Ben Roberts, a 33-year-old from Fowlerville, Mich., estimates that medical bracelets and necklaces have cost him more than $1,000 since he was diagnosed with type 1 diabetes at age 6.
Frustrated, he headed to a tattoo parlor four years ago. "It's a negative thing to say, but diabetes isn't going away any time soon," he said. "You might as well get a tattoo."
Today, "Diabetic, Type 1" is tattooed underneath the six-pointed "Star of Life" with a snake running through it, the traditional symbol for emergency medical services.
"It's hard to miss," Roberts said. "I'm happy with it -- I've even gotten compliments from doctors and paramedics."
JEMS: Pro Bono: Should You Pay Attention to or Obey a Patient’s Medical Tattoo?
Douglas Wolfberg JD, EMT and Steve Wirth, Esq., EMT-P
JEMS: Use of Tattoos for Medical Information Begins to Grow
Researchers and tattoo artists alike agree that more people are replacing traditional medical ID bracelets, which average around $30 at Walmart, with medical alert tattoos.
But the lack of regulation of the tattoos -- which are intended to warn emergency medical personnel about diseases -- means first responders don't always pay attention to them.
"We're not going to stop to read a tattoo in an emergency situation," said Don Lundy, president of the National Association of Emergency Medical Technicians.
There's no hard data on the number of people opting for medical alert tattoos, but Saleh Aldasouqi, a diabetes expert in Michigan, said a quick Google search shows how popular they've become in recent years.
But, he said, there isn't any medical literature on the tattoos. He has been pushing doctors to start talking about the tattoos to ensure they're done safely and effectively.
The American Diabetes Association has not, and probably will not, put out guidelines for those seeking medical alert tattoos, said Matt Petersen, its managing director of medical information.
"We do recommend that people with diabetes wear medical IDs," Petersen said. "And we say stick with the traditional medical bracelet. It's what works."
But tattoos offer some benefits that traditional IDs cannot.
"They're convenient," said Nicolas Kluger, a dermatologist, who co-authored a 2013 study about medical alert tattoos with Aldasouqi. "And their permanence can make people feel more comfortable."
Ian Jones, a tattoo artist at True Tattoo in Los Angeles, said that although designs vary, there are some similarities across most medical alert tattoos.
"We usually do them on the wrist, because the first thing paramedics will do is check for pulse," Jones said.