Endocrine Abstracts

Millions of people travel across time zones every day for business and for pleasure. Travel-related health issues arise from a variety of factors: infections, prolonged limited mobility during travel, and participation in certain activities, such as diving and high-altitude hiking during travel. Besides that, air travel allows individuals to traverse time zones faster than the internal clock, or circadian rhythm, can adjust. This results in desynchrony between the external light-dark cycle and the endogenous circadian rhythm. Adjusting the hormone replacement during travel in people with endocrine dysfunctions can be challenging. Adjusting strategies vary depending on the medication, the importance of precise timing of medication usage, distance travelled, and duration of the visit. In general, in patients with diabetes, adjustments of insulin doses are unnecessary if patients are crossing fewer than five time zones. Traveling east will shorten one’s day, and, in general, may require a reduction in insulin because insulin doses would be administered closer than normal and thus could cause hypoglycemia. Westward travel means a longer day, and so insulin doses may need to be increased. People with adrenal insufficiency should switch the hydrocortisone schedule to the local time. Throughout the time of travelling, hydrocortisone should be used every five to six hours. Estrogen use represents a risk factors for the development of venous thromboembolism during long-distance travel and therefore, in women taking estrogens, prevention of venous thromboembolism during prolonged travel should be considered. Continuous patient education regarding hormone replacement and prevention of possible acute complications are the cornerstones of managing common travel-related problems in patients with endocrine disorders.