On other hand in diabetic patients authors [22] have found a twofold higher mortality risk compared with nondiabetic patients; in particular, diabetic patients treated with insulin had a threefold higher mortality risk compared to nondiabetic patients, while diabetic patients not treated with insulin had only a modestly and nonsignificantly higher mortality risk (HR 1.59) compared to nondiabetic patients with HF [22]. Here, INS is linked to hydrops fetalis.