Tattoos Replace Bracelets for Medical Alerts

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PHILADELPHIA -- As more people with diabetes replace their medical alert bracelets with tattooed warnings, there might be a need for a standard design and body location, a researcher here said.

"The tattoo has to be easily recognizable to first responders," Saleh Aldasouqi, MD, from the Sparrow Diabetes Center of Michigan State University in East Lansing, said during a press conference.

"It may be that we need guidelines for medical alert tattoos for both patients and tattoo artists," Aldasouqi said. "Should tattoos be prescriptive? I don't know. We're at the beginning of this dialogue and I think it's an important one."

Medical alert tattoos for diabetes are a relatively new phenomenon and Aldasouqi admitted he has no hard data on the number of people who choose ink over metal to alert first responders in case of an emergency.

He initially became aware of medical tattoos about 3 years ago when a patient showed up with one. His search of the literature, however, produced only two case reports. But a search on the Internet revealed ample evidence that the practice is alive and well.

"You can find groups of people discussing their medical tattoos," he said.

Rick Lopez, who works at Hard Ink Tattoo in Philadelphia, told that he recently inked a diabetes alert on a young man.

"He brought the bracelet into the shop and I just copied it onto his wrist," Lopez said.

He said he has tattooed a lot of "cancer ribbons" on customers, generally family members of those with cancer who want to show support, but also on cancer survivors as well. And he has inked the autism puzzle ribbon. But only one medical alert.

Aldasouqi and colleagues reported a case presentation here of a 32-year-old women with type 1 diabetes who decided to shed the alert jewelry for a permanent ink reminder on her wrist.

She said she was frustrated with the numerous broken necklaces and bracelets throughout her life, and the ensuing costs of them.

Last year in the American Family Physician journal, Aldasouqi published another case report of a man who tattooed his diabetic condition onto his wrist.

As the practice of medical tattoos grows, he wants to ensure it's headed in the right direction. Paramedics have to be educated about these tattoos so they recognize them during an emergency. There perhaps should be some standardization in design and location, such as the wrist, so it's easier to identify the tattoo as an alert, he said.

He cited a case where a man had the letters "DNR" inked on his chest. During an emergency, first responders thought the tattoo might be a directive for "do not resuscitate." As it turned out, the man had lost a bet in his youth, which resulted in those letters emblazoned on his chest.

Aldasouqi has recently teamed up with a colleague from the University of Helsinki to produce peer-reviewed studies on the phenomenon and to begin a registry of patients with medical tattoos.