“New Twist” in Diabetes Care for HbA1c Reporting: “It Takes Two to Tango”!

Most likely everyone, at some point in an everyday conversation, has heard the phrase, “ it takes two to tango . ” The saying originated in a song, “Takes Two to Tango,” which was written and composed in 1952 by Al Hoffman and Dick Manning (1). Apparently this particular phrase was incorporated in the lyrics of a song about romance, but this expression has been applied to a much broader range of situations. For example, it might be used to describe an activity between two individuals or organizations that cannot be completed unless both are in complete agreement and cooperate. The phrase, perhaps accompanied by throwing up one’s hands, may also describe why certain activities are not brought to fruition: because one or the other party refuses to cooperate or does not hold up their end of the bargain, or because both parties are to blame. Given these variations on the theme, we suggest that, given the focus on HbA1c in this issue of Diabetes Care , the phrase “it takes two to tango” is an appropriate description of our new policy at the journal to require dual reporting of units for HbA1c. Readers may be curious why so much focus is placed on HbA1c in the current issue. First, there is an original research article on a metric assessing discordance between HbA1c and blood glucose, termed the glycation gap (2). We also feature a review on the history and standardization of HbA1c by Dr. David Sacks (3), a very thoughtful commentary on the original research and HbA1c review by Cohen and Lindsell (4), and our new initiative (Profiles in Progress) about …