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This article originally posted 18 May, 2014 and appeared in  Safety and Error PreventionPatient ErrorsDiabetes Clinical Mastery Series Issue 189

Diabetes and Tattoos: Case Study and Guidance

A 29-year-old woman with insulin-dependent diabetes noted a painful erosion at the site of the tattoo which she had gotten 7 days before. A culture isolated staphylococcus aureus confirming the clinical impression of staph. This diagnosis was not entirely unexpected, since patients with diabetes mellitus are predisposed to staphylococcal infection. An oral cephalosporin cleared the cellulitis, leaving the tattoo a little distorted. The tattoo artist blamed the cellulitis on the patient's failure to take proper care of the wound site. However, the lack of recurrent infections in the patient's history indicates that she probably was not a carrier, and the infection grew from a new source.

Tattoos are very popular, especially with teens. But the tattoo application process and aftercare, which can be long, painful and stressful, can create some problems for our diabetes patients. Blood pressure and blood sugar levels can both rise while a tattoo is being applied, and high blood sugar levels can also complicate the healing process, increasing the risk of infection.

Other things to consider before getting a tattoo include....

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Tattooist quality

The tattoo studio should be licensed and/or accredited. The patients can also research the company's reputation, and hygiene and safety practices.

Safety and awareness

The tattooist should be informed of the patient's diabetes so they can tailor both the procedure and aftercare information.

Placement

Certain areas 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).

Other Risks
  • Allergic reactions - 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 sterilized, there is a 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.
If the patient feels unwell or sees any sign of infection after the tattoo has been completed, they should seek immediate help from their doctor 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.http://match.adsrvr.org/track/cmf/generic?ttd_pid=switchconcepts

Scientists at the Massachusetts Institute of Technology (MIT) and Draper Laboratory, U.S., 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.

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 revolutionize glucose monitoring.

Examples of Diabetes Tattoos

diabetes-tattoos-images 
This guidance adapted from information found on the Diabetes UK website at http://www.diabetes.co.uk/tattoos-and-diabetes.html.
 
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This article originally posted 18 May, 2014 and appeared in  Safety and Error PreventionPatient ErrorsDiabetes Clinical Mastery Series Issue 189

Past five issues: Diabetes Clinical Mastery Series Issue 202 | SGLT-2 Inhibitors Special Edition August 2014 | Issue 742 | Diabetes Clinical Mastery Series Issue 201 | Humulin Insulin Special Edition August 2014 |


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