There are a ton of medications for diabetes that can help prevent blood sugar elevations for meals. This is the most common issue I see for diabetics. There is an insulin resistance that we need to overcome at meal time.
Medications designed to make you MAKE MORE INSULIN can sometimes help. These are glyburide, glipizide, glimepiride, Januvia, Onglyza, Tradjenta, Byetta, Bydureon, Trulicity, Tanzeum, Victoza. If these medications are not effective in reducing the sugar levels for meals, then we often recommend using a fast-acting insulin to cover that meal.
Just because the level is 280 doesn't mean you NEED insulin. If the sugar value comes down within a few hours with pills or other medication, then you're fine.
Many factors help me determine need for mealtime insulin. The average blood sugar values, hemoglobin A1c value > goal, current medications, duration of diabetes, weight, etc.
Diabetes is not a one-size-fits-all. I like to use combinations of medications to suit patient preference and lifestyle.
It is better to start taking insulin as your blood glucose is taking longer to come down (meaning, your pancreas is weak). You may need only 3-4 units of short acting insulin premeal to help with this. You may also try avoiding fatty foods for a week or so and see if sugars are better, before trying the insulin - in which case, all you have to do is to avoid fat in meals.