Because of the relative weight-neutral effect of DPP-4 inhibitors [29] and a recent clinical outcomes trial report on increased risk of hospitalization for heart failure attributable to saxagliptin use (the risk of “class effect”) [30], the ADA-EASD recommends the preferred consideration of GLP-1 receptor agonists over DPP-4 inhibitors in T2D patients with ASCVD or weight-related problems. This evidence concerns the gene DPP4 and heart failure.