This framework emphasized four major interventions to reduce average glycosylated hemoglobin (HgbA1c or A1c) in patients with HgbA1c greater than 9%—improved healthy eating and physical activity (L—lifestyle), increased use of insulin to control blood sugars (I—insulin), increased visit frequency (to a goal of every 1–3 months) (V—visit frequency), and attention to comorbid emotional and mood disorders that can worsen diabetes control (E—emotional care). This evidence concerns the gene INS and mood disorder.