattooing that could be easily covered.

Medical Tattoos

There are a several reasons why someone might get a tattoo for medical purposes or as result of a medical procedure. A tattoo can cover a disfiguring scar, add a nipple to a reconstructed breast or redirect light away from a damaged eye. Researchers are currently working on “smart” tattoos that use nanoparticle ink or tiny LEDs implanted in the skin to keep track of glucose levels.

Meanwhile, inked wrists and forearms have begun to replace medical alert bracelets for some people who require special attention in an emergency, such as anyone who uses insulin or is allergic to specific types of medication. If you dislike, or often forget to wear, medical alert jewelry, you may be more likely to consider a diabetes alert tattoo.

Photo courtesy of Benno Schmidt. Tattoo by Darren Brass of Miami Ink.

Keep in mind that medical tattoos are not the most common way to alert emergency healthcare workers to your condition, so visibility and a clear, simple design are essential to help ensure the tattoo is seen and recognized. Along with the name of the condition, the design of inked alerts often includes a common medical emblem, such as the Rod of Asclepius or caduceus (serpent(s) wrapped around a stick) or the blue circle that is the symbol of diabetes. The wrist or forearm is considered a good location, because that is where you would otherwise wear a medical alert bracelet and where emergency responders will go to check your pulse.

Safety First

All the same tattoo safety precautions for the general population apply to people with diabetes. Additionally, you may be at higher risk of infection, and healing may take longer than in those who do not have diabetes. That’s why it is important to be sure your blood sugar is well under control before you get a tattoo.

Start by choosing a licensed, reputable tattoo studio to do the work. Be sure your tattoo artist uses single-use disposable needles, fresh ink in disposable containers, and equipment that is disinfected with an autoclave, a machine that sterilizes with steam. Consult with your healthcare provider before getting inked, and try to get a referral from someone you trust to a tattoo artist who has worked with customers who have diabetes.

Any professional tattoo studio will have you sign a release form before the artist begins to work. The form should ask if you have diabetes. If you check “yes,” they will ask if your blood sugar is under control, and it is up to you to answer honestly.

“You have to be at least 18 to get a tattoo,” points out Stephan Lanphear, owner of Lefty’s Tattoo Studio in Pittsfield, MA, who also has type 1 diabetes. “So I would hope a client with diabetes knows their own body well enough at that point and is responsible enough to be sure their AC1 levels are within range before getting a tattoo.”

Lanphear also talks to clients with diabetes about their general healing process, whether it normally takes 10 days or 2 months for a cut to heal. This way, he can personalize a discussion about the tattoo healing process before he begins. Because he has diabetes himself, Lamphear is particularly sensitive to any potential problems.

“Sometimes people lie about their glucose control or healing because they really want a tattoo and are willing to take risks,” Lanphear says. “All I can do is go by what they tell me, but if I suspect there might be serious healing issues or if I think a client would be harmed in any way, I would opt out of giving them a tattoo until they spoke with their doctor and came back and told me they got a go-ahead.”

Tattoo Style

Since very little research has been done to date on medical tattooing, no one knows how many people actually have medical tattoos. Nor are the pros and cons of medical or decorative tattooing for people with diabetes fully understood. While this might still be the early stage of an emerging trend, more people appear to be considering medical alert tattoos than ever before. Lamphear has seen this in his own studio, and says more people with diabetes are coming in for tattoos, though not necessarily for medical alerts.

“The people who are getting tattoos in 2015 aren’t the same types of people who were getting them 25 years ago,” he point out. “Nowadays, all kinds of people want tattoos for all kinds of reasons, and that includes people with diabetes because it is no longer considered taboo or unsafe.”

Whether you are “just looking,” or seriously considering a tattoo for decorative or medical purposes, there are several sites that contain information and photos specifically for people with diabetes. These include diabetesadvocacy, Healthline, and DiabeticInk.

Updated on: May 13, 2019 View Sources

Lamphear, Stephan. Lefty’s tattoo studio. Interview with author, November 6, 2015.

Collier, R. Medical Ink. CMAJ News. June 12, 2012;184(9):1019

Continue Reading How to Keep Your Skin Healthy When You Have Diabetes

Getting Inked When You Have Diabetes… (AKA: All About D-Tattoos)

Fun fact you may not know: Both tattoos and diabetes first came around in the Middle Bronze Age, way back in 2000 B.C. and 1550 B.C. respectively. Yep, history says so. The earliest examples of tattoos date back to Egypt when they were found on female mummies, according to the Smithsonian. They’ve meant different things in different cultures for centuries, and in our own Diabetes Community they’ve been growing in popularity… probably not since the earliest days of diabetes way back in 1550 B.C. based on deciphered Egyptian manuscripts.

But hey, times have changed and in this 21st century, getting inked is a point of pride for many people with diabetes (PWDs).

Opting to get tattooed and selecting a design are deeply personal choices and can vary in meaning. Our hearts were warmed a few years ago when a Quebec couple got insulin pumps tattooed on their stomachs in support of their young son with type 1 diabetes who was feeling alone in his use of an insulin pump. That story along with many others over the years have spread the love. Of course, there’s also all the hype around futuristic “glucose-sensing tattoos” that are being designed to sense blood sugar fluctuations and change colors accordingly.

Sure, many have wondered if it’s safe for PWDs to get tattoos — the short answer is YES, but like anything, diabetes must be taken into account if you choose to get inked whether it’s a medical alert tattoo or a fun butterfly you got to look pretty. There’s some important stuff to keep in mind and we’ve gone through that below.

But before we get to that sage ink advice, we were lucky to connect with one of our own D-peeps who’s pretty much an expert on this front: Utah D-peep Chris Clement who happens to live with both type 1 diabetes and Tourette Syndrome. He created the popular site Diabetic Ink, that pops right up in any Google search on this topic. When it comes to talking about tattoos and diabetes, “Clem” is the guy to connect with. Here’s a recent chat we had with him about his own D-story and how tattoos first came into the picture.

An Interview with Chris Clement on Diabetes Tattoos

DM) Can you start by telling us your diabetes story?

CC) It started at the very end of my senior year of high school. Symptoms became obvious just two months after I turned 18 and progressed quickly. My hand was a blur in front of my face — that awful feeling I now know is associated with DKA was just a normal Thursday to me. During that time I had friends and family asking me if I was on drugs and expressing concern, encouraging me to go to a doctor. Thinking I was just malnourished, I purchased a gallon jug of juice one afternoon before work, which was gone in hours due to my unquenchable thirst.

That night, my mother told me she had made an appointment to see our doctor the next morning because she was concerned that it might be diabetes. Turned out that she was right. I learned that my blood sugar was was around 750 mg/dL and I weighed 114 lbs, down from 145. My doctor told us to head over to the Emergency Room, which was right across the street. From the doctor’s office to our car my mother had to support me over her shoulder because I was so weak. A minute later she was dragging me into the ER as I was starting to lose consciousness. Hours later, I awoke to my mother and better vision than I’d seen in ages. I started out with a very positive attitude as I learned some of the basics and overcame my fear of needles during my stay at the hospital. I went to prom the following week and graduated high school a week later.

Wow, what a start! Was everything positive from that point on?

No, the next part of my story isn’t so positive. It wasn’t long before the structure and my restrictive diabetes management plan got the best of me, even after starting on an insulin pump just over a year into my diagnosis. Between my own misconceptions about diabetes and the straight-up denial I went through, my motivation and management plan was out the window. I even went an entire year without testing my blood sugar at one point — partially because I didn’t care, but also because I refused to spend money on anything diabetes-related other than insulin and pump supplies, which I stretched out longer than is safe. I would do a rough carb-count and bolus for meals, or take a few units of insulin when I felt very high. It wasn’t until I decided to get a diabetes tattoo that I finally rebooted my brain and reclaimed my health.

You also have a sister with type 1 diabetes?

I have always felt close with all of my 4 sisters, and that hasn’t changed. But when Nikki, my youngest sister, was diagnosed in her 20s, it was amazing how the diabetes connection added a deep new layer. Her story is much different from mine. It has a very rough and frustrating start. The day of her diagnosis she and I met up and I gave her a deep dive into the world of the newly diagnosed, teaching her how to use needles and giving her tips on testing blood sugar, counting carbs, and finding her insulin:carb ratio. Since then, she and I frequently share learnings and influence each other, and have been there to help each other avoid supply-related disasters. But the emotional support has been the greatest and most important thing either of us have given each other. We have a special bond that has made diabetes just a little bit more okay, at least for me.

What exactly led to you getting your first diabetes tattoo?

I wanted a tattoo since I was a kid. It was a controversial desire in my household, and in my religious culture — I was raised in the Church of Jesus Christ of Latter Day Saints (though I’m no longer practicing). On top of that, I had learned in conjunction with my diabetes diagnosis that I would have a difficult time healing. I kept hearing ‘Diabetics can’t get tattoos, it’s too risky.’ I settled into that narrative, but never lost my desire for tattoos.

During my years of poor diabetes management and denial I would actually forget that I had diabetes because I gave so little thought to it. When I would remember, anxiety and guilt would flicker deep inside. I knew I needed to change, to get back on track, to find my motivation.

One day, shortly after I had discovered the Diabetes Online Community, I came across an image of a diabetes-themed tattoo. I was initially confused, but quickly my brain started buzzing about the idea of getting one. If I was going to accept the risk of getting a tattoo, I felt like it should be something that would be a reminder that diabetes is a part of me; that it isn’t something to be ashamed of, or to ignore.

As I researched further I came across an article by Wil Dubois here at DiabetesMine. I learned that many of the diabetes reasons to not get tattoos were not necessarily true. People with diabetes get tattoos. They heal up just fine. Some are meant to be a medical alert. Others are just for the art of it. But, the bottom line was, it was my choice, and could be done. So I did it. No regrets!

How many tattoos do you have now?

I added a lot of new ink last summer. As of now, I have six pieces — seven if I count the addition to my second tattoo. They are not all diabetes-related. My first one was very directly a diabetes tattoo. My second is a family piece. Of the four I added last year, one of them is about diabetes and the others all represent a separate part of my life. I do have plans for more, including one to represent Tourette Syndrome, another condition I live with.

Why did you start Diabetic Ink?

In all the research I did before my first tattoo I found myself in a struggle to find one great place where I could find a database of great diabetes tattoo ideas. I decided to create my Tumblr and Facebook page so I could find and highlight as many great diabetes tattoos as I could so others could easily find inspiration for their own.

I also wanted to create a place where people with diabetes could learn more and come to understand that we can get tattoos, that diabetes itself should not hold anybody back. Destigmatizing diabetes is something I am very passionate about, and Diabetic Ink has been a significant outlet for me do do that. Thirdly, I wanted to create a community where people with diabetes and tattoos could tell their stories and be recognized for owning it.

I eventually expanded to Instagram and Twitter to take advantage of the potential audience and community attention. It’s been so much fun engaging with the Diabetes Community, as well as discovering a piece of myself, through Diabetic Ink.

Is there stigma on medical-related tattoos?

Tattoos are definitely becoming more and more mainstream. All my tattoos were done while employed in a professional environment. Frankly, the professional environment seems to have evolved significantly. I grew up with the narrative that tattoos make people less employable. That has not been my experience.

I do believe the stigma has begun to lift. However, that doesn’t mean the stigma is gone. Factors like industry, proximity to customers, content and location of tattoos can influence a potential employer’s decision whether or not to hire a candidate.

Regarding medical-related tattoos: I proudly wear my first diabetes tattoo, displayed for all to see. It sparks some great conversation and has been an excellent advocacy tool. But, I do not currently have a medical-alert tattoo on my wrist. I have yet to hear a story of somebody who suspected that they lost an opportunity due to a medical-alert tattoo. If it has happened, I would love to talk more with anybody who has experienced this. I would assume that a stigma about such a tattoo may be correlated with the stigma that is unfortunately and incorrectly associated with diabetes in general.

What are the most common questions and/or concerns about getting a tattoo when you have diabetes?

I sometimes hear from critics, ‘Why would you want to get something representing diabetes tattooed?’ My answer is that, for some people, such a significant reminder can help the PWD wearing it to claim it as part of their identity, keep diabetes front of mind, and shape a new attitude about what it means to take control. That’s what it did for me.

One of the most humorous questions I’ve been asked on multiple occasions is, ‘What are you going to do when there’s a cure?’ My answer: I look forward to facing that problem. But I’d proudly wear my diabetes tattoos forever as a symbol of the battle, struggle, triumph and the amazing journey it has been. To me, living with diabetes isn’t just about the dumb broken pancreas. It is about the life I live with it.

But, one of the best questions I’ve heard came from a young lady named Ashley who wrote to me a few years ago, ‘If I’m ever brave enough to get a tattoo I was wondering what are some ways I could take care of it?,’ and ‘How long did yours take to heal?’ These are great questions.

The answer to the second question is that all of my tattoos have taken the normal amount of time to heal that my artist told me it should take. There is oozing and swelling for a few days before scabbing begins. The tattooed areas begin to itch and the damaged outer layer of skin begins to flake off just over a week in (it’s important not to pick at it or scratch the itch). A few weeks after the tattoo, things look pretty well healed on the outside, but there is still healing underneath the skin’s surface for a while, so it is important to continue caring for the tattoo. This was my experience, but not everyone has the same timing, regardless of diabetes. We are all different, and we all heal differently. It is very important to follow the tattoo artist’s care instructions.

What advice do you have for PWDs who are considering getting a tattoo?

Be thoughtful. Tattoos are very personal, very permanent, and can affect different aspects of life. Think about your job or career path. Think about the future, and whether the theme of your tattoo will still be personal to you down the road.

One piece of advice I usually give is to allow an artist to create a piece of art. Go to the artist with the content you want incorporated into your tattoo, the tattoo style you want (making sure you’ve chosen an artist who specializes in that style), and where on your body you want the tattoo placed. If you go in with a tattoo already drawn up and demand the artist simply put it on you as is, you may not like the result.

What are your thoughts on diabetes alert tattoos vs. tattoos that are personally significant because of diabetes?

I sincerely love both. I was originally going to go the alert tattoo route, but since it was going to be my first, and I had always wanted something even before the diabetes tattoo ideas started, I quickly changed my course to personal significance. However, I’m not done yet. I’ve been seriously considering getting a diabetes alert tattoo on my wrist, especially after talking with a close family member who is an EMT.

I learned that EMTs are looking for clues, not jewelry. If I’m wearing an alert bracelet, they will likely see and understand that quickly. If they come across the alert necklace that I wear, that would work as well. If I have a diabetes indicator tattooed on my wrist, the EMT will likely read that clue as well. But, in his department, they have a policy to always check blood sugar if someone is unconscious, so regardless of any jewelry or tattoos, they’ll see if low blood sugar is the problem and go from there.

One thing he stressed is that the tattoo has to be very obvious. Don’t expect them to decode it. So, if/when I get my diabetes alert tattoo on my wrist, it will be very specific.

If you choose to get tattooed, whether you go with something diabetes-related or not, whether you get an alert tattoo or a a full sleeve of black ink, tattoos are personal. They are meaningful. They are art. They are culture. But they aren’t for everybody. I strongly encourage anyone who wants tattoos to go for it. Don’t let diabetes be a barrier to choice. But, please put your health first.

About Medical Alert Tattoos

Medical ID tattoos are growing in popularity across the chronic disease community.

Our own Ask D’Mine columnist Wil Dubois has advice on getting a medical alert tattoo if you’re considering it:

“So first the standard disclaimer: I have a medic alert tattoo myself. My mother, who hates tattoos, and my wife teamed up on this project because I’m on the sloppy side about wearing medic alert jewelry, and I’m on the road a lot. It gives them a measure of security knowing I have an alert that I can’t accidentally leave behind,” says Wil. “Of course, tattoos aren’t for everyone, but you’d be surprised how universal this kind of tattoo is becoming. I know a 70-year-old insulin-dependent type 2 who just got one. And she’s not the kind of lady you’d expect to find in a tattoo parlor.”

And hey, if a permanent tattoo sounds like too much, there’s always the Temp Option for PWDs. If you’re not interested in something inked onto your skin for all time, but do want a non-jewelry alternative for a medical alert, there’s this fun temp tattoo by PumpPeelz that might scratch that ink itch.

Before Getting Inked – What To Know

Once you’ve made the decision to get a tattoo, it’s important to know a few things when it comes to tattoos and diabetes.

“Working in medicine, I do have a few health and safety tips for you,” Wil says. “Plenty of people got hepatitis in the old days getting tattoos. This really isn’t a problem anymore, but make sure the shop you choose uses a brand new needle just for you, make sure they autoclave their guns between customers, and ensure that they either use disposable ink ‘pots’ or that the pots are autoclaved too. That’ll keep the viruses at bay.”

Making sure the tattoo parlor is up to snuff is the first medical consideration. But what about you, are you up to snuff?

“No tattoos if your A1C is over 9.0, and to really be safe, it should probably be sub-8,” Wil explains. “If your blood sugar is high, you won’t heal well, which opens up a whole range of risks from scarring on the bottom end to sepsis and amputation on the top end.”

With all that in mind, it IS safe for PWDs to get and enjoy tattoos. Even DiabetesMine editor Amy Tenderich got her first ink this past winter, without a hitch.

People with diabetes are increasingly choosing to get tattoos that relate to diabetes. The tattoos are chosen for various reasons, and we found five people with type 1 diabetes who have chosen to let the world know with permanent ink and found out the reason behind the tattoos.

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1. Glucose Molecule Tattoo

Rebecca Pasquarelli was diagnosed with type 1 diabetes at age 9 and got this tattoo from Ink and Water in Toronto. The tattoo is a simplified glucose molecule in the tattoo shop’s logo. The tattoo has drawn attention from “classmates at school as well as strangers I pass at the mall asking about my tattoo, which has given me the opportunity to educate others on the meaning behind my tattoo,” Pasquarelli said.

“Growing up with type 1 diabetes I had felt at many times embarrassed and ashamed to even let a family member know that I had diabetes, since I felt that there was constantly such stigma around diabetes in general” Pasquarelli said. “I’ve always been a fan of getting tattoos that tell a story or spread a powerful message, but it was in that moment where I realized I shouldn’t hide my diabetes from the world that I felt a sense of inspiration to get a tattoo that would draw people’s attention to ask me about my tattoo so that I could educate and share my story with them on diabetes.”

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The tattoo’s presence on her lower arm is a visible reminder to Pasquarelli that having diabetes doesn’t stop her from living life to the fullest. “Today almost 20 years after being diagnosed with type 1 diabetes…I feel more powerful than ever challenging myself with doing Spartan races, climbing 1,776 steps up the CN tower and many more things without letting my diabetes stop me from living my life,” she said.

2. Medical Symbol Diabetes Tattoo

Alena Waters chose to design her own tattoo: T1D in a caduceus medical symbol “because it was something that combined a known medical symbol to an identification that emergency services would be able to decipher if an emergency were to arise,” Waters said.

Waters, 20, was diagnosed with type 1 diabetes at 3 years old. She said she has just started feeling that she has the condition under control. “It’s constantly a work in progress, and the toughest thing I’ve had to come to realize is there’s no perfecting diabetes,” Waters said. “It’s a medical condition in practice.”

The decision to get a type 1 diabetes tattoo was simple for Waters. Medical identification like bracelets and necklaces were “constantly in the way” since she is such an active individual, “but I needed identification, so I made it permanent.” Wateres has received plenty of positive feedback on the tattoo, but she said “If the day comes where there’s a cure, tattoo removal is always an option!”

3. World Diabetes Logo Tattoo

Jordan Scara, who has been diagnosed with diabetes since age 6, chose this bold design to signify that diabetes “will always be apart of my life and will always have significance in what I pursue.”

Scara included the date of diabetes diagnosis, the World Diabetes logo and a red star symbol to represent the medical condition. Scara started drawing tattoo designs at age 13 and now, after 11 years with diabetes, is proud to have it inked permanently.

4. Simple Diabetes Tattoo

Nancy Swain was diagnosed with type 1 diabetes later in life, at age 39. She chose a simple design “so there would never be any confusion if there was a medical emergency,” she said. The text says “type 1 diabetic” and the 1 is surrounded by a blue circle.

“I chose to get a diabetes tattoo instead of wearing a medical alert bracelet because a tattoo is permanent,” Swain said. “It cannot fall off and I cannot forget to wear it…I decided to get a tattoo on my forearm so if there is ever an instance when I’m am unresponsive, medical teams will know my condition and can act appropriately.”

The tattoo garners plenty of attention from other people with diabetes, Swain said. She said the tattoo has inspired others to get inked as well and the tattoo has brought support from people who otherwise wouldn’t be aware that she has diabetes. “There is a sense of support that diabetics get from each other because they know the daily struggles of the illness,” Swain said.

5. Type One Text Tattoo

Katrina McElhany chose a simple “type one” text tattoo because she feels it suits her personality. “I’m also a very simple person…I didn’t want anything that was too flashy,” she said. “It’s two words that are a huge part of my identity.”

McElhany was diagnosed with diabetes at age 10 and said, “diabetes is a part of what shaped me into the person I am today.” But it has taken years of living with diabetes for her to feel confident about it. Now, she loves that her tattoo starts conversations when people see it. It reminds her of how far she has come.

“Nowadays everyone knows someone with type one diabetes and my tattoo often opens up a dialogue about type one,” McElhany said. “I’ve had strangers start up conversations with me and then all of a sudden they whip out their insulin pump and you instantly have that shared connection.”

The best way to know if it’s safe for you to get a tattoo with diabetes is to see your doctor or healthcare provider. They can review your numbers, draw your A1C, and determine if your diabetes is controlled. If your diabetes is not well controlled, or if your blood pressure is elevated, you should take measures to get both within range prior to getting a tattoo.
After you are evaluated by the healthcare provider and they confirm that your diabetes is under control,you will be given clearance to get a tattoo or a piercing. It will also be a good idea to have the doctor write a note, or even a prescription, in attention of the tattoo parlor or piercing clinic that will be performing the procedure. Normally, a tattoo or piercing establishment will take the word of the client, and the forms that you fill out there should have a question about diabetes, and whether it’s controlled.

Your response should be honest on the form, and if your diabetes is not well-controlled, lying about it could be to your peril. The question is on the form for your own safety, Understand that it is imperative that your diabetes must be controlled, along with your blood pressure, prior to obtaining a piercing or tattoo with diabetes.

Considerations for getting a tattoo or piercing with diabetes

There are many things that your doctor or healthcare provider should consider prior to giving you the ok for the procedure, even with your blood sugar and A1C in your target ranges. If it’s a tattoo, your doctor may want to know its location on your body. Areas farther away from the heart, and areas with poor blood flow are harder to heal, and people with diabetes may have existing compromised circulation in these areas.

If it’s a body piercing, where will it be placed is important to consider. Will gauges be used, or bars that are larger in diameter than the usual size studs commonly used for earrings? Will the procedure involve using a gun to pierce the skin with a small stud, or will it be a more complex procedure that involves puncturing the skin with a large bar, while holding a portion up with surgical tweezers? Will it be a procedure in which a gauge will be inserted into a larger hole made in the skin?

These factors can help your doctor or healthcare provider determine if the procedure is one that you may have trouble healing from afterwards since you have diabetes.

Your healthcare provider should also consider any complications that you have related to your diabetes, especially issues such as diabetic skin conditions, and complications of diabetes related to neuropathies, or nerve damage, or circulation issues such as Peripheral Arterial Disease. The last thing you want as someone with diabetes is to end up losing a limb due to amputation.

Picking your creative design, and making sure you can live with it forever

Tattoos are especially permanent. That’s why you want to really think about it, and weigh whether you might regret it later.

There is no turning back with some of the body piercings either. Often, as you grow and mature as a person, you learn that you may not make the same decisions as you did when you were younger. You may not have the same tastes, or likes, and your body piercing, or tattoo could become one of those things that you regret doing in your life.

To help prevent making unfortunate tattoo or body piercing choices, avoid getting the procedures on a whim, when under the influence of alcohol, drugs, or peer pressure. It’s best to think about these things for a very long time.

As far as for a tattoo design, deciding on a design that you can live with for the rest of your life, and what’s more, like, or even love, for the rest of your life, is no easy task. On top of finding a facility that uses safe, sanitary practices, you also want to use a tattoo artist that is an actual artist.

A piercing clinic performs a sterile invasive procedure of inserting a large piercing bar into the skin.

Have your blood sugar levels controlled before you get a tattoo or body piercing with diabetes

If you are considering a tattoo or body piercing, and you have diabetes, you should make sure that your A1C are withing your target, which for most people is less than 7%. If you manage to keep your blood sugars in a target range everyday, or at least most days, then you can rest assured that your A1C will be low enough to get a tattoo or piercing as well. Still, you must speak with your healthcare provider first, before getting either a tattoo, or a body piercing.

Ensure that the place and the person you are going to see is licensed or accredited

All tattoo parlors and piercing agencies are licensed and accredited by the state in which they provide tattoos and body piercings. Local environmental health agency representatives know how many tattoo and piercing licensed establishments there are in their county or locale. In our county, there is one inspector in the county Environmental Health office who is trained to conduct inspections, and provide sanitation and safety ratings for tattoo and piercing merchants who are licensed by the state.

They go around, and check each facility for sanitation and safety, ensuring that they follow state guidelines for licensure of tattoo parlors and body piercing establishments. They will issue a grade from A through F, like the grades given to restaurants. These are the types of tattoo parlors and body piercing facilities that you want to look for. Look for those with an “A” rating, and never get a tattoo or a body piercing from someone who is not licensed by the state, and has received an “A” rating.

Looking out for the ratings of tattoo parlors and body piercing facilities can help to ensure that you find one where safe practices when performing the procedure have been demonstrated. They have been trained, and they know what the state guidelines for tattoos and body piercings are. Beware of the do-it-yourself home-based tattoo “artists,” who think that they don’t have to play by the rules.

Not only can they give you a tattoo that looks unprofessionally done, but they can give you Hepatitis C, Hepatitis B, and HIV from the use of non-sterile equipment, and the re-use of needles from patient to patient. These home tattoo “artists” may also lack an autoclave to use on their equipment between customers.

If they aren’t playing by the rules, then don’t try them out. When you have diabetes, you must make sure that whomever you use for tattoo or body piercing services is a quality provider. It can be the difference between having a great procedure with no complications, and having an infection that progresses to a more serious issue.

Let the artist know of your diabetes so they can give you personalized aftercare information

You must be 18 years old to consent to get a tattoo. From a study of teenagers from age 11-18, where eight percent of them had tattoos, and 27 percent of them had body piercings, it can only be concluded that their parents must have signed for them to get their first adolescent or teenage “tats.”

When you go into a facility for a procedure, you will be given a consent form for the procedure, where you will be releasing the tattoo parlor or piercing establishment from any problems you may encounter related to being tattooed or pierced in the after-care phase. It is on this form that they will ask if you have diabetes, and if it is well controlled.

As said, be honest. If your A1C is a 9%, they will likely not let you get the tattoo or piercing, but that’s ok! You shouldn’t get it if your A1C is much higher than 7%, and your blood sugars have been out of your target ranges. Work on getting your blood sugars in to your target range, and your A1C down so that you can revisit the idea of getting a tattoo or body piercing. Remember, better safe than sorry later.

You also want to let the tattoo artist know that you have diabetes so that they can tailor your after care to be extra vigilant against infection. Tattoo artists and body piercing professionals who are licensed are trained to understand about diabetes and the risk of infection. They also should know what the signs of a low blood sugar are, and how to treat one.

Risks and Safety warnings

It’s a good idea to talk to the person performing your procedure, and make sure that they know what to look for if you were to start having a low or high blood sugar during the procedure.

Risk of experiencing low blood sugar during a tattoo or body piercing procedure

Prior to the procedure, discuss low and high blood sugar symptoms. Talk to the tattoo parlor owner or the person doing your tattoo, or to the body piercing professional, and make sure that they understand what could happen if you were to have a low blood sugar. Educate them of the signs and symptoms, have your glucometer and supplies close by, and medication if applicable, ready if you need them. Keep a 15-gram carbohydrate options with you as well. Don’t leave them in the car.

Experiencing a high blood sugar during a tattooing or body piercing experience

Getting tattoos and body piercings can be painful. It’s stressful on the body, and it may raise blood sugars. This will be temporary, and usually goes away within a day, but if blood sugars were high upon entering the tattoo parlor or piercing facility, then they could get dangerously high during the procedure.

In this case, you will want to have plenty of water to drink, have your insulin with you if you take extra doses for high blood sugar, and always keep your glucometer and supplies with you. Carry them with you to the facility. Re-educate your tattoo or body piercing professional about the signs and symptoms of low and high blood sugar in case they need a refresher course.

Make sure the facility uses a new needle just for you, with fresh ink in disposable containers

If it’s a licensed facility, with an “A” rating, you should ge an individual inking needle used only for you, with fresh ink in a disposable container, that won’t have been used on anyone else. This ensures sterility in the procedure, and helps to keep you safe from infections and problems from your tattoo or piercing procedure later.

Autoclave their machines in between customers

All good, reputable and state licensed tattoo and body piercing facilities will have an autoclave machine. This is a machine where they place the instruments to sterilize them between each client getting a tattoo or a body piercing. This is extremely important for infections control. You should look around to gauge the cleanliness of the facility. If it looks dirty on the surface, chances are you might catch an infection by having a procedure there.

Healing may take longer than those with no diabetes

If your blood sugars are not within your target ranges, and your A1C has crept up over 7%, then you could have a tough time healing if you get a tattoo or a body piercing. You could get an infection that could lead to gangrene, and even an amputated limb. That is not a path that you want to be on. That’s why you want to make sure your diabetes is well-controlled, and consult with your doctor or healthcare provider before you have either procedure.

A tattoo for a person without diabetes normally takes about two weeks to heal completely. It can take person with diabetes up to twice as long to heal after a tattoo or a body piercing. Body piercings may in fact take much longer to heal if they are extremely invasive, such as with large piercing bars.

Don’t get tattoos or body piercings if you have skin conditions related to your diabetes

If you have any kind of diabetic skin condition, or breaks in your skin near the area where you plan to have the tattoo placed, or where you plan to have the piercing, then you shouldn’t get either procedure. People with diabetes can have a variety of skin infections, including:

  • Eyelid infections (sties)
  • Boils and carbuncles (deep infection of tissues underneath skin)
  • Infection of hair follicles (folliculitis)
  • Fungal infections around nail beds of fingers and toes (Candida Albicans, or yeast)
  • Staphylococcus infections
  • Yeast infections in skin folds where moisture lies (jock itch in men), and on feet (athlete’s foot)
  • Ringworm (fungus of itchy, ring-like patch of skin
  • Itching due to dry skin from diabetes, due to dehydration from high blood sugars or poor circulation (if due to circulation, itching may be on the lower extremities)
  • Vaginal internal, and external yeast infection in women
  • Yeast infection of mucous membranes of mouth, and skin (corners of the mouth are dry, cracked)

The best way to take care of your skin if your have diabetes, and to prevent diabetes-related skin infections, is to practice good skin care. You should avoid taking prolonged baths in dry weather, and use a mild soap. Apply a non-alcohol lotion to your skin, but not between your toes. Some good ones for diabetes are, Gold Bond for Diabetes, Destin for Diabetes, and Udderly Smooth.

Some of the diabetes skin infections that may be a reason not to get a tattoo or a body piercing are:

  • Diabetic dermopathy – this is light brown and scaly looking skin patches that are due to changes in the working of smaller blood vessels that go to the fingers and toes, and to outer layers of skin all over the body.
  • Allergic reactions – allergic reactions can develop to diabetes medications, or to other medications, which may cause skin reactions, such as rashes, or even hives, and closing up of the throat
  • Eruptive Xanthomatosis – these are about 1-2-centimeter yellow enlargements on the skin that can itch, and have a red center on the hands, arms, feet, legs, and buttock area (seen in Type 1 young men with high cholesterol)
  • Acanthosis Nigricans – these are dark spots on the neck, groin, or armpits, or the hands, elbows, knees (most often seen in dark skinned people, i.e.: African Americans)
  • Bullosis Diabeticorum – this condition is an eruption of blisters on extremities, and can occur with people with nerve damage, or neuropathies related to diabetes
  • Digital Sclerosis – thick skin on the back of the hand thickens, making it hard to move joints. It can occur in other areas of the body, and can occur in one third of T1Ds which are uncontrolled
  • Necrobiosis Lipoidica Diabeticorum is caused by changes in blood vessels similar to diabetic dermopathy, with similar looking spots (there are fewer spots, they are larger, and they may reach deeper under the skin than diabetic dermopathies)
  • Disseminated Granuloma Annulare are raised areas on the skin that are reddish brown, or skin colored, and occur distally, far from the heart, sometimes on fingers, toes, or ears 3

Placement

Placement of tattoos or body piercings are also important for people with diabetes. Tattoos and body piercings are available in just about any size, and for any part of the body, literally. If you have diabetes, though, there are certain body parts that are better left un-inked. These areas can be prone to poor circulation and nerve damage from diabetes, especially uncontrolled diabetes.

Avoid areas that have poor circulation

People with both Type 1 and Type 2 Diabetes should avoid tattoos and body piercings in the lower legs, and ankle area, and on the feet. Hands and lower arms can also be an area where diabetes can cause circulation to be compromised, and these areas should be avoided.

Anywhere where insulin injections are given should not be used for tattoos or body piercings. This includes the fatty areas on the back of the arms, the fatty areas on the sides of the thighs, and the subcutaneous tissue around the abdominal area, or stomach. Buttocks and shins can also be deficient in circulation if you have diabetes.

After-care

After care is important if you get a tattoo or body piercing, and you have diabetes. It’s important to make sure that you don’t get an infection, and it will help your tattoo or body piercing to heal as it was meant to.

Bleeding may be excess

Following a tattoo or body piercing procedure, depending on the procedure, you may have excessive bleeding.

Scarring

If you are a person prone to keloid development, having a tattoo may cause you to have keloid formation along the ink lines of the tattoo. These will appear as a raised area of skin along the design. Many African-Americans who get tattoos have problems with keloid formation, but it is only a cosmetic problem, and it doesn’t cause other problems other than it being an esthetic issue that distorts the look of the tattoo.

Large piercings can also leave areas of scarring. Repeated piercings in the same ear related to the hole closing can cause scarring, or cause a tear in the ear lobe if the procedure is repeated too many times. Sometimes, piercings that are done with small gauge studs grow back with little or no scarring, but bigger piercing “bars,” and other piercing apparatus (they pierce with just about anything these days), may leave huge scars. Certainly, gauges placed in earlobes will leave disfigurements that may not be something you don’t want to have for the rest of your life.

How to Prevent infected tattoos and body piercings

To prevent an infection, follow all your aftercare instructions as they are given to you. Clean your site as directed, and report any of the signs and symptoms of infection listed below to your doctor.

What to do if you have an infection
Deficient circulation and open skin can lead to an increased incidence of infection in the area where the ink is administered underneath the skin surface, or in areas where piercings procedures are done. You could take a long time to heal if your tattoo gets infected, or if your body piercing doesn’t heal up like it should.

Signs and symptoms of an infected tattoo or body piercing include:

  • Weeping at the site of the tattoo that is brown, greenish, purulent or yellow drainage, or any other color than clear
  • Redness and swelling at the site of the tattoo or body piercing
  • A fever
  • Increased pain or throbbing at the site of the tattoo or body piercing
  • Increased healing time

If you notice any of the signs and symptoms of an infected tattoo, or if you have questions about how your tattoo is healing, consult with your doctor or healthcare provider. If your tattoo is infected, you will want to start on an antibiotic treatment right away, and not wait. If your doctor orders antibiotics to treat your infection, make sure to take it as directed, and take all the medication until it is gone. This helps prevent the development of super bacteria, that are resistant to current antibiotics available on the market.

Medical alert tattoo

Tattoos can also be used to identify someone with a chronic condition, including those with diabetes, and they may be used to replace Medical Identification bracelets, and other similar jewelry. This is fine to do, if certain precautions related to pre-care, procedural care, and after-care for the person with diabetes receiving the tattoo, are followed.

Generally, a person with diabetes will pick a medical symbol, such as a caduceus, that also displays the name of the type of diabetes that they have. They may also use many different symbols that signify diabetes.

The main thing is that it’s identifiable. It may be a challenge to find an area to place a medical tattoo that will easily be seen and identified by medical personnel, but will not cause problems for the diabetic when getting the procedure, such as in the wrist area.

For example, a medical alert bracelet is most often worn on the right wrist, but this is an area of decreased circulation for a person with diabetes, and therefore shouldn’t be tattooed. On the neck, near the carotid artery, is one place where medical personnel go to check pulse, so this may be one option for placement of a medical ID tattoo.

Placing a tattoo in an area on the chest near the heart may also be an option for people with diabetes wishing to get a permanent medical identification tattoo. Make sure you have a good tattoo artist, with a steady hand. You want the text in your medical identification tattoo to be legible, otherwise medical professionals will have no idea what it means. You will want to use a style of letters that is easily read, and not cursive or script.

Would you have regrets if you got a tattoo or a body piercing?

It’s certainly possible that after getting a tattoo, you may decide that you no longer like the design after many years. Old age mellows, and so really think about it before you commit to it. Getting laser treatments to remove it amounts to a burning off your skin. It costs a lot and insurance doesn’t cover it because of it’s cosmetic nature.

Is there an alternative to getting a tattoo?

Yes, you could get a temporary tattoo. This allows you to try out different images without having to live with them permanently on your body. If you fall in love with one of them, and you can’t live without it, then you will know you have found the right tattoo design for you.

Is there an alternative to body piercings?

There are clip on earrings, and other clip on mock piercing clips that you can use to simulate the look, if that’s what you are after. 4

Are there any other considerations for getting a tattoo or a body piercing with diabetes?

People with Type 1 Diabetes may often be affected by more than one autoimmune disease. If a Type 1 Diabetic has more than one autoimmune disease, then they must be managing all their conditions well prior to obtaining a tattoo or a body piercing. This situation complicates things, and when Type 1 Diabetics have Celiacs, Addison’s, or Grave’s disease on top of Type 1 Diabetes, they should likely see an endocrinologist, and consult with them before having any procedures.

Interesting factoid about tattoos and diabetes

There is something that researchers are working on that may provide a way for people to get “SMART” tattoos. These tattoos will use a special ink with nanoparticles that have tiny LED lights implanted in the skin. These new SMART nanoparticles will be a way to keep track of blood glucose levels. Now if there was ever a reason to get a tattoo with diabetes, that would be the best one.

Over to you

What do you think about our article about getting tattoos and body piercings with diabetes? Have you ever had either procedure done, and had any complications related to your diabetes? Also, please share any comments or thoughts in our comment box below.

TheDiabetesCouncil Article | Reviewed by Dr. Christine Traxler MD on September 07, 2018

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Last Updated: Saturday, September 8, 2018 Last Reviewed: Saturday, September 8, 2018

By: Sue Cotey and Andrea Harris, RNs

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Tattoos. They are more popular than ever. Today, more than 45 million Americans have at least one tattoo. But if you have diabetes, getting a tattoo may pose unique risks.

As diabetes educators, people sometimes ask us for advice about getting a tattoo. When you have diabetes, you really have to consider the physical consequences of everything you do.

How does my blood sugar affect risks associated with tattoos?

People may not realize that to get a tattoo, the skin is pierced between 50 and 3,000 times a minute by a tattoo machine. Your skin is a barrier that protects you from infections. Getting a tattoo breaks this barrier. A tattoo affects the dermis, or the second layer of skin, because the cells of the dermis are more stable than the first layer, or epidermis.

Piercing skin at this level poses unique risks to people with diabetes. If your blood sugars are not in good control, your immune system is also affected — putting you at even higher risk for infection and potential difficulty fighting it off.

Skin Conditions with Diabetes

Tattooing is under strict hygiene rules from the Food and Drug Administration (FDA) because of this risk of infection. The needles must only be used once and the tattoo artist must wear gloves while doing the work. According to the FDA, among the most severe infections that can be transmitted is hepatitis.

If you have considered the risk, and still want to get a tattoo, remember to do the following:

  • Talk to your doctor first. It’s important to discuss your particular case with your doctor so he or she can assess your individual risk. Involving your doctor is even more important as the American Diabetes Association, which would normally offer guidance, has issued no official position statement at this time about tattoos.
  • Make sure your blood sugar is in good control. This means blood glucose tests and hemoglobin A1C, or an index of average blood glucose for the previous three to four months, need to be in the target range. Your hemoglobin A1C should be less than 7 percent.
  • Make sure you are going to a reputable place. Sounds obvious, but sometimes it’s not so clear which places are truly reputable with more than 20,000 tattoo parlors in the United States alone. You can find a good place by asking for references and checking with the Better Business Bureau for any complaints filed.

By taking the right precautions, you can be sure that you are making an informed decision about tattoos and risks involved when you have diabetes. Taking the time to involve your doctor could prevent future problems. Body art is beautiful, but a healthy body is even more beautiful.

Diabetes And Tattoos: Here’s The Lowdown

Can a Diabetic get a tattoo?

Sure! As we always say, Diabetics can do everything a healthy person can do – we just need a little bit of preparation, and it’s the same with getting a tattoo. That said, you should already look after your numbers a few weeks before your tattoo appointment – this may be not the time to start that new diet or try out a new basal rate. Just make sure that your blood sugar is more or less steady and that you know how it will react to physical stress.

On the day of the appointment I always start with a big breakfast – as any person should do! Your body will need a lot of energy, so eat something that will keep your blood sugar steady for a long time and will not cause it to spike, like whole grain products. You should also drink lots of water to keep your body hydrated.

Getting started

As Diabetics we should be used to needles pricking our skin, right? Yeah, right – but tattooing brings this to a whole new level. You should never underestimate how much stress it is for your body to get wounds inflicted over several hours – and a tattoo is basically nothing else than a wound. I never start the tattoo with a blood sugar under 200 mg/dl (11.1 mmol/l), because it will drop anyway.

Starting with the same numbers as when you would do sports is a good reference point. Bring enough food and sweets for hypos that may occur, but it’s better to make sure it won’t even happen. So check your blood sugar regularly, at least every 30 minutes, and make enough breaks to eat and drink. I always told my tattoo artists before that I am diabetic and it might take some more time, and they were all very kind and understanding. I never got rejected at a tattoo place for having Diabetes, and if they do reject you, this is not the right place anyway. Just tell them that you know your disease and your body very well and that you know what to do.

Aftercare

So you survived the process of tattooing and feel great with the new piece of art under your skin – congratulations! 😀 But now the most important part just starts: The aftercare. In the first few days and weeks you really have to look after your new tattoo so it will still look good in a few years. Your tattoo artist will give you instructions about the aftercare, but basically it is no sun, no swimming, no sauna and not pulling off the loose skin for at least 6 weeks.

I use pathenol cream 2-3 times a day in the first two weeks to keep the tattoo moisturized, then I just go on with normal body lotion and in summer, of course, sun screen. After about 2 months you should visit your tattoo artist again to check if it has healed properly and to maybe get a touchup.

I hope these tips helped you with getting a tattoo as a Diabetic. Enjoy your skin – wear art

Ramona

If you read outdated books on living with diabetes, those of us living with this disease shouldn’t even walk around our house barefoot let alone get a tattoo! But these days, people with all types of diabetes are “living dangerously” by walking barefoot in their own home and even getting tattoos that are about diabetes.

You can absolutely get a tattoo if you live with diabetes, but there are still a few things you need to consider before popping into your local tattoo parlor.

In this post, I will cover everything you need to know about diabetes and tattoos, what it looks like when things go wrong — and if doctors and EMTs even trust those diabetes-related medical alert tattoos!

Table of Contents

Your A1c and overall risk of infection in a new tattoo

The reason people with diabetes are traditionally discouraged from getting a tattoo is that higher blood sugars levels impair your body’s ability to heal properly, and can easily lead to an infection.

People with type 1 and type 2 diabetes have a significantly increased risk of developing any type of infection, according to Diabetes Care Journals. And those with type 1 diabetes have an even higher risk than those with type 2.

Just like an ignored blister in a person with consistently high blood sugar levels can lead to an infection severe enough to become gangrene and risk losing their toe or entire foot, a tattoo on a person with high blood sugar levels could become severely infected, too.

The University of Southern California’s REAL Diabetes program says people with diabetes should consider the following details regarding HbA1c levels before getting a tattoo:

  • A1c under 8.0: “If you want a tattoo and your last couple of A1c tests were under 8%, and you don’t have any neurological problems, heart disease, or kidney damage, getting a tattoo should be safe as long as you keep it clean and keep your blood glucose levels in range. Your body shouldn’t have any trouble healing the tattoo as long as they take good care of it.”
  • A1c over 9.0: “However, if your last few A1cs were 9% or over, or if you’re experiencing any neuropathy, circulation, or kidney problems, getting a tattoo could put your life in danger. When your tattoo can’t heal quickly, it becomes a playground for bacteria and can lead to infection and eventually gangrene.”

If your A1c is above 9 percent, that doesn’t mean you can’t ever get a tattoo safely, it simply means you may have just found a new motivation for improving your overall diabetes management and getting your blood sugars into a healthier overall range before getting a tattoo.

“It was definitely on my mind,” says Leanne Matthews. She’s lived with type 1 diabetes since age 7, over 16 years, and has three tattoos. “But my blood sugars are in tight control and my A1c is under 7, so I wasn’t that concerned.”

Leanne’s first tattoo was purposefully small, so she could see how her body reacted to getting one. In addition to diabetes, she knew some people’s skin reacts poorly to tattoos, including rare sensitivities to the colored ink.

“I got my first tattoo in Italy, so, yeah maybe that was a little sketchy when I look back at the condition of the tattoo parlor,” recalls Leanne. “Maybe not the smartest decision!”

As a health coach, Leanne definitely agrees with the standard advice that you should wait until your blood sugars are in a healthier range before getting a tattoo.

“And if you have any history of infections, you really don’t want to risk getting a tattoo if your A1c is high.”

*Read Diabetes Strong’s Guide to Lowering Your A1c!

What the healthy healing process of a tattoo should look like

Nobody’s tattoo looks all that pretty in the first week of healing, so it’s important to understand what the normal healing process will be like. Authority Tattoo explains:

  • Stage One (Days 1-6): “Oozing, swelling, and redness that gets better gradually over each day. Scabbing begins to form over the area.”
  • Stage Two (Days 7-14): “Itching and flaking begin, and this continues until all layers of dead skin and scabbing have fallen off.”
  • Stage Three (Days 15-30): “Tattoo looks fully healed but may look slightly cloudy for a few weeks. Deeper layers of skin are still repairing, so continue to look after your tattoo.”

How to properly care for your new tattoo

Caring for your new tattoo is actually very straight-forward, and critical when it comes to preventing infection, and for ensuring it looks beautiful when it’s finally healed! Your tattoo artist should give you clear instructions on a piece of paper, but here are the basics from:

  • Gently wash your tattoo every morning and night with lukewarm water and antibacterial soap. Pat it dry with a clean towel or paper towel.
  • Rinse it with water (at least) any time it comes in contact with dirt or excessive sweat, or other dirty environments.
  • Apply a recommended “lotion” at least twice a day. Vaseline or cocoa butter are usually recommended. Avoid anything with added scents or colors–these could contribute to an infection.

“Every tattoo I’ve had they tell me something different about how to care for it,” Leanne said. “But the point, no matter what, is about keeping it clean.”

Being a regular gym-goer, Leanne was concerned about her own sweat drenching her new tattoos and germs from everyone else all over the gym equipment. Her solution for this was simple: wash it immediately after every workout.

“With my largest tattoo on my thigh,” adds Leanne, “I definitely paid extra attention to keeping it clean and taking care of it, because it’s a bigger area that could potentially get infected.”

Most common causes of infections in tattoos

Preventing an infection in your new tattoo while it heals is actually pretty straightforward….right? Just keep it clean! But there’s a nice long list of things that can easily introduce an infection–many of which you might not even think of, like the type of body lotion you use every day!

  • High blood sugars in those with diabetes
  • Unsanitary tattooing environment
  • Unsanitary tattooing equipment
  • Ineffective cleaning
  • Rewrapping the tattoo (which traps germs and sweat in the area)
  • Picking and peeling your scabs (scabs help your skin heal!)
  • Scratching your tattoo
  • Bathing in dirty water…take showers instead!
  • Letting others touch your new tattoo
  • Using too much lotion — apply only as directed, not constantly
  • Generally unhealthy lifestyle habits around nutrition, alcohol, sleep, etc.

Keep it clean and dry. Don’t scratch or pick at it. Use vaseline or another recommended tattoo moisturizer. And when you’re showing it off to your new friends, tell ‘em to keep their hands off it!

Signs of an infection in a new tattoo

“Straight after getting a new tattoo,” explains Authority Tattoo, “the area is essentially just a large and open wound that is very vulnerable to germs and bacteria until the skin is able to protect itself by creating a formation of scabs over the wound before finally regenerating a permanent outer protective layer of skin over the area.”

Authority Tattoo cautions that just because your tattoo may be small doesn’t mean an infection isn’t incredibly real and crucial to take care of quickly.

“If left untreated, some infections can actually lead to blood poisoning, shock, and even eventually organ failure and death.”

The most common signs of infection include:

  • Spotty rash: sometimes red, sometimes white
  • Extreme redness 5 days after getting the tattoo
  • Extreme itching (healthy scabs will itch a little, apply more vaseline!)
  • Feels hot to the touch
  • Swelling 5 days after getting the tattoo
  • Oozing scabs (healthy scabbing is normal, oozing scabs are not)
  • Blistering
  • Excessive oozing, pus, especially associated with pimple-like bumps
  • Foul odor
  • Red streaking on the skin around the tattoo (also known as blood poisoning)
  • Swollen lymph nodes (a sign your body is trying to fight infection)
  • Fever and tiredness

If you think your tattoo may be infected, visit your doctor or local urgent care immediately. As people with diabetes, we need to take infections very seriously and get them treated very quickly. Even with an A1c under 8 percent, our bodies are still inevitably more prone to infection than a non-diabetic, and those infections can worsen more quickly, too.

To see pictures of infection symptoms, visit Authority Tattoo. *Warning: very graphic!

Consider the location of your tattoo

As if diabetes doesn’t rear its ugly head enough in every part of your life, it’s also going to try to tell you where on your body can get a tattoo.

Areas with impaired circulation

It’s easy to forget that even if your A1c has been under 8 percent for decades, areas of your body inevitably have impaired blood circulation compared to others.

Our hands, feet, ankles, and even your shins are the most common “tattooable” areas on your body that can easily have poor blood circulation. That means these areas are less ideal for a tattoo simply because they may not heal as quickly or are at a greater risk of infection during the healing process. If you already have diagnosed neuropathy, and you’re choosing to get a tattoo despite suggestions that you shouldn’t, it would be wise to avoid any of those affected areas.

Common sites for your injections, infusion sites & CGM sensors

Do you often inject insulin in the back of your arm? Is your favorite spot for an insulin pump infusion site on your abdomen or thigh?

Think carefully about where you most frequently inject insulin, where you place infusion sites for your pump, and where you insert sensors for your continuous glucose monitor (CGM), because all of those sites will inevitably have more scar-tissue.

Those areas will also be unavailable after you get a tattoo placed there because constantly piercing it with sharp objects and injecting it with insulin will inevitably destroy your beautiful tattoo!

Leanne admits she didn’t follow this advice too closely.

“I picked the spot on my body where I wanted it. I’m not gonna let diabetes tell me where I can get a tattoo, especially since my blood sugars are healthy. If I want to get a tattoo in the middle of my thigh, then that’s where I’m getting it,” she says firmly. “And I would just not use that area for injections anymore.”

It’s tedious–definitely–that diabetes gets to have a say in where on your body you get a tattoo but it’s also critical and in your best interest to think carefully before accidentally getting a tattoo in your favorite injection area!

When it’s time to get your first tattoo…

If there was ever a time to be a little bit obsessed with your blood sugar management, the days before you get your tattoo and the few weeks that follow when it’s working to heal are worthy of diabetes management obsession.

It’s critical to remember that just because your tattoo is healed on the outside of your skin within that first week, there is still a great deal of healing that takes place in the tissue below your skin. The more your blood sugars stay in a healthy range during the weeks after getting a tattoo, the better it will heal, the more quickly it will heal, and the less likely you’ll experience a healing-related complication or infection.

Do EMTs notice “medical alert” diabetes tattoos?

It’s so common these days to see “type 1 diabetes medic alert” tattoos on Instagram, but before you swap your medic alert jewelry for a tattoo, it’s important to find out if EMTs and healthcare professionals in emergency rooms even notice or look for a medic alert tattoo on a patient.

The answer is that EMTs will not necessarily look for a medic alert tattoo.

“A friend of mine is an EMT,” explains Leanne. “She said they can’t assume you have diabetes just because of a tattoo because it might be there to represent your child’s diabetes.”

However, they’re still likely to notice it, and then consider checking your blood sugar and eventually learning that you have diabetes. So it’s not completely lost, it’s just not an exact and equal replacement for medical alert jewelry.

Is a tattoo the right choice for you?

Getting a tattoo is a very permanent choice, and for the wrong person, it can be a life-threatening choice. While none of us want to let diabetes tell us what we can or cannot do, being honest about your overall blood sugar control before getting a tattoo is pretty darn important.

If the idea of getting a tattoo motivates you to improve your blood sugars, that’s awesome!

In the meantime, maybe grab a Sharpie marker and draw one on there every day until you’re ready. (And for heaven’s sake, think carefully about the picture you choose because you might not think a picture of Ryan Gosling’s face on your left butt-cheek is so cute when you’re 65 years old!)

Diabetes tattoo ideas

We asked our Facebook community to share their diabetes tattoos. More than 100 people posted their tattoos in reply. Here are a few examples:

“I am more than my highs and lows” diabetes tattoo

Medical alert diabetes tattoo

Type 1 diabetes tattoo

Insulin dependent tattoo

Artistic diabetes tattoo

T1 Diabetic tattoo

Blue circle diabetes tattoo

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Tattoos & T1D

People with Type 1 diabetes often wonder whether or not getting a tattoo is a safe option for them. We have good news – you can safely get “inked,” but just like anyone else, there is certain protocol and things to keep in mind to ensure that you have the best tattoo experience possible.

Standard Safety Precautions

  • Find a licensed/accredited tattoo parlor with experienced artists.
  • Be certain that the needle being used is brand new and sterile.
  • Make sure the artist autoclaves their machine between customers.
  • Ink pots should be disposable.
  • Ask your tattoo artist to put a temporary sticker/rendering of your tattoo on your body before committing to the permanent ink, to be sure that it is exactly what you want!

T1D-Specific Risks

  • Healing time

According to many tattoo artists and doctors, the only hesitation with regards to a person with diabetes getting a tattoo has to do with the overall healing time. If your diabetes it not well managed, the body will take much longer to heal. It is important to make sure that your A1C is within a healthy range before considering getting your tattoo.

  • Infection

In addition to healing time, poorly managed diabetes can put your tattoo site at a much higher risk for infection. Regardless of your A1C, it is important to keep an eye on the tattoo as it heals, and follow the after-care instructions given to you by your tattoo artist.

  • Tattoo locations

Certain areas on the body can be trickier than others for tattoo placement if you have poor blood circulation, which makes them more susceptible to infection. Some examples are: feet, shins, ankles, and buttocks.

  • Check your blood sugar!

Depending on the size and detail of your tattoo, your appointment could last quite a while. Be sure to bring your blood sugar meter, CGM, insulin, snacks, quick sugar (i.e.: glucose tabs), and whatever else you need to keep your levels in check while in the chair. It is a good idea to notify your tattoo artists ahead of time that you might need to take some BG testing/snack breaks!

Read The Boyfriend/Girlfriend Guide to Caring for Someone with Type 1.

Is it Safe for Diabetics to Get Tattooed?

Image courtesy: © Thinkstockphotos/ Getty images

Tattooing is an increasingly popular form of permanent body art that uses needles to inject ink under the skin. However, if you are diabetic and wish to get tattooed, think again because unless and until you have a good control over the disease before you go under the needle there could be complications in the healing process.
Dr Apratim Goel, dermatologist, Goel Cutis Skin Clinic says, “If a diabetic wishes to get tattooed, there is nothing wrong in that. But they’ve got to be fastidious about their disease management and have good control over their blood glucose levels. Otherwise, a tattoo could be downright dangerous.”
So, what determines whether or not a diabetic has control? A simple blood test called haemoglobin A1C levels can be monitored. The result is the best indicator of how well that person is managing their diabetes.
“If a diabetic wants a tattoo and their last A1C tests was under 8%, and they don’t have neurological problems, heart disease, or kidney damage, getting a tattoo should be safe. They just need to keep it clean and continue to keep their blood glucose levels in range
In case of high sugar levels, the tattoo can’t heal quickly, it can get infected, which can lead to gangrene and even heart disease,” she adds.
Risks
If proper precautions are not taken, there is a risk of infection and complications. According to Dr Goel, these include allergic reactions, skin infections, other skin problems (like keloids) and diseases. Diabetics specifically risk problems with wound healing and infection.
Where to get tattooed?
So your blood sugar level is under control and you have decided to get tattooed, but to avoid complications, you must carefully select the location of your tattoo. This can be done after consultation with your physician. “Avoid getting a tattoo on places with poor circulation, such as the feet, ankles, shins, buttocks and common injection sites such as arms, abdomen and thighs. Tattoo placement can make a big difference in how quickly and successfully the tattoo heals,” says Dr Goel.
Precautions

  • If you’re a tattoo artist and your client is diabetic inform them that mismanaged diabetes and tattoos don’t go well together.
  • Before beginning the actual tattoo, especially if it’s a large one, check the sensation in that part of the body. Also a long procedure can lower blood sugar levels. Be sure to have a stable blood glucose level and food in your system before starting the procedure. Your blood glucose levels may rise due to the stress and pain of tattoo application but they should go back down the next day.

Tattoo to be used to monitor blood sugar levels?
Scientists are developing special tattoos, which may allow those with diabetes to more accurately and quickly monitor their glucose levels. Dr Goel informs, “To create the blood sugar-reading ink, scientists used nanotubes wrapped in a glucose-sensitive polymer. After the ink is injected beneath the surface of the skin, the nano-ink seeks out glucose and fluoresces, which can be read with a hand held machine.”
Bear these in mind to be safe while getting a tattoo if you are diabetic.
Written by: Zoha Tapia

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