When compared to non-insulin non-glitazone antidiabetic drugs, the proportional reporting ratio (PRR) of HF for DPP4is was 0.62 (95% CI 0.56–0.68) up to 2013q3 and 2.12 (95% CI 1.96–2.28) from 2013q4 to 2017q3. Here, INS is linked to hydrops fetalis.