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.

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.