This class of drugs has been reported to be neutral with regard to the incidence of HF except for saxagliptin which was associated with an increased risk for hHF in the SAVOR-TIMI 53 (Saxagliptin and Cardiovascular Outcomes in Patients with Type 2 Diabetes Mellitus) randomized trial, mostly in patients with HF history or elevated plasma NT-pro-BNP levels without clear explanation for that [141]. Here, NPPB is linked to hydrops fetalis.