A virtual diabetes pandemic is sweeping the world, with record levels of obesity and diabetes crippling the health of hundreds of millions of people globally. As horrible as this is, what is even worse is the sobering evidence that most people appear unwilling to take the lifestyle steps that can prevent this killer disease. Do we have a death wish?

A recent article in the British medical journal The Lancet said the following: “For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention, with evidence of a 40—70 percent relative-risk reduction.”

To simplify, we know that most people can avoid Type 2 diabetes with lifestyle modifications. Yet despite this very well-established medical fact, most people will simply allow themselves to slip into diabetes and become drug-dependent, rather than change their eating habits and exercise.

According to the Diabetes Foundation, almost 26 million Americans have diabetes, while an estimated 79 million have pre-diabetes. Diabetes contributes to almost a quarter of a million US deaths per year, and the total cost of this disease in the U.S. alone exceeds $218 billion.

Every month, magazines, newspapers, TV news programs and radio programs put out new, ever-startling information about the steady increase of diabetes. The topic is virtually impossible to avoid. And what is the national response? Eat more fries, buy more deadly sodas, guzzle more beer, sit around and allow the diabetes epidemic to rage on.

Diabetes, most often associated with obesity, is a major contributing factor in heart disease, stroke, high blood pressure, blindness, kidney disease, neuropathy and amputation. Face it: Diabetes is a gruesome, life-threatening disease.

But where is the national health initiative to get Americans back on a healthier track? With costs as high as these, and with mortality data as scary, you’d think that Congress would be crafting health policy that would support the production and promotion of wholesome foods, educate the general public ceaselessly about better eating habits, resurrect The President’s Council on Physical Fitness, revamp school lunch programs, get the fast food and junk out of every publicly funded institution in the nation, and basically wake up and smell the coffee.

Instead of taking diabetes on as a major national health, economic and security issue, our feckless politicians are dithering over tax breaks for the rich and bailing out bloated banks while we citizens lose our net worth. Meanwhile, people are literally dropping like flies.

So the question is, what is it going to take? Do we need five million Americans to die every year of diabetes before we recognize that we have to act? Or will we simply sit increasingly fat and idle while we are bombarded with ads for drugs that are palliative at best?

I realize full well that my own comments, like the comments of other advocates of sane health policy, will likely fall on deaf ears. But here are my suggestions for reducing diabetes and obesity in the U.S., and changing our society from fat and sick to trim and healthy:

-Teach healthy nutrition to everyone who goes to school, with no exceptions. Ensure that every school provides physical education classes to every student every day. Serve only genuinely healthful, un-processed foods in schools and all public institutions, and throw out the fast food, junk food, sodas, vending machines and diabetes-causing drek.

-Establish a national task force that is highly visible, that systematically re-educates the entire national population on nutrition and exercise. Get every American off of their ever-expanding buttocks and on their feet, engaged in some kind of exercise, whatever it may be.

-Stop promoting garbage foods to children, and eliminate all advertising, marketing and promotion of junk foods with no exceptions. In other words, create a national health plan and put it into effect.

I remember when I was a child, people littered a lot more than they do now. Litter was a blight in all public places, notably on highways and roadways. But an aggressive, multi-year anti-litter campaign greatly reduced littering. And tough laws on littering helped greatly. It’s time we do the same with diabetes and obesity. It’s either that, or die.