Medical Optimization and Management of Pregnancies with Overt Type 2 Diabetes (MOMPOD) is a clinical trial, funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, examining the impact of combined Metformin and insulin therapy on infant outcomes with mothers experiencing Type 2 diabetes in pregnancy. More than 100,000 women per year in the United States experience Type 2 diabetes during pregnancy, and more than one-third of pregnancies in mothers with Type 2 diabetes have some type of adverse neonatal outcome. Insulin therapy has been the standard for treating Type 2 diabetes during pregnancy, but negative effects still exist. Outside of pregnancy, the drug Metformin is favored over insulin by the American Diabetes Association because it results in less weight gain and fewer hypoglycemic episodes. Metformin currently is not recommended for treating Type 2 diabetes in pregnancy, however, due to a lack of large-scale clinical studies. The MOMPOD Study Consortium addresses this gap with an enrollment goal of 1,200 mothers who are randomized to receive either Metformin or a placebo in addition to insulin. MOMPOD is the largest trial of Type 2 diabetes in pregnancy ever conducted in the U.S., and the findings potentially will define the optimal therapy for pregnant women with Type 2 diabetes in the future.