Middle-aged people who develop diabetes could lose years off their life, according a major new study in China.

Researchers found that people with the disease lost an average of nine years of life.

However they suggested that part of the reason for this was that the condition was not as well controlled in China as in high-income countries.

They also found that people in urban areas were twice as likely to get diabetes than those living in the countryside, but the later lost an average of 10 years of life, compared to eight for city-dwellers.

Diabetes has quadrupled in China in recent decades and an estimated 100 million adults are thought to have the condition today.

Writing in the journal JAMA, the researchers said: “As the prevalence of diabetes in young adults increases and the adult population grows, the annual number of deaths related to diabetes is likely to continue to increase, unless there is substantial improvement in prevention and management.”

The study, by Dr Zhengming Chen, of Oxford University, and colleagues, considered information about the health of 512,869 people aged 30 to 79 years from five rural and five urban areas in different parts of China.

About four per cent of people in the countryside had diabetes, compared to eight per cent in cities.

They were recruited to the study between 2004 and 2008 and the scientists then checked to see who died up until 2014.

The researchers found that people with diabetes were twice as likely to die over the period.

The disease was linked to an increased chance of dying from stroke, various forms of cancer, chronic liver disease, infection in general, chronic kidney disease, and ischemic heart disease.

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The risk of dying from inadequate treatment of the diabetes was much higher than in high-income countries, the researchers found.

They also discovered this was more likely to happen in rural areas of China than in the cities.

Overall, they estimated someone diagnosed with diabetes at the age of 50 had a 69 per cent chance of dying within the next 25 years, compared to 38 per cent for people who did not have the disease.