INS and hydrops fetalis: Linagliptin, a DPP-4 inhibitor, functions by preventing the degradation of glucagon-like peptide-1, thereby enhancing glucose-dependent insulin secretion and inhibiting glucagon release.[29,30] This mechanism improves glycemic control without significantly increasing the risk of hypoglycemia and may offer modest anti-inflammatory and endothelial-protective effects that are relevant in the management of HF.[19]