After thinking about it for a long time we did it. We just got tired of the super high highs when there was a failure of some kind with the pump/site/tube/insulin. It seemed like three times a month she would be over four hundred for pump related reasons and by the time we diagnosed the problem and corrected far too much time had gone by while high. The last time it happened she was high for only two hours and already had large ketones and was sick to her stomach throwing up. If I can spare her this just occasionally it will be worth it. The clinic had told us that people who use lantus and a pump only do it because they are athletes and they want to be disconnected for hours at a time. So we knew it could be done. They were also not that willing to think about the pros and the cons nor even to give it much thought at all. So we just too the plunge. The first night I wrongly calculated how much basal to leave with the pump and how much to give with the lantus pen. If I had done the math right I think the transition would have been seamless. I can't say for sure but it just might be that that our numbers are slightly more stable throughout the day. I expected to have to do some tweaking of pump settings to make up for peaks in the lantus but so far the settings are just right. One thing I have learned is that living with something is far more informative than just thinking about it: Pros: Yes the high highs are less. If any number of things with the pump goes wrong then she still has lantus working to keep things from getting way out of control. She can disconnect for longer periods with less effect on numbers. I think numbers are a bit more stable. She has always swung rapidly from high to low and vice versa and now her numbers look more like her brothers. I did not expect this and have no explanation. This was true when she was on MDI and true when on a pump alone. Less insulin is delivered through the pump so the capacity of the reservoir is in effect larger. I knew the day would come when the cartridge would not be large enough and she would have to change it every two days. Now that day might not come. She gives lantus in the stomach where she does not put in sites so less relative insulin is being delivered through the other sites. We can still increase a temp rate as much as we want. Cons: We have to remember to give the lantus shot. We have been late twice and early once now with no negative effect. Super boluses are not as strong since the basal from the pump is lower. Shutting off the basal does not bring up BG as fast since the basal from the pump is lower. When a site goes bad it will be less obvious. We will have to get the clinic to approve a prescription for lantus again. I think they will especially now that we are already doing it.