According to a National Diabetes Report and the Center of Disease Control and Prevention (CDC), 29.1 million people have diabetes. Many diabetics find it difficult to keep their Blood Sugar (or blood glucose) at proper levels. Here are a few reasons why your blood sugar may fluctuate more than usual.

Stress – Long-term stress can cause high Blood Sugar Levels in diabetics. Studies have shown mental and physical stress can raise blood sugar levels in both type 1 and type 2 diabetes. People who are under stress may not take care of themselves. Stress tends to cause people to consume unhealthy foods and increase their consumption of alcohol. Others under stress may skip meals or eat less than normal. This can cause blood sugar levels to drop. Try to make helpful changes in your life to decrease or avoid stress altogether.

Dried Fruit – Yes, it is fruit, but the dried version has more carbohydrates and sugar in a much smaller serving. Just think of dried fruit as the more concentrated version of your favorite fruit. The spike in sugar will cause your body to work harder to produce insulin. You’re better off eating fruits in its natural state. If you have dried fruit on hand, eat small amounts preferably with other nutritious foods.

Change in Hormones – Menopause can cause changes in your hormone levels. These changes can cause fluctuations in your blood sugar level. Your cells respond to insulin based on what your estrogen and progesterone levels are. You may notice that your blood sugar level is less predictable than before.

Yogurt – All yogurts aren’t created equal. Many yogurts have added sugars. Stick with light yogurt without the added sugar and syrupy fruit. Yogurt is great for its healthy bacteria called probiotics. These probiotics are known to aid in digestion and help manage your blood sugar.

Lack of Sleep –  Sleep deprivation can make it harder to manage your blood sugar level. People who are tired tend to seek energy from sugary foods and caffeinated drinks to get a jolt. People who don’t get enough sleep are often overweight. Obesity is a precursor of diabetes and sleep apnea. The more fatigued a person is, the more likely they’ll develop insulin deficiencies.

Alcohol – Alcohol can cause your blood sugar to spike or fall. Moderate drinking can cause your blood sugar to rise, but excessive drinking can cause your blood sugar to dangerously drop. This is especially dangerous for those with type 1 diabetes. Alcohol also increases your appetite causing you to overeat or make bad food choices. Alcohol can also negatively impact your diabetic medicine and insulin. According to The American Diabetes Association, a diabetic should have no more than one drink a day for women and two drinks for men. One drink is considered 5 ounces of wine, 12 ounces of beer, or 1½ ounces of liquor like vodka.

Artificial Sweeteners – To cut back on sugar, your first thought may be to consume artificial sweeteners. Many have declared drinking diet sodas helped them lose weight and satisfy their craving for high fructose sugary soda. Scientist found that saccharin, sucralose and aspartame raised blood sugar levels. These artificial sweeteners dramatically changed a person’s gut microorganisms, found in the intestines, that helps with nutrition and the immune system. Researches studied 400 people and found the bacteria in the guts of those who ate and drank artificial sweeteners were different from those who did not. Here’s the kicker, there are some studies that show artificial sweeteners don’t impact blood sugar levels. Questions still remain about the impact of sweeteners, so for now, consume in moderation.

Dehydration – When your body isn’t properly hydrated, it tries to maintain balance by taking water from your bloodstream. When your blood loses water, glucose remains. This causes a higher blood sugar concentration. The longer you go without water, your blood sugar levels will rise along with insulin resistance. Make sure you stay hydrated by drinking water and eating water-rich foods.

Sports Drinks – Sports drinks may seem like a great idea for rehydrating after a workout, but many of these drinks contain more sugar than soda. Try to rehydrate with plain water or make your own sports drink without the sugar.

Final Note – Always monitor your blood sugar levels and never let them dip or increase above recommended levels. If you have any questions about what you should and shouldn’t do to maintain your blood sugar, consult your physician.

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