Diabetes and tattoo: Ink before you do it too

Mumbai-based Gilmerio Seraphino Dsouza, a global project manager at Merkle, wanted to prove everyone wrong. He was diagnosed with type 1 diabetes when he was ten years old and has been on insulin shots since then. From the time of his diagnosis, he has been told what he could do and what he couldn’t. When children of his age went out and play, he had to be very cautious of everything that he was doing. He says, “I was in Kuwait back then. It was very disheartening, and I felt my life was over. My family and I moved to India. I was treated like an outcast and others would tell me that I can’t eat or play with them. I eventually overcame it over a period of time and while I was dealing with the stigma, getting a tattoo came across my mind. As I am diabetic, I have always been told what I can’t do. So, I wanted to prove to myself that I can do something that others think I can’t.” He got his first tattoo despite being diabetic when he was around 20.

He says the biggest fear that he had while getting inked was his family’s reactions. He tried to hide the tattoo from his family for a couple of days, but eventually, his mother found out. “She was taken aback but was supportive. She helped me apply cream since I was struggling to reach my back where I got the small tattoo, indicating the origin of my name, which comes from the word, Gilmore,” he recalls.

After he got his first tattoo, he says he could not stop; getting inked became a ‘good addiction.’ “I was exhilarated. The experience was amazing, and my outlook changed. I felt like I needed more,” he adds.

Before getting the tattoo, he did extensive research and visited the doctor to know more about the precautions he needed to take. “I did research on the internet as well. Though there wasn’t a lot of information online, the one common thing I saw was that the sugar levels needed to be under control before getting a tattoo so that the chances of getting an infection were lower. I changed my diet to ensure my sugar levels were under control.”

Diabetes and tattoos risks

Dr Rajesh Rajendran, consultant diabetologist and endocrinologist, Chennai, says, if diabetes is well controlled and a proper process is followed, it should be okay to get tattoos. “If sugar is well controlled, the risk of infection is less. The blood sugar should be under 200 and the HbA1c levels between seven and eight per cent. The needle should be clean and sterilised too. It should not be shared with anyone else,” he explains.

The body is like a canvas, believes chef Harsh Kedia, founder of A Diabetic Chef, an online service that offers sugar-free products. Harsh was diagnosed with type 2 diabetes when he was 14-and-a-half years old. He finds tattoos motivating and always wanted to get one but couldn’t for a long time due to his health and social norms. “I have five big tattoos now and the last one covers my entire arm. I’ve got most tattoos on my hands and one on my back,” he says.

He got his first tattoo when he was 16 years old; it was the initials of his parents on his shoulders. He says that since he was in high school at the time, he had to get inked in a part that was not visible. He managed to hide it from his family for six months. “I used to bake and sell then. I saved the money I made for 1.5 months and got the tattoo. When my family found out, they got upset but they came around eventually,” he says.

Things you must know when you get tattoos

Tattoo artists say they get multiple queries in a week regarding tattoos for diabetic patients and the process around it. Jeffry Dsouza, founder of True Ink Tattoo in Mumbai, says when diabetes clients visit him, he first checks when the last time they got hurt and how the wound healed.

“I look at the scars and if they haven’t healed even after a long time, I suggest they don’t get inked. A tattoo is also a kind of wound that damages your skin and hence, it’s important to take precautions. We also get a consent form filled by them when they decide to go ahead and get the tattoo, stating that we won’t be responsible in case of any complications,” he says.

Tattoo causes micro-injuries, and they need to heal properly. He suggests his clients go with something small and light first. “It is easier to understand how it heals then. I keep the machine slow and try and give my best to do minimal skin damage. It is better to have a light tattoo than damaged skin and you can always go for a touch-up. You can see how your body is reacting to the ink and skin damage,” he says.

Lokesh Verma, the founder of Devil’z Tattooz & Heartwork tattoo festival, New Delhi, says that usually diabetic people get small tattoos to start with and it is mostly done around the lower arm area. The process of tattooing is more or less the same for every client, with or without diabetes. “We usually recommend diabetic clients to have a good meal before getting the tattoo so that they can maintain proper blood sugar levels,” he says.

READ MORE:

The 60-plus diabetic fight club

How hormones affect blood sugar levels

Six ways to tackle diabetic foot ulcers and gangrene

Diabetes awareness tattoo

Tattoo artists say diabetes patients mostly get tattoos usually based on their personal experiences. “There is no underlying reason except for their preferences. Diabetics rarely get medical tattoos (tattoos which convey the medical conditions of a person), which tell that they are diabetics. It depends on the kind of design they want to get. It is not based on their medical conditions,” says Lokesh.

Harsh and Gilmerio say their tattoos express the driving factors of their lives, life experiences and things they love and describe them best. Harsh’s tattoos include an anchor, a steering wheel, the world map, tribal art, feathers, the moon and sunrise, paws, an eye crying and ‘a diabetic chef’ written on his arm highlighting his life as a chef. Gilmerio has a shark, a giant manta and a Memoriam for the people he’s lost in his life. He also has the words, ‘type 1 diabetic’ on his left arm along with a blue circle, the global symbol for diabetes. “In case, I am in a bad situation and out of insulin, the paramedics will get to know that I am type 1 diabetic,” he says.

Jeffry says, “Not everyone is fine with letting everyone know their medical conditions but it is also not possible to carry your medical reports everywhere you go and hence, in case of a medical emergency, a diabetic tattoo can be helpful. It is their personal choice,” he says.

Precautions before getting tattoos

Dr Anshul Kumar, founder of Dr Anshul’s Diabetes and Endocrine Care Center, New Delhi, suggests it is better to avoid getting inked on the upper arm, thighs or abdomen. “These are the sites where patients might have to take insulin injections if their sugar levels are deranged and their diabetes progresses. So, these body parts should ideally be spared,” he says.

He says the precautions one should take are similar to the ones before a minor surgery. “It is a small but painful procedure as there is no anaesthesia and hence, it can lead to the release of stress hormones like cortisol, which in turn can lead to derangement of sugar levels,” he points out. Here are some of the precautions that he and Dr Rajesh suggest before going for inking.

• Sugar levels should be under control
• Hydrate your body well
• Have a good meal two hours before the procedure
• Start with something small
• Ensure that the site where you are getting the tattoo is clean and free of infections
• Ensure that you are not allergic to the ink
• Check if the needles are clean and sterile before use

The recovery

The tattoo takes longer to heal for people with diabetes. The recovery time further depends on the size and place of the tattoo. Usually, a non-diabetic person might take a week to recover but a diabetic takes twice the healing time. Gilmerio says his tattoo usually takes about 15 days to heal. Harsh adds, “the longest recovery time I’ve had is one month for my entire right-hand tattoo.”

Harsh says he never developed any complications due to his tattoos but there were the usual challenges. “I love swimming and since the tattoo cannot be exposed to sunlight, water or chlorine, I had to postpone some travel plans until it healed. While bathing too, I ensured that I had it covered,” he says.

Gilmerio recalls difficulty walking when he got a tattoo on his foot. “I wear full sleeves when I get tattoos on my arms to avoid direct sunlight. It is important to keep rehydrating while getting inked and ensure that the tattoo is cleaned at the end of the day; it is a wound,” he adds.

Tattoo aftercare 

There is a risk of the needle being infected and infection on the site of the tattoo. Dr Rajesh says, “diabetics are more prone to getting blood-borne diseases like hepatitis B and HIV if the needles are not sterile. Even a non-diabetic person holds the same risks, but treatment gets more difficult if you are diabetic.”

Here are the signs that you need to look out for if you are diabetic and have just got a tattoo:

• Increase in redness
• Pain
• Swelling
• Itching
• Rashes around the tattoo or all over the body
• Any discharge around the tattoo

If it leads to infections, it gets difficult to treat. “We might prescribe antibiotics, injections or even a local surgery, depending on the severity of the complications. There are chances of the tattoo getting disfigured as the skin gets scarred and you may not get the desired results. With ageing, the skin becomes frailer and hence in older people, risk of tattoos getting disfigured is more compared to younger people,” warns Dr Rajesh.

Tattoos are a way of expression for many. Jeffry says that he once inked a 65-year-old man with diabetes. “He wanted to get it (a tattoo) for 30 years. He got tired of dealing with diabetes for all those years and wanted to go a little adventurous. He said I’m anyway going to die. So don’t worry, please do it,” says Jeffry.

When asked if there are plans to get more tattoos, Gilmerio laughs and says, “I am getting my 19th tattoo as we speak.” Harsh, on the other hand, says, “the possibility is infinite. If life gives me more accomplishments and a better journey, then I will do it.”