If you're one of the more than 21 million people in the U.S. living with diabetes, you may have days when everything goes as expected with your blood sugar and days when, no matter what you do, you just can’t make sense of the highs and lows. Many factors can contribute to blood sugar levels. We’ll examine a number of them in detail here.

What you eat

What, when, and how much you eat can play a huge role in your life with diabetes. One way to become more comfortable with managing your blood sugar is to understand all you can about how food affects it. That could mean reading nutrition labels, counting carbs, limiting portion sizes, choosing healthier alternatives, and learning about the effects of alcohol.

Added to the challenges of everyday meal planning are life’s special occasions, many of which revolve around food. These could include holiday get-togethers, birthday parties, travel, weddings, Halloween, game days, a group lunch in the workplace, or even something as simple as a meal out at a restaurant.

Along with understanding food options, it may help to learn tips for eating mindfully and being fully aware of the food choices you make, while recognizing any emotional eating triggers you may have. Just make sure you talk to your healthcare provider or nutritionist about a healthy eating plan that is right for you.

How much you move

Activity levels also play a role in managing blood sugar levels. Again, just be sure to check with your healthcare team before trying any new activities or changing your exercise routine.

It isn’t always easy to stay motivated. But it may help you to learn how burning calories, losing pounds, and keeping off extra weight may benefit blood sugar levels. Even making a habit of moving more—including smaller steps like stretching and learning a few tai chi exercises—may have an impact on overall fitness.

Being stressed out

Paying attention to overall health also means learning to recognize the signs of stress. Too much stress may throw blood sugar levels out of whack and increase the risk for anxiety, depression, fatigue, and sleep issues. Learning to practice mindfulness techniques may help reduce stress levels.

Being a woman

Did you know that diabetes affects men and women differently? For women, the hormones progesterone and estrogen, which regulate the menstrual cycle, may also increase insulin resistance. Hormonal fluctuations following ovulation and during menopause may also impact blood sugar levels.

Your environment

There are also a number of other variables that may affect blood sugar management. For example: hot, cold, or humid weather; changes in altitude; a seasonal cold, flu or other illness; even traveling. Supplies such as insulin may react to changes in temperature.

Get support

Many things can cause blood sugar to go up and down. The good news is that there is no shortage of help, support, tools, and community available to you. For starters, your diabetes healthcare team is made up of specialists who know specific areas of care and who can each play a role in helping you live healthy! They can also provide information on diabetes self-management training, education, and monitoring blood sugar levels at home.

Diabetes support organizations—from awareness and advocacy organizations to online groups—may also be a good resource. The Diabetes Online Community (DOC) in particular was created by—and consists of—many kinds of people who share their journeys and experiences juggling the factors of life with diabetes.

Loved ones and spouses, whether longtime life partners or recent newlyweds, may be a source of support and strength. And family members, friends, and even coworkers may play key supportive roles.

Yes, life with diabetes may feel complicated at times—and daily highs and lows may not always make sense even when you’re closely tracking and managing food, activity, stress, and other factors. That's why living well with diabetes may sometimes mean being sure to set aside that extra minute each day to take a deep breath and pat yourself on the back.