Clinical practice recommendations for the pharmacologic management of type 2 diabetes prioritise sodium-glucose cotransporter 2 (SGLT-2) inhibitors for people with comorbid heart failure (HF) or chronic kidney disease (CKD) and either glucagon-like peptide 1 (GLP-1) receptor agonists or SGLT-2 inhibitors for those with atherosclerotic cardiovascular disease (CVD) or with multiple cardiovascular risk factors [1, 2]. The gene discussed is SLC5A2; the disease is hydrops fetalis.