In Louisiana, we love our food, and it shows in our waistlines — and if we’re not careful, in our pocketbooks.

The rising rate of diabetes cases is not just costly but staggeringly so, according to three researchers writing in the December issue of Diabetes Care. The editor of that medical journal, William T. Cefalu, is director of LSU’s Pennington Biomedical Research Center.

The report looks at the rise in costs for diabetes and prediabetes cases. Direct and indirect costs in Louisiana alone come to $5.4 billion a year.

The researchers pointed to the need for medical response to those whose onset of diabetes can be avoided.

“Increased prevalence of the disease, not increased cost per patient, is the driving force behind the increased economic burden of diabetes,” said Cefalu and his American Diabetes Association colleagues. “The crisis is worsening — the time to act is now. These data clearly should signal a call for action.”

The financial cost to Louisiana is reflected in higher costs for everyone, not just in the Medicaid or uninsured populations, but in the “hidden tax” of costs passed on to insured patients. Louisiana’s rising medical costs are not limited to the patient in particular.

“The increasing number of new cases of diabetes is a primary driver of increasing costs to state health systems,” Cefalu and his colleagues write. “This makes prevention a priority for so much more than health improvement.”

Maybe it’s not the most palatable bit of bad news, as we reach for the third helping of pumpkin pie during a holiday feast.

Yet, the diabetes epidemic in Louisiana ought to be on the minds of policymakers, not just those in the medical professions. All too often, despite doctors’ guidance, people fail to exercise or are caught up in a rat-race at work that includes a lot of time at a desk and not much time up and moving around.

The good news is that even modest levels of exercise can help. Lifestyle changes and attention to a better diet greatly reduce the risk of adult-onset diabetes. The national Diabetes Prevention Program study, which Pennington Biomedical participated in, proved that people can reduce their risk of being diagnosed with diabetes by 58 percent through moderate diet and exercise, resulting in a 5 percent to 7 percent weight loss.

We see some positive signs in the growing efforts toward smart-growth policies that give people a healthier environment in which it is possible to walk or bike to work. In New Orleans, Baton Rouge and Lafayette, city governments are looking for ways to build “complete streets” that make bicycles an option to traffic jams.

Mayor Mitch Landrieu recently announced that New Orleans has been recognized by the League of American Bicyclists as a “silver level” bicycle-friendly community. The city now boasts approximately 93.5 miles of completed bikeways, which includes 37 miles of bike lanes, 40 miles of shared lanes and 16.5 miles of off-street paths. The city will have over 100 miles of bikeways by early 2015.

Still, it is very difficult to change a “built environment” of streets and structures that are accessible only by car. To deal with the diabetes epidemic, most of us are going to have to search out the time for exercise either in a gym or sports field, or just walking in our neighborhoods.

Prevention is a more cost-effective way to deal with a rising medical emergency, but it requires action earlier rather than later.