This article summarizes a presentation by one of the authors (CAH) to the Fifth Annual Meeting of the Diabetes in Pregnancy Study Group of North America. Dr Hobbs, MD, PhD, the Director of the Arkansas Center for Birth Defects Research and Prevention, presented an overview of the collaborative strategies developed for investigating the etiology of birth defects. A multidisciplinary group of scientists and clinicians explores current hypotheses in diabetic embryopathy, drawing upon expertise in experimental biology, genetic epidemiology, genomics, metabolomics and translational research. The prevalence rate of birth defects among infants of diabetic mothers is as high as 11%, despite the knowledge that maternal metabolic control is strongly correlated with the risk of malformations. Specifically, caudal dysgenesis, renal anomalies, heart and neural tube defects and situs abnormalities occur more often among infants of diabetic women than non-diabetic women. Researchers are also working to discover the underlying mechanisms that make some women with diabetes more susceptible than others to having infants with birth defects.