This multinational population-based cohort study of more than 50 000 pregnant women with type 2 diabetes and their infants did not find greater risk of malformations after periconceptional use of sulfonylureas, dipeptidyl peptidase 4 inhibitors, GLP-1 receptor agonists, or sodium-glucose cotransporter 2 inhibitors compared with insulin. The gene discussed is SLC5A2; the disease is type 2 diabetes mellitus.