In a nationwide cohort of patients with T2D starting second-line add-on therapy with metformin and with no history of cardiovascular events, initiating either GLP-1 RA or SGLT-2 inhibitor treatment was associated with comparable risks of hospitalisation for HF and death, and a lower risk of the composite endpoint of MI, stroke, or CV death for GLP-1 RAs, relative to DPP-4 inhibitors. This evidence concerns the gene DPP4 and hydrops fetalis.