It has to be noted that if a patient, during the course of DPP4 inhibitor-based therapy, is diagnosed with ASCVD, HF, or CKD, it is recommended, in accordance with established guidelines, to consider the initiation of treatment with an SGLT-2 inhibitor or a GLP-1 RA with proven cardiorenal benefits, provided that the patient is not already receiving these agents. The gene discussed is DPP4; the disease is hydrops fetalis.