INS and hydrops fetalis: Our results of favorable effect on nebivolol on insulin sensitivity in HF patients can be explained by Manrique and colleagues [21]; they conducted an experimental study on insulin resistance Sprague-Dawley rat model treated with nebivolol for 3 weeks; they assessed HOMA-IR index as well as nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity (NADPH is an insulin metabolic signaling in skeletal muscle) before and after nebivolol treatment.