Treatments for diabetic cardiomyopathy have largely focused on managing the symptoms of diabetes, such as controlling glycaemic control, lowering lipid levels, and managing oxidative stress.5 However, glucose-lowering treatments such as insulin sensitisers,343 glucagon-like peptide (GLP1) agonists,344 sulfonylureas, and some dipeptidyl peptidase-4 inhibitors,345 have had limited clinical success preventing HF and can even increase the risk of HF. Here, INS is linked to hydrops fetalis.