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

M ost 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 HbA 1c 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 HbA 1c. Readers may be curious why so much focus is placed on HbA 1c in the current issue. First, there is an original research article on a metric assessing discordance between HbA 1c and blood glucose, termed the glycation gap (2). We also feature a review on the history and standardization of HbA 1c by Dr. David Sacks (3), a very thoughtful commentary on the original research and HbA 1c review by Cohen and Lindsell (4), and our new initiative (Profiles in Progress) about Dr. Samuel Rahbar, the person who first reported the significance of HbA 1c for individuals with diabetes (5). What could be so new about a test that has been validated as the gold standard for assessing glycemic control, has been clinically proven to be associated with diabetes complications , and has become such a routine part of diabetes care by providers across the world? Perhaps the fact that we are so comfortable with this test may be the exact reason why important recent developments have really been " flying under the radar. " One of the new initiatives we would like to report is called Profiles in Progress, and the first narrative appears in this issue. This initiative …