With this in mind, we sought to examine the value of a SMART design compared to an RCT for two telemedicine strategies to support titration of insulin therapy for Type 2 Diabetes Mellitus (T2DM) patients new to insulin: (1) a largely self-contained smartphone app, Diabetes Pal [20] and (2) a nurse-based telephone consultation service, SingHealth Polyclinics’ (SHP) Insulin Initiation Telecare Program (see the Methods section for details about these two telemedicine modalities). The gene discussed is INS; the disease is type 2 diabetes mellitus.