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WASHINGTON -- An estimated 16 million Americans between 40 and 74 years old suffer from "prediabetes," a dangerous condition that can lead to full-fledged diabetes within a decade, federal health officials said.

In addition to the likelihood of developing diabetes, prediabetes carries its own risks, such as a 50% greater risk of developing heart disease. The good news for those with prediabetes is that lifestyle changes, such as eating a more nutritious diet and walking for 30 minutes five days a week, can delay or prevent full-blown diabetes in most cases, according to recent research.

Wednesday, a panel of experts on the disease advised doctors to take steps to identify people who have prediabetes and educate patients about how to ward off diabetes. The panel "strongly" recommended that doctors screen patients who are overweight and who are 45 or older for prediabetes. The term applies to people with higher-than-normal blood glucose but still below the threshold for a diagnosis of diabetes.

The recommendations don't change who is supposed to receive tests for diabetes -- those over 45 and overweight already fall within testing guidelines.

"People with prediabetes need to be identified, and they need to know the seriousness of their condition," Health and Human Services Secretary Tommy Thompson said.

Overall, an estimated 17 million Americans have diabetes, which results from the body's failure to produce enough insulin or to use it properly. The disease can be fatal, or result in blindness or amputation. The number of people with diabetes has tripled in the past 30 years, and diabetes now ranks as the most expensive health problem in the U.S., costing $98 billion in 1997 in medical costs, disability, work loss and premature death, according to the American Diabetes Association.

The panel recommended that overweight people under 45 years old should discuss screening with their doctors if they have another risk factor for diabetes: a race other than white, a close relative with the condition or a history of the illness during pregnancy. The panel is made up of diabetes experts from inside and outside the federal government.

The two blood tests that identify diabetes can also identify prediabetes. One test measures for impaired glucose tolerance; a blood-sugar measure between 140 and 199 milligrams a deciliter indicates prediabetes. The other test detects impaired-fasting glucose. If the blood-sugar level after an overnight fast is between 110 and 125 milligrams per deciliter, that also indicates prediabetes.

Francine Kaufman, president-elect of the diabetes association, said people in the prediabetic group should know their blood-sugar levels, much as people know their cholesterol levels.

"Prediabetes is not a benign condition," said Judith Fradkin of the National Institutes of Health. And many more than 16 million people are probably affected by it, but fall outside the age range of the estimate, HHS officials said.

There are three main types of diabetes. Type 1 occurs in children and young adults, who must take daily insulin shots to stay alive. Type 2, also known as adult-onset diabetes, accounts for 90% to 95% of the diabetes in the U.S. Gestational diabetes affects about 2% to 5% of pregnant women and usually goes away after they give birth.

Mr. Thompson said the Department of Health and Human Services is contacting insurance companies, labor unions and large employers to inform them about the problem of prediabetes, in the hope they will educate employees about screening.

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