ELN and diabetes mellitus: Chronically high levels of glucose, as seen in patients with diabetes mellitus, causes a higher degree of cross-linking in collagen and elastin via the formation of advanced glycation end-products and premature cellular senescence in dermal fibroblasts (Blazer et al. 2002; Dekker et al. 2009; Lan et al. 2009; Paul and Bailey 1996).