Hello, you haven t mentioned if 288 was a fasting or postprandial measurement. In any case, it is very high, but it would be much worse if it were fasting. Type 2 diabetes treatment consists of 3 different but equally important elements: (1) diet: reducing body weight to normal, avoiding simple sugars and high glycemic index food and eating a lot of fiber. (2) physical activity: daily fast walking for 30 minutes unless you already do more. (3) drugs: a lot of choices here. Insulin is still the most efficient one. Your glucosylated hemoglobin A1c is very important in deciding whether janumet is enough for you or not. If you close to the target level of 7% then you can continue on janumet. You should pay more attention to the first two elements of treatment (diet and physical activity) though. If you re more than 7,5% or more then another drug should be added to your regimen. If you re above 8,5% then I believe that unless you can improve a lot of things regarding your diet and activity, you ll have to use insulin for a better glucose control. I hope I ve helped! If you d like more guidance, please ask again and tell me all the details about your diet, activity and glucosylated hemoglobin A1c. Kind Regards!